This inspection took place on 27 September 2017 and was unannounced. This meant staff and the provider did not know that we would be visiting.

Beamish Residential Care Home can accommodate up to 21 older people who do not require nursing care. On the day of our visit there were 20 people using the service.

Beamish Residential Care Home was last inspected by CQC on 3 August 2015 and was rated Good overall. At this inspection the rating continued to be Good overall.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Safeguarding procedures were in place. There had been no recent safeguarding matters formally investigated. The premises were effectively maintained and safety checks undertaken on a regular basis, including checks with regard to fire safety. Risk assessments were in place related to the environment and the delivery of care.

People’s medicines were managed safely. There were enough staff deployed to keep people safe. The provider’s recruitment processes minimised the risk of unsuitable staff being employed.

Staff received mandatory training in a number of areas, which assisted them to support people effectively, and were supported with regular supervisions and appraisals. People’s rights under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were protected.

People were supported to maintain a healthy diet and had access to health care professionals to help maintain their wellbeing and staff responded to any health concerns. There was a homely feel to the building and people’s individual rooms were decorated to their tastes.

People and their relatives spoke positively about the staff at the service, describing them as kind and caring. Staff treated people with dignity and respect. Staff knew the people they were supporting well, and throughout our inspection we saw all staff including the cook and operations director having friendly and meaningful conversations with people. People were supported to be as independent as possible and had access to advocacy services where needed.

People and their relatives told us staff at the service provided personalised care. Care plans were person centred and regularly reviewed to ensure they reflected people’s current needs and preferences. People were supported to access activities they enjoyed. Procedures were in place to investigate and respond to complaints.

People and staff spoke positively about the registered manager and operations director, saying they were accessible and included them in the running of the service. The provider carried out a number of quality assurance checks to monitor and improve standards at the service.

The provider had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.

We carried out this inspection to check on improvements the provider had made in relation to the compliance action set for outcome 21 (records) at our last inspection. We had also received some information of concern about the management of medicines within the home, so we inspected this outcome too.

We found the provider had made improvements to the monitoring and evaluation of people's plans of care, however we identified some concerns about the management of people's medicines.

We spoke to two people who used the service about their medicines at this visit. One person said about their tablets "They (the staff) bring them up and I take them" but also that "I don’t always get my inhalers unless I ask for them." The other said "The staff are marvellous and very helpful.’

We carried out this responsive inspection because we had received some anonymous information of concern about Beamish Residential Care Home. This related to allegations about early morning routines, the availability and use of equipment, fees for additional services and staffing levels.

In response to these concerns, we carried out an unannounced inspection at 0520 on 25 June 2012. We did not plan to inspect outcome 21 (records), however concerns identified during the course of our inspection led us to do so.

All the people we spoke with said they were happy at Beamish Residential Care Home. One person said "I like it. The company's good and the food's good." People also said they were involved in their care, with their preferences being sought and taken into consideration. One person told us "I say to them (the staff), get me up at 6am; it's all about personal choice." Another person said "It's up to you if you want to go outside."

People told us they were happy with the care and treatment they were receiving. One person said "I'm well looked after" and another said "Everything's so wonderful, I wouldn't change anything."

People also said if they wanted anything, they would ask the staff who would see to it for them. One person told us "You just have to ring the bell and they (the staff) are there straight away; they don't hesitate." Another person said "Staff come straight away if you need help. They're very, very good that way."

People said they were happy with the staff at Beamish Residential Care Home and the care they provided. One person said "They (the staff) are great. They have a bit of a chat with you when they get time." Another person said "They (the staff) are kind people. They are the one's who work hard to find out what's wrong with me."

People also said they believed there was sufficient staff on duty to meet their needs.

“I have a key worker, she talks to me all of the time about things that are important to me, and she listens and always takes notice of the things that I want or need”.

“Everyone here is very good at asking me what I want. They take notice of me and respect my views”.

“I am asked about what I think could be improved, but there is nothing to improve, but it’s nice to be asked. If I had any concerns at all, they deal with them quickly. I certainly feel that I still have control of my life and I am still able to make my own decisions”.

“The care I receive is excellent, the managers and all the staff are very caring and all my needs are met in the way that I want”.

“Oh yes, I have a care record that I have seen, I read what it said, and I added a few things. They (the staff) make sure that I get the support that I need. I am still independent and do as much for myself as I can”

“I have just bought a lap top and the staff and a relative have showed me how to use it, I think it’s great because I can keep in contact with my family abroad.

The care and support that I receive is wonderful. I have no concerns at all”.

“The food is excellent, everything is home made, the meat pies are the best I have ever tasted”.

“The food cannot be faulted”.

“We are always offered a good selection and choice”.

“Every meal that I have is lovely”.

“I used to manage all my own medicines, but sometimes I would forget to take them at the right times. The staff now make sure that I get all of my tablets at the right times”. “I manage to apply my own creams, but I like the staff to organise the pills that I take”.

“This place is always lovely and clean, my room is cleaned everyday whether it needs it or not”.

“Always kept very clean and fresh, the toilets and bathrooms are spotless. It is very homely here”.

“I love working here. I receive excellent support and training. I have an NVQ (National Vocational Qualification) level 3 in care. We all receive regular training updates”.

“I had a very good induction training when I started working here. I had a mentor who provided me with lots of support. It’s a lovely place to work”.

The inspection took place on 3, 4 and 5 August 2015 and was unannounced. This meant the provider or staff did not know about our inspection visit.

We previously inspected Beamish Residential Care Home on 12 December 2013, at which time the service was compliant with all regulatory standards.

Beamish Residential Care Home is a small residential home in West Pelton providing accommodation for up to 21 older people who require personal care. 21 people were living in the home at the time of our inspection.

The service has a registered manager in place. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was on annual leave at the time of our inspection. The operations manager and assistant manager were on site during our inspection. A recent management restructure meant they had more responsibility for the day-to-day running of the home than previously.

We found that there were sufficient numbers of staff on duty in order to meet the needs of people using the service. All staff were trained in core areas such as safeguarding, as well as training specific to the individual needs of people who used the service. The means by which the service ensured training for staff was current and refreshed when needed was not efficient and the operations manager was in the process of reviewing the training matrix system. We found that staff had a comprehensive knowledge of people’s preferences, needs, likes and dislikes.

Dignity and privacy were at the forefront of the staff code of conduct and the policies and procedures of the service. We observed discreet and thoughtful interactions during our inspection and saw evidence in recorded documentation of the promotion of people’s right to dignified care. Relatives and external stakeholders told us that people were treated well and unanimously agreed that the service was welcoming and effective.

There were effective pre-employment checks of staff in place and effective staff supervision and appraisal processes. The service was clean throughout.

Person-centred care plans were in place for all people using the service and the provider sought consent from people for the care provided. Regular reviews ensured relatives and healthcare professionals were involved in ensuring people’s medical, personal, social and nutritional needs were met.

The service had individualised risk assessments in place and a robust range of policies and procedures to deal with a range of eventualities. We saw these processes were reviewed regularly and were supported by an effective quality assurance regime. All people using the service we spoke with, relatives, staff and external professionals were complimentary about the management and ethos of the service.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. DoLS are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. The operations manager was knowledgeable on the subject of DoLS and had provided appropriate paperwork to the local authority to deprive people of their liberty, where it was in their best interests.