We inspected this service on 11 and 15 May 2017. The first day of the inspection was unannounced.

Beauchamp House is a care home for up to 43 older people, some of whom may be living with dementia. Accommodation is spread over two floors, and separated into small units, each with its own communal areas, bathroom and toilets. There is a large dining room on the ground floor, which can be used for events. There is a shaft lift between the two floors so that people do not have to use stairs. At the time of our inspection, there were 38 people living in the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 newly in post having completed registration with CQC in January 2017.

The service people received was not always as safe as it should be. There was a high level of people requiring support from two staff for aspects of their care, which impacted upon how quickly staff were able to respond to requests for assistance. There was a risk that, if the home were fully occupied, staff would not be able to meet people's needs properly. The registered manager was in the process of taking action to implement more robust assessments before people were admitted and engaged in a significant recruitment drive to help contribute to more stable and consistent care arrangements.

Staff understood risks to people's safety and welfare, for example of falls, not eating or drinking enough or to their skin integrity. They knew what action they needed to take to minimise these risks. They were also aware of the importance of raising any concerns or suspicions that people may be at risk of harm or abuse so that people were protected. Recruitment processes contributed to protecting people from the appointment of staff who were unsuitable to work in care.

Staff received training and support to meet people's needs competently. This included training to understand their obligations in relation to supporting people who may find it difficult to give informed consent to aspects of their care.

People received support from staff to eat and drink enough to ensure their welfare. They had a choice of food and staff went to considerable lengths to try and find something people would like to eat if they were reluctant to do so. Where there were concerns about this aspect of people's health, staff ensured they sought advice about people's diet. They also took action when there were other changes in people's health or welfare to ensure that people received appropriate professional advice and support.

People received support from staff who were kind and compassionate. They took action to intervene promptly when people became anxious. Interactions between people using the service and staff were warm, respectful and polite. They took into account people's wishes, preferences and interests in the way they delivered care.

People were confident that, if they had any concerns or complaints, the management team would listen to them and take action to address their concerns.

There had been a lot of changes in the management arrangements at the home, which now needed to consolidate to ensure consistent leadership. Although the registered manager was relatively newly in post, she had a clear vision for the service and an action plan agreed with the provider's regional manager for driving improvements.

Systems for assessing, monitoring and improving the quality of the service provided for regular consultation with people. The management team took action to respond to people's views and opinions as far as practicable.

Staff were well motivated and enthusiastic about their work. They understood the standard of c

The inspection took place on 9 February 2015 and was unannounced.

The home provides care for a maximum of 43 older people, some of whom may be living with dementia. Accommodation is across two floors with a range of dining areas and lounges, and there is access to a garden. At the time of our inspection there were 34 people living in the home. Some rooms had been kept empty because there was refurbishment taking place on one part of the ground floor.

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 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 service was safe. Staff understood how to protect people from abuse and how to report any concerns. There were enough staff to support people safely, although we found that sometimes staff hadn’t been deployed effectively to ensure people had prompt access to support on both floors of the home. Medicines were managed safely.

The Care Quality Commission is required by law to monitor the operation of the Mental capacity Act 2005 and Deprivation of Liberty Safeguards, and to report on what we find. The manager knew when to seek advice about imposing any restrictions on the freedom of people who may not understand the risks to which they were exposed so their rights could be promoted.

People were supported to maintain their health and to eat and drink enough to meet their needs.

Staff were kind and attentive to people. People were treated with respect. People’s privacy and dignity was promoted. Staff took time to listen to them and to engage people living with dementia about their personal histories so that they could participate in meaningful conversations.

People’s needs were assessed and care was planned that would meet each individual’s needs. Staff understood what people’s support needs were, their preferences, likes and dislikes and how to support people with their care. People were confident their complaints would be listened to although they did not always feel they saw changes as a result of raising a concern.

Staff had a clear understanding of their roles and worked well together as a team. They valued the support of the manager and how they were able to make suggestions for change. Systems for monitoring the quality of the service also took into account the views of people living in the home and their relatives so that improvements could be made where necessary.

At the time of visit, there were 36 people living at Beauchamp House, and we reviewed the care records for eight of these people.

We found there were appropriate processes in place for obtaining the consent of people to their care and treatment. Each person had an individualised mental capacity assessment in place.

We found that there were detailed pre admission assessments, care plans, and risk assessments in place for each of the eight people whose records we reviewed. These reflected the current needs of people using the service, and people's care documents had been reviewed regularly to ensure they were up to date. One person told us, "The staff are excellent, they're very caring." Another person told us, "I'm very happy here, it's great".

We found that people were protected from the risks of inadequate nutrition and hydration. People were provided with assistance and encouragement to eat their meals and maintain good nutrition. One person told us, "My meal was lovely today". However, another person told us, "There wasn't much of it, and it wasn't very hot. It hadn't been cooked through." when describing their meal.

We found that there were enough qualified, skilled and experienced staff to meet people’s needs. Staff we spoke with were happy that there were enough staff to meet the needs of people living at Beauchamp House. The service had access to agency staff to cover for unexpected staff absence.

Some people were not able to tell us verbally what they thought about their care. For this reason we spent an hour observing how people were supported, how staff communicated with them and seeing how people responded. We saw no signs of people being ill at ease. Some were not engaged or were withdrawn for part of the time we were observing but this was the minority of the timeframes we looked at. People responded very positively to staff and were willing to engage in activities or discussion. We also saw that, where one person was rather confused about their glasses, the time of day and what they were eating, staff took time to offer reassurance and to intervene when this was needed.

Other people were able to tell us what they thought. One said that there was always something going on but that they did not always wish to join in with organised activities. They enjoyed music and the television. They said that the food was good and, "They ask you on the day what you would like to eat." They said if they had concerns, "I can go the manager. You can talk to her." One person added, "The care couldn't be better."