We inspected Beaumond House on 18 August 2016. The inspection was unannounced.

Beaumond House is a community hospice managed by the registered charity Beaumond House Community Hospice. It is a nurse-led service with medical support provided by people’s own doctors. It is situated in the town of Newark in Nottinghamshire. They provide palliative care to people who live in Newark and surrounding areas with life limiting or terminal illnesses. The services provided included accommodation within four short term respite beds, care in people’s own homes and a day therapy service.

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. Two registered managers were in post at the time of the inspection who shared the role equally.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards (DoLS) under the Mental Capacity Act 2005 (MCA) and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. No one staying in the hospice had any restrictions of their liberty and the registered persons knew how to seek out any DoLS authorisations that may be required in the future.

People felt safe when they received care from staff, whether they were staying in the hospice or receiving care in their own home. Risks to their health, safety and welfare were minimised and staff knew how to respond to any concerns that might arise so that people were kept safe from abuse. There were enough staff on duty and background checks had been completed before new staff were appointed.

People had been supported to eat and drink enough to maintain their well-being and they had received all of the healthcare assistance they needed.

People had been consulted about the care they wanted to receive and they had been given all of the care and support they needed. People were supported to maintain their interests and were offered a range of meaningful activities to choose from when they visited the hospice. They knew how to raise concerns or make a complaint if they needed to and there was a system in place for resolving complaints.

People were treated with care, kindness and compassion. Staff recognised and upheld people’s right to privacy, promoted their dignity and respected confidential information.

Staff had received training and support which was designed to meet people’s individual needs. They knew how to care for people in the right way. They were supported to maintain and develop their knowledge and skills and were supported to speak out if they had any concerns about poor practice.

The registered persons promoted an inclusive approach to managing the services with an emphasis on continuous development. Quality checks had been completed to ensure that people received the care and services they needed.

This inspection was carried out on the respite care service. We did not inspect the domiciliary care service where the regulated activity “Personal care” is provided from. Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with two people who used the service and asked them for their views. We also spoke with two care workers, a nurse, one of the two registered managers and the nominated individual. We also looked at some of the records held in the service including the care files for four people.

We found people gave consent to their care and treatment and received care and support that met their needs. A person who used the service told us, “If I say I want something they act upon it.” A person also told us, “I discussed my care plan, they do that with me every time I come here. I feel they know what they are doing. They ask me what I would like and everything.”

We found people who used the service were kept safe and protected from harm. Staff knew how to respond to any allegation of abuse. We asked people if they felt safe in the home and they said they did. One person told us, “They come and check on me in the night to make sure I am safe.”

We found that suitable arrangements were in place to manage people’s medication and ensure they received any medication they needed. A person who used the service told us, “They monitor my tablets for me, they are exceedingly good at that.”

We found there were sufficient staff to meet people’s needs and the provider assessed and monitored the quality of the service. A person who used the service told us, “They are all very good. I trust every one of them.”

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with one domiciliary care worker, the community coordinator, the registered manager and the managing director. We spoke with one person who was using the day care service (which does not require registration) who previously had used the domiciliary care service. We also looked at some of the records held in the service including the care files for two people.

The respite care service was temporarily closed so we were unable to inspect the following regulated activities which are only provided from that service:

“Accommodation for persons who require nursing or personal care”

“Diagnostic and screening procedures”

“Treatment of disease, disorder or injury”

The domiciliary care service provides personal care to people who use the service when needed. At the time of the visit there were few people using the service and due to their health conditions it was not appropriate to be making contact with them.

We carried out this responsive inspection because we had concerns that this service had not been inspected since 2010. We inspected the respite service only.

During the visit we spoke with three people who were using or had previously used the service at Beaumond House.

People told us they were well cared for and felt safe. One person said staff were, “A first class team” and, “Give credit where it’s due and they’ll come up top”. Another person said, “Staff here are absolutely incredible” and there is, “Always someone on hand”. Another person said, “Here, everything was nice. I couldn’t speak too highly of them”.

People told us they were involved in decisions about their care. They also told us they would talk to staff if they had any complaints or comments to make about the service. One person said the service was, “Wonderfully run”.