About the service:

Beauvale Care Home accommodates up to 35 older persons who require nursing or personal care. At the time of our inspection there were 34 people living at the home.

People’s experience of using this service:

¿ People were safe at the home. A visiting professional told us, “I have never seen anything that has worried me here. Staff are very kind to the residents.”

¿ The home was well-staffed with nurses and care workers. People told us staff were quick to attend to their needs. A person said, “I need help with washing and dressing and if I need staff at any time they soon come.”

¿ The home was clean, tidy and fresh throughout.

¿ The staff were skilled and knowledgeable. A relative said, “I think the staff have the right training for the job and seem happy working together.”

¿ People said they liked the food served. They told us it was freshly cooked on the premises and there was plenty of choice.

¿ People’s healthcare needs were met. A relative told us, “Staff organise all the eye tests, chiropody, GP checks – whatever [person] needs really. I have peace of mind knowing [person] is well looked after.”

¿ People and relatives told us all the staff were caring and kind. A person said, “Everyone here is lovely from the cleaners to the carers. They are kind to me and help me do all sorts of things.”

¿ People received personalised care and staff knew about their likes, dislikes, culture and life history.

¿ People said they enjoyed the home’s activity programme which included trips out in the home’s minibus, quizzes, and visits from children at a local nursery school.

¿ People and relatives made many positive comments about the registered manager. A relative told us, “The manager is very caring and does anything she can to ensure that it runs smoothly here.”

¿ Staff also praised the registered manager. A staff member said, “[The registered manager’s] door is always open to residents, relatives and staff. She is approachable and has great empathy with the residents and she makes sure they get the care they deserve.”

¿ People, relatives and staff were encouraged to share their views on the home at meetings, one-to-one discussions, and through annual surveys. A person said, “They do ask me what I think about the service and I am quite open with them."

¿ The provider and registered manager conducted quality checks across all areas of the service and worked to an action plan to make improvements were necessary.

Rating at last inspection: Good (report published 18 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 02 August 2016 and was unannounced.

Beauvale Care Home provides nursing and residential care for up to 35 older people and people living with dementia. On the day of our inspection there were 33 people using the service.

Beauvale Care Home is required to have a registered manager. 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. At the time of our inspection a manager was in place and their application for registered manager was being processed.

During our previous inspection on 12 and 13 August 2015, we identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to the service not having sufficient numbers of suitably qualified, competent, skilled and experienced staff deployed in order to meet the needs of the people using the service at all times.

During this inspection we checked to see whether improvements had been made. We found improvements had been made and this breach in regulation had been met. There were sufficient experienced, skilled and trained staff available to meet people's individual needs.

Staff were aware of their responsibilities to protect people from abuse and avoidable harm. Staff had received adult safeguarding training and had available the provider’s safeguarding policy and procedure.

Risks to people's individual needs and the environment had been assessed. Staff had information available about how to meet people’s needs, including action required to reduce and manage known risks. These were reviewed on a regular basis. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. The internal and external environment was safe.

Safe recruitment practices meant as far as possible only suitable staff were employed. Staff received an induction, training and appropriate support.

People's healthcare needs had been assessed and were regularly monitored. The provider worked with healthcare professionals to ensure they provided an effective and responsive service.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People received a choice of meals and independence was promoted.

The manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people's rights were protected. Where people lacked mental capacity to consent to specific decisions about their care and support, appropriate assessments and best interest decisions had been made in line with this legislation. Where there were concerns about restrictions on people’s freedom and liberty, the manager had appropriately applied to the supervisory body for further assessment.

Staff were kind, caring and respectful towards the people they supported. They had a person centred approach and a clear understanding of people's individual needs, routines and what was important to them.

The provider enabled people who used the service and their relatives or representatives to share their experience about the service provided.

People were involved as fully as possible in their care and support. There was a complaints policy and procedure available but not all people were aware of this. People had access to an independent advocacy and support service that regularly visited the service and advocacy information was also provided and displayed.

People were supported to participate in activities, interests and hobbies of their choice. Staff promoted people’s independence.

The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits. These were fou

Prior to our visit we reviewed all the information we had received from the provider. During the visit we spoke with five people who used the service and one relative and asked them for their views. We also spoke with three care workers, a housekeeper, the deputy manager and the registered manager. We also looked at some of the records held in the service including the care files for four people. We observed the support people who used the service received from staff and carried out a brief tour of the building.

We found people had given their consent to the care provided for them. A person told us, “It is nice living here. The staff do what I want the way I like them to.” However we also found there was not a system in place to determine when people who used the service did not have the capacity to consent to their care.

We found staff responded to people’s needs. A staff member told us they knew what people liked and what made them happy. A person said to us, “Don’t they look after me well.”

We found people who used the service were kept safe and protected from harm. Staff knew how to respond to any allegation of abuse. People told us they felt safe at the home. A staff member told us, “We make them safe.”

We found the staff team were supported through training and the provider assessed and monitored the quality of the service. A person told us, “They are excellent, all the staff. They do their jobs well.” Another person told us, “I am asked if I have got any suggestions.”

We carried out an unannounced inspection of the service on 12 August 2015.

Beauvale Care Home provides nursing and residential care for up to 35 people. On the day of our inspection there were 33 people using the service.

Beauvale Care Home is required to have 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. At the time of the inspection a manager had been in post for six weeks. The manager told us that they were in the process of submitting their application for the registered manager position. We will monitor this situation.

At our last inspection in October 2013 we found the provider was in breach of one Regulation of the Health and Social Care Act 2008. This was in relation to consent to care and treatment. The provider sent us an action plan detailing what action they would take to become compliant with this regulation. At this inspection we found the provider had made the required improvements.

CQC is required by law to monitor the operation of the Mental capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. This is legislation that protects people who are unable to make specific decisions about their care and treatment. It ensures best interest decisions are made correctly and a person’s liberty and freedom is not unlawfully restricted.

At this inspection some people raised concerns about the length of time they had to wait to have their requests for assistance met by staff. We found staff were not always available to respond to people’s needs in a timely manner and that communal areas did not always have staff present to check on people’s needs and safety. The staff roster showed that there were not always sufficient staff deployed appropriately to meet people’s needs and keep them safe.

Individual plans of care and risk assessments were in place for people’s that were regularly monitored and reviewed. Additionally, the environment and equipment had safety checks completed. However, personal evacuation plans in place for people in the event of emergency, lacked specific individual information.

Accidents and incidents were recorded and analysed for patterns and trends but it was not always clear what action had been taken to reduce risks. Staff were aware of safeguarding procedures and had received appropriate training. There was safe management and administration of medicines. Safe recruitment checks were in place that ensured people were cared for by suitable staff.

People’s dietary and nutritional needs had been assessed and support plans and risk assessments were in place. However, the recording of people’s food and fluid intake was not always accurately recorded or monitored.

Staff were appropriately supported, this consisted of formal and informal meetings to discuss and review their learning and development needs. Staff additionally received an induction and ongoing training. On the whole staff were positive about the leadership of the service and were clear about the vision and values.

Some people raised concerns about the care and approach of staff. We found on the whole staff were caring and compassionate and were knowledgeable about people’s needs. People’s preferences, routines and what was important to them had been assessed. However, specific details were sometimes missing affecting the person centred care being provided.

There was a complaint procedure available to people who used the service and visitors, including additional systems in place to enable people to share their opinions about the service. Some people told us they were not aware of how to make a complaint.

Staff provided daily activities and social opportunities for people to pursue their interests and hobbies and independence was promoted.

The provider had checks in place to monitor the quality and safety of the service. However, the audits in place had not identified all the shortfalls we found during this inspection. The provider had notified us of important events registered providers are required to do.

We found the provider was in breach of one regulation of the of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.