This inspection took place on 23 and 24 August 2016 and was unannounced. There were no concerns at the last inspection of December 2013. Beech House provides accommodation and nursing care for up to 55 people. A unit in the home called the Poplars provides care for those people who have a diagnosis of dementia. At the time of our visit there were 55 people living at the service.

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.

We were introduced to people throughout our visits and they welcomed us. People were relaxed, comfortable and confident in their home. We received positive comments about people’s views and experiences throughout our visits. People and relatives recently wrote in the homes survey, “Please continue to maintain your impressive standards”, “This is my home and I love it”, “Keep up the good work”, and “I consider myself very fortunate to be here”. One relative wrote to the registered manager, “We would like to express our thanks and appreciation to all staff involved in the care of our mother, for their kindness, understanding and support; it was a great comfort to us both”.

Staff involved in this inspection demonstrated a genuine passion for the roles they performed and their individual responsibilities. Visions and plans for the future were understood and shared across the staff team. They embraced new initiatives with the support of the registered manager and colleagues. They continued to look at the needs of people who used the service and ways to improve these so people felt able to make positive changes.

People experienced a lifestyle that met their individual expectations, capacity and preferences. There was a strong sense of empowering people wherever possible and providing facilities where independence would be encouraged and celebrated. People’s health, well-being and safety were paramount.

The registered manager listened to people and staff to ensure there were enough staff on duty to meet people's needs. They demonstrated their responsibilities in recognising changing circumstances within the service and used a risk based approach to help ensure the staffing levels and skill mix was effective. One relative told us, “I like how there is always a staff member in sight and someone on reception, it’s reassuring”.

Staff had the knowledge and skills they needed to carry out their roles effectively. They enjoyed attending training sessions and sharing what they had learnt with colleagues. There was an emphasis on teamwork and unison amongst the staff at all levels. Following a recent review carried out in the Poplars unit by Staffordshire university, they wrote, “There was a range of training opportunities available to staff and a core of highly- committed staff members who had been with the organisation for a number of years. All of these features contribute to the sense of a robust and dynamic organisation that reliably protects the interest of the people for whom it cares”.

People were supported to enjoy a healthy, nutritious, balanced diet whilst promoting and respecting choice. The ‘residents’ annual surveys consistently reflected how much they enjoyed the quality of food, the variety and the constant access to beverages and snacks through the day.

Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful. People were supported to maintain their personal interests and hobbies.

The registered manager understood their responsibility to comply

Since the inspection of July 2013 the home had continued to look at the needs of the wider community and innovative ways to improve services for people. They had expanded their services so that people with a diagnosis of dementia could be afforded specialist care with the added benefit of nursing care if required.

The manager was available throughout the day. They were very knowledgeable about people in their care, the policies, procedures and systems in place to ensure the continued smooth running of the home.

We were introduced to people, visitors and staff throughout the visit and we were welcomed. They were happy to share their experiences with us. We looked at some of the comments received from this year’s survey results. People were asked if they had any suggestions to improve the service. One person wrote “Just carry on being kind and considerate to the residents as you are all so wonderful at doing this.

Other written comments received included “All staff are brilliant, I have been impressed across the board from the youngest kitchen staff right up to management level”, “The carers are really good” and “It’s a very happy atmosphere, very welcoming and homely”.

We spent time in various parts of the home, including communal areas and individual bedrooms so that we could observe the direct care, attention and support that people who live at this home receive. People were very happy living at Beech House and the atmosphere was calm and relaxed.

People were positive about their experiences. Comments included, “I have never looked back, it was the best thing I did moving here”, “How can you fault it look around you” and “I’m very happy living here, I have all I need and the staff are exceptional”.