This inspection was carried out on 19 October 2016 and was unannounced. At our last inspection on 8 October 2014 the provider was meeting the regulations in relation to outcomes we inspected.

Beech Tree Care Home provides accommodation and support for up to nine people with mental health conditions. At the time of this inspection there were seven people using the service.

The home had 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 people living at the home were able to communicate clearly with us and provide feedback on the service. People were protected from the risk of harm and abuse by staff who knew how to recognise and respond appropriately to any concerns that they had.

Staff knew how to support people safely. Risks associated with people's care and support had been appropriately assessed and included ways to enable people to take risks, which respected their wishes to try new things. Staff were knowledgeable about the Mental Capacity Act and supported people to make decisions for themselves as far as possible.

Staff supported and encouraged people to keep healthy and well, they supported people to attend appointments with GP’s and external healthcare support when required. The staff team had developed excellent collaborative relationships with the external professionals. A senior member of staff from the mental health team reported positively on the service and the positive impact this had for people who used the service.

People were supported by a staff team who had the knowledge and the motivation required to support people achieve their goals to lead more independent lives. Reports were of a really caring service, relatives told of their overall impression of a manager and staff that really cared about people at Beech Tree and were not just ‘giving care’. People's independence was actively promoted, with people using the service and their families (with agreement) included in any decision making.

People had their nutritional needs assessed and people were supported develop practical skills and be more independent in shopping and involved in meal preparation. Mealtimes were friendly and sociable occasions with much interaction between people and staff. People were supported to take their medicines as prescribed by staff who knew what they were for. Medicines were ordered, stored and dispensed according to national guidelines.

The provider recognised the importance of regularly monitoring the quality of the service provided to people. They sought the views of people using the service and where people had made suggestions they had been listened to and acted upon. Staff enjoyed working at the home and they received good support from the registered manager. There was an out of hours on call system in operation that ensured management support and advice was always available when staff needed it.

Beech Tree Care Home provides accommodation and support for up to nine people with mental health conditions. At the time of this inspection there were eight people using the service.

The service met all of the regulations we inspected against at our last inspection on 5 December 2013.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The home had systems in place that helped identify,assess and manage risks to the health, safety and welfare of people using the service. Risks to individuals were managed in a way which helped protect people from harm but their freedom was supported and respected.

People told us they trusted staff and felt safe using the service. There was good communication between staff and healthcare professionals. People received on-going advice and treatment from health and social care professionals to ensure that they stayed as well as possible. Staff helped individuals to follow the professional recommendations and advice they were given.

Each person had a tailored support plan covering the areas of support accordingly. One of the people using the service described the “hope and optimism” they felt since coming to live at the home due the encouragement and support received from staff.

Support plans contained relevant information and up to date contingency plans for when a person experienced a relapse in their mental health. Staff were aware of possible signs and triggers that may indicate a person was becoming unwell and could present a risk to themselves or others.

Staff liaised with people’s care coordinators if they had concerns that a person’s mental wellbeing was becoming unstable so they could access early on the appropriate support and treatment.

Relatives told us they felt assured their “loved ones received good care”.

People told us they were treated with dignity and respect and there were enough suitably skilled staff to support them.

Staff were up to date with core training and had relevant experience and qualifications in health and social care.

Staff received supervision and support that enabled them to fulfil their roles effectively.

People knew how to make a complaint, if they needed to, but all of the people currently using the service told us they had no complaints. They were confident the provider would listen to them and they were sure their complaints would be fully investigated and action taken if necessary.

Staff felt well supported by the manager. Members of staff had confidence in the out of hours on call system. They found management support and advice was always available when they needed it.

We recommend that the service considers the Department of Health guidance on the use of ‘Health Action Plans.’

On the day of our visit the care home had eight people using the service. All the people that we spoke to said that they were using the service to enable them to rehabilitate back into the community and become independent. We spoke to three people using the service and they were all happy to be there. One person told us that it was better than their last place and that they "loved the staff to death" and that "there was plenty to do". Another person that we spoke with told us that they had been there three years and liked it there. They told us that they had their own room and it was comfortable and warm. People told us that they never felt alone and that there was always someone to talk to. Most of the people who used the service were out at community courses or appointments.

We saw that peoples needs were met through assessments and agreed care pathways and support. Arrangements were in place to ensure peoples safety.

The service collected the views of people using the service and ensured that changes were implemented where needed.

At our last inspection in May 2012 we identified areas where the provider was not meeting the essential standards of quality and safety. The provider sent us an action plan to tell us how it was going to become compliant with the regulations. We carried out this inspection to review improvements

There were seven people using the service and we met with four of them. People told us they could talk to staff if they had any worries or concerns. One person commented, “I enjoy being here, it’s a nicer atmosphere than my last place.”

People told us they received ongoing advice and treatment from heath and social care professionals to ensure that they stayed as well as possible.

Since our last inspection, the provider had registered a manager for the service. Staff told us that there had been improvements since the new manager took over. They had attended training which supported them in their role and felt that the record keeping had improved. One staff told us “it’s all running like clockwork now, things have gelled together.”

Quality monitoring systems had been strengthened. This meant that the manager knew what was working well and what needed improving in the home.

Beech Tree Care Home provides accommodation and support for up to nine people with mental health conditions. At the time of this inspection there were eight people using the service.

The service met all of the regulations we inspected against at our last inspection on 5 December 2013.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The home had systems in place that helped identify, assess and manage risks to the health, safety and welfare of people using the service. Risks to individuals were managed in a way which helped protect people from harm but their freedom was supported and respected.

People told us they trusted staff and felt safe using the service.

There was good communication between staff and healthcare professionals. People received on-going advice and treatment from health and social care professionals to ensure that they stayed as well as possible. Staff helped individuals to follow the professional recommendations and advice they were given.

Each person had a tailored support plan covering the areas of support accordingly. One of the people using the service described the “hope and optimism” they felt since coming to live at the home due the encouragement and support received from staff.

Support plans contained relevant information and up to date contingency plans for when a person experienced a relapse in their mental health. Staff were aware of possible signs and triggers that may indicate a person was becoming unwell and could present a risk to themselves or others.

Staff liaised with people’s care coordinators if they had concerns that a person’s mental wellbeing was becoming unstable so they could access early on the appropriate support and treatment.

Relatives told us they felt assured their “loved ones received good care”.

People told us they were treated with dignity and respect and there were enough suitably skilled staff to support them.

Staff were up to date with core training and had relevant experience and qualifications in health and social care. Staff received supervision and support that enabled them to fulfil their roles effectively.

People knew how to make a complaint, if they needed to, but all of the people currently using the service told us they had no complaints. They were confident the provider would listen to them and they were sure their complaints would be fully investigated and action taken if necessary.

Staff felt well supported by the manager. Members of staff had confidence in the out of hours on call system. They found management support and advice was always available when they needed it.

We recommend that

the service considers the Department of Health guidance on the use of ‘Health Action Plans.’