Beechcroft – Torquay is a care home registered to provide accommodation and personal care for up to 34 older people. The majority of people who lived in the home at the time of this inspection were living with a form of dementia.

We carried out a previous inspection of this service on 22 April 2015 where we found the service was rated ‘good’.

This inspection took place on 8 and 15 March 2017 and the first day was unannounced. At the time of our inspection there were 32 people living in Beechcroft - Torquay. People had a range of needs, with some being more independent and others requiring a significant amount of support relating to their physical health, dementia and wellbeing.

The home had 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff treated people with kindness and respect. People enjoyed pleasant interactions with staff which demonstrated people felt comfortable in their presence. During our inspection we saw positive and caring interactions between people and staff. We found staff had caring attitudes towards people and provided people with affection and humour. Staff knew people’s needs, preferences, likes and dislikes and spoke about people with respect and admiration.

Staff knew how to recognise possible signs of abuse which also helped protect people. Staff knew what signs to look out for and the procedures to follow should they need to report concerns. Safeguarding information and contact numbers for the relevant bodies were accessible. Staff told us they felt comfortable raising concerns.

Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work in order to ensure they were suitable to work with people who were vulnerable.

Staffing numbers at the service were sufficient to meet people’s needs and provide them with the care and support they required. Staff had the competencies and information they required in order to meet people’s needs. Staff received sufficient training as well as regular supervision and appraisal. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put it into practice. Where people had been unable to make a particular decision at a particular time, their capacity had been assessed and best interests decisions had taken place and had been recorded. Where people were being deprived of their liberty for their own safety the manager had made Deprivation of Liberty Safeguard (DoLS) applications to the local authority.

The registered manager was in the process of introducing new care plans for people, which contained more detailed information about their histories, individual needs, preferences and interests. The registered manager was then using this information to develop more comprehensive and personalised activity plans for people to ensure they had stimulation and activities that met their desires, interests and needs.

People were protected from risks relating to their health, mobility, medicines, nutrition and behaviours. Staff had assessed individual risks to people and had taken action to seek guidance and minimise identified risks. Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence. Staff supported people to take their medicines safely and as prescribed by their doctor.

People were supported to have enough to eat and drink in ways that met their needs and preferences. People were supported to make choices about what they wanted to eat and food was presented in ways which met people’s individual needs. People spoke highl

Beechcroft was registered to provide care and accommodation for up to 34 people. People living at the service were older people, some of whom had memory problems. There were 33 people living at the service at the time of our inspection.

This inspection visit took place on 22nd April 2015 and was unannounced. Prior to this inspection we had received some concerns about the care being provided at night and early morning so our visit commenced at 06.00hrs. We could not substantiate the concerns that had been raised.

The service had 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.

People were cared for by a staff group that were skilled, trained and supported in their role. There were enough staff on duty throughout the day and night to meet people’s needs. It was clear from our observations and discussions that staff knew people well.

Staff understood people’s vulnerability and how to protect them from abuse, harm or injury. Staff were aware of the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005. Staff told us that most people were encouraged to make their own decisions about their care, but some may not be able to make more major decisions. There has been a recent change to the interpretation of the Deprivation of Liberty Safeguards and the manager had made the appropriate applications to the local authority in order to comply with the changes. People were protected from abuse because staff demonstrated a good knowledge of the types of abuse and knew how to report any suspicions.

Staff recruitment procedures were robust. This protected people from unsuitable individuals being employed by Beechcroft.

The registered manager set the standards the staff were expected to meet. She was available to hear the views of people and their families, and support the staff to carry out their work. We saw that people’s care was planned to meet their individual needs, with the plans being formulated in conjunction with families and involved professionals.

Throughout the day we saw that people were treated as individuals with respect, care and kindness. People were supported to pursue activities of their choice and to maintain links with the local community.

People received a nutritious diet, with plenty of snacks and drinks available. Consideration was given to those requiring special diets. Staff had received training in supporting people with swallowing problems and /or choking risks. People were able to choose alternatives if they did not like or want what was on the menu.

Medication was managed safely and people received their medication on time.

The registered manager had developed quality assurance methods and there was a clear complaints procedure. There were audits and checks in place to monitor the safety and quality of care. All incidents and accidents were recorded and analysed, this helped the staff identify any triggers that may help to prevent further accidents or incidents.

At this visit we spoke with four people who lived at the home as well as two care workers, the cook, the provider and the manager.

People told us “You won’t find somewhere better” and “Staff are lovely, do anything for you”. We looked at the care records for three people. The records showed that people's needs and risks had been identified and planned for. Care workers that we spoke with were able to tell us what they did to support people and knew what to do for them if they needed any additional support.

There were arrangements in place to deal with foreseeable emergencies. For example, care files contained Personal Emergency Evacuation Plans (PEEPS), this meant that care workers had access to the information they would need if an evacuation of the premises was needed.

We saw that there were policies and procedures in place for staff to follow if they suspected abuse had occurred. Care workers were aware of the documents and knew how to access them.

Care workers’ files showed there were effective recruitment procedures in place. For example, there was evidence that Disclosure and Barring Service (DBS) (criminal records) checks had been performed.

We found that people’s personal records including medical records were accurate and fit for purpose. For example, we found that people’s care plans gave good directions to staff and were regularly reviewed.

The home was last inspected by the Care Quality Commission in October 2011 and improvements were required relating to standards of caring for people safely and protecting them from harm and management. We followed up on the improvements required at this inspection.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We (the Care Quality Commission) spoke with three people, four staff, one relative and one visiting healthcare professional. We also spent time observing care and lunch time and looked at four care plans. On the day of our inspection 31 people were living at the home and receiving care from the service. One person was receiving respite care.

We saw staff interact with people in a caring, respectful and polite manner. People enjoyed good humour with staff. We observed that visitors were made welcome by staff. One person said “Everything is nice. In my opinion they treat us very, very well.” A relative we spoke with said “I couldn’t ask for anything more. The staff are very helpful and caring.” All the staff we spoke with were complimentary about the standard of care and the support they received.

Medicines were managed safely and systems were in use to monitor the quality of the service.

On the day of our visit we walked around the home and spoke with 6 of the people that use the service. We also spoke with manager and staff.

People told us that Beechcroft was “very good” and said “I am very happy here, better than home". We asked people what made the care given by the home so good. People told us that all of the care and support they received was good and that the staff were friendly, helpful and patient. They also said that the food was good. Throughout this visit we saw staff talking to people in a kind and friendly way and caring for people in a polite and professional manner.

We saw that the home was clean and hygienic throughout and that the building and facilities were being well maintained.

Some of the care planning documentation that was being used could be improved in order to better support the delivery of care and a few of the records could also be better maintained.