About the service: Beechmere is a domiciliary care service that was providing personal care to 50 people aged 65 and over at the time of the inspection. The service supports people living in their own apartments within a supported living complex.

People’s experience of using this service: People were supported safely. The potential hazards that people faced during their support and from the wider environment was always taken into account. Medication administration was robust and person- centred. Staff always arrived on time and provided support within the agreed timescale. People felt safe with the staff team and trusted them.

People told us that staff were knowledgeable and knew what they were doing. Staff received the training they needed to perform their role and received supervision so that they could discuss work practice as well as professional development. Sufficient measures were in place to enable new staff to become familiar with and be prepared for their role. The nutritional needs of people were met. People were always asked to give their consent before support was given.

Without exception, people told us that they were supported in respectful and friendly way with staff respecting the fact that they were visiting a person’s home. Support was provided in a patient and unhurried manner with an emphasis on maintaining people’s privacy and dignity. The communication needs of people were taken into account with staff taking the time to ensure that people were able to express themselves and make their needs known.

Support was provided in a person-centred way. People who used the service were able to contribute and be in control of the ways in which they were supported. People did not have any complaints but felt confident that any issues would be listened to and acted upon.

People felt they received a well-run service. The registered manager was very familiar with the individual needs of people and was very visible and available to all people. The registered manager was seen as approachable and supportive to the staff team. The registered provider had robust quality assurance processes in place to measure the quality of support given. The views of people who used the service and their relatives were listened to. People told us that they felt involved, in control and were listened to. The registered provider worked closely with other agencies to ensure positive outcomes for people and to maximise their independence.

Rating at last inspection: The service was rated as requires good at our last inspection in August 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remains 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection visit at Beechmere took place on 03 August 2016 and was announced. The provider was given 48 hours notice because the location provides support to people living in their own apartments. We needed to be sure people in the office and people receiving a service would be available to speak to us.

Beechmere provides an independent lifestyle to people wishing to continue to own or rent their own apartment. There is a team of qualified staff on hand 24 hours a day, seven days a week. Beechmere, situated in Crewe, consists of 132 one and two bedroom apartments. The service offers personal care and support. At the time of our inspection, 53 people received a service from Beechmere.

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.

Staff had received abuse training. They understood their responsibilities to report any unsafe care or abusive practices related to the safeguarding of vulnerable adults. Staff we spoke with told us they were aware of the safeguarding procedure and would not hesitate to raise an alert should it be required.

The provider had procedures around recruitment and selection to minimise the risk of unsuitable employees working with vulnerable people. Required checks had been completed prior to any staff commencing work at the service. This was confirmed from discussions with staff.

We found staffing levels within the service were adequate with an appropriate skill mix to meet the needs of people who used the service. The number of people being supported and their individual needs determined staffing levels.

Staff responsible for assisting people with their medicines had received training to ensure they were competent and had the skills required. People were supported to meet their care-planned requirements in relation to medicines.

Staff members received training related to their role and were knowledgeable about their responsibilities. They had the skills, knowledge and experience required to support people with their care needs.

People and their representatives told us they were involved in their care and had discussed and consented to their care packages. We found staff had an understanding of the Mental Capacity Act 2005 (MCA).

People told us they were supported to maintain a balanced diet to prevent the risk of malnutrition and dehydration.

We found people had access to healthcare professionals and their health needs were met. We saw the management team had responded promptly when people had experienced health problems.

People told us the same group of staff supported them. This ensured staff understood the support needs of people they visited and how individuals wanted their care to be delivered. Conversations we observed between people and staff showed positive relationships had developed.

Care plans were organised and identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

People told us they were happy with the support they received to engage with activities organised by Beechmere.

The registered manager and staff were clear about their roles and responsibilities. They were committed to providing a good standard of care to people they supported.

A complaints procedure was available and people we spoke with said they knew how to complain. Staff spoken with felt the registered manager was accessible, supportive and approachable and would listen and act on concerns raised.

The registered manager used a variety of methods to assess and monitor the quality of the service. People we spoke with during