This unannounced comprehensive inspection took place on the 11 December 2018. The inspection team consisted of one inspector, an assistant inspector, a specialist advisor who was a nurse and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Edgbaston Beaumont is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Edgbaston Beaumont accommodates up to 28 people in one adapted building. At the time of our inspection 24 people were using the service. Some people living at the home were living with Dementia.

At our last inspection on 11 August 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

There was a registered manager in post and who was present at the time of this inspection. 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 continued to receive care that made them feel safe. People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Risk assessments had been completed to show how people should be supported with everyday risks. Recruitment checks had been carried out to ensure staff were suitable to work in a care setting with vulnerable people. At the time of our inspection there were sufficient staff to respond promptly to people's needs. People had their medicines administered safely by trained and competent staff. People told us their home was clean and staff followed safe infection control practices.

People continued to receive effective support from staff with a sufficient level of skills and knowledge to meet their specific needs. People received a varied and healthy diet that offered choice and met their needs. Staff enabled people to access external healthcare services to promote their health and well-being. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the records and systems in the service required some further improvement.

People were cared for by kind, caring and compassionate staff. People and staff had a good relationship and staff knew people well. People’s privacy and dignity was upheld and they were supported to maintain their independence whenever possible.

Care was provided in a personalised way from staff who knew people's needs and preferences. People were involved in the planning and review of their care and support. People were supported to maintain their hobbies and interests, including links with and trips out to the local community. Processes were in place to ensure complaints were responded to and resolved where possible.

People and staff were positive about the leadership skills of the registered manager. The service continued to be well-led, including making detailed checks and monitoring of the quality of the service. The registered manager led by example and encouraged an open and honest culture within their staff team. People were encouraged to express their views which were listened to and acted upon. The registered manager and their staff team worked together with other organisations to ensure people's wellbeing.

This inspection was completed by one inspector. We found that 24 people were living at Beaumont Edgbaston. We spoke with six people who used the service. Due to their complex health needs we were not able to speak with some people. We observed their experiences to inform our inspection. We spoke with the registered manager, the administrator, one qualified nurse, the activities coordinator and three care staff. Below is a summary of what we found. The summary describes what people told us, the records we looked at and what staff told us. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. One person told us, "I feel safe." Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.

We found the provider had not met legal requirements for people who were unable to give consent to their care. This meant people's rights were not protected.

Staff knew about people's risk management plans and we saw they were supported in line with those plans. This meant people were cared for in a way that protected them from harm.

People were protected from the risks associated with the administration of medicines.

Systems were in place to make sure the registered manager learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that applications had needed to be submitted for eleven people and that these applications had been completed in line with legal requirements.

Is the service effective?

People told us their care needs were assessed with them. We saw care plans were regularly updated. One person told us, "The care is fine."

People received their medicines in the way they were prescribed.

Staff were appropriately trained to ensure they effectively met people's needs.

Is the service caring?

People were supported by kind and caring staff. One person told us, "The staff are caring and gentle."

People’s preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people’s wishes.

Is the service responsive?

People were asked their views about the service and the provider acted on comments that people made. One person told us, "We have a choice about what we do. We can make suggestions about things like outings."

Where care staff had noticed people's changing needs, their care plans were updated to reflect this. We found staff discussed people's care needs with them on a regular basis.

Is the service well led?

The provider had risk management systems in place. We found the provider checked that risks were managed effectively. We found the provider used the information they gathered from their checks to develop a service improvement plan.

The provider sought the views of people who used the service. Records seen by us indicated that people were asked about the service and their views were acted on.

Staff told us they were clear about their roles and responsibilities. Staff told us they did not receive regular supervision or appraisals. Staff were not kept informed of improvements that needed to be made to the service.

On the day of our unannounced visit twenty people were living at Edgbaston Beaumont Nursing Home. We subsequently spoke to eight people who lived there, four of the friends and relatives, the manager and four members of staff.

From our observations it was apparent that care staff were attentive, polite and that there were enough qualified, skilled and experienced staff on duty to meet people’s needs.

People were complimentary about the care and nursing staff who supported them. Comments included, “The staff are really wonderful, they are really caring” and “My health has really improved since I came to the home, I’m very grateful.”

People’s needs were assessed and care and support was planned and delivered in line with individual care plans. We found that each person had their own individual plan of care and support which included assessed needs, risk assessments and useful information about their health conditions.

People who lived at the home were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We noted that most care and nursing staff had received training in relation to safeguarding vulnerable adults.

People were not always protected against the risks associated with medicines as medication was not always administered consistently. We found that one person had not received all of their medication on two occasions within an eight day period.

On the day of our unannounced visit we found 25 people were living at Edgbaston Beaumont Nursing Home. We subsequently spoke to four people who use the service and three members of nursing and care staff.

We found the home to be clean, homely and comfortable. People were complimentary about the care staff. Comments included, “It’s wonderful here and the care staff are very kind” and “It’s very good and I have no complaints.”

We observed that care staff were attentive and polite and that people were comfortable and relaxed with care staff. It was clear that the staff had a good knowledge of all of the people who used the service and were familiar with their preferences and health conditions. People's diversity, values and human rights were respected.

We found that since our last inspection of the home that improvements had been made in relation to staffing arrangements and that people who use services were safe and that their health and welfare needs were being met by sufficient numbers of appropriately trained staff.

On the day of our unannounced inspection we found 25 people residing at Edgbaston Beaumont care home. We spoke to four people who use the service and four of their relatives.

People told us, ” it’s very good here, I like it ” and “ the food is wonderful.” However we also received further comments such as, " there's not enough staff on nights ” and " staffing is a problem.”

Relatives of people using the service made complimentary comments about the home. We were told, " I’m very satisfied with the service " and " I know that he is in good hands and is safe and well cared for here."

Our inspection confirmed much of the feedback we had received. We found the home to be clean, spacious, nicely presented and well maintained. We also found that good quality checking systems were in place to ensure people's wellbeing and safety.

Our observations and conversations with people using the service confirmed that the staff were attentive, polite and that the managers were approachable and responsive to suggestions and feedback. It was clear that the staff had a good knowledge of all of the people who lived at Edgbaston Beaumont and were familiar with their preferences and health conditions.

Our inspection revealed that there were insufficient members of staff on duty at all times to provide the level of service required.

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We inspected this home on 11 and 12 August 2015. This was an unannounced Inspection. The home was registered to provide nursing care and accommodation for up to 28 people. At the time of our inspection 25 people were living at the home some of whom were living with dementia or had mental health support needs. The accommodation was provided in single bedrooms, all with ensuite toilets; the home had bedrooms and bathrooms on the ground and first floors. There were shared lounges on both floors and two dining facilities were available on the ground floor. Lift access was available to all floors.

The service was previously inspected in July 2014 and at that time we found the service was not compliant with one of the regulations we looked at. The provider did not have suitable arrangements in place for obtaining and acting in accordance with the consent of service users. At this inspection we found improvements had been made.

The registered manager was present during our inspection. 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 found that people using this service were safe. Staff knew how to recognise when people might be at risk of harm and were aware of the provider’s procedures for reporting any concerns.

We received some mixed opinions from relatives about the staffing arrangements in the home. Whilst they did not raise any concerns about people’s safety in relation to staffing levels some relatives told us there were less staff at weekends and during particular periods of the day.

People were supported by staff who had received training and had been supported to obtain qualifications to enable them to ensure that care provided was safe and followed best practice guidelines. Robust recruitment checks were in place to ensure new staff were suitable to work in the home.

People had received their medicines safely.

Measures had been put into place to ensure risks were managed appropriately. These ensured that people were involved in making decisions which minimised restrictions on their freedom, choice and independence.

People’s nutritional and dietary needs had been assessed and people were supported to eat and drink sufficient amounts to maintain good health. People told us they had access to a variety of food and drinks which they enjoyed. People had been supported to stay healthy and to access support and advice from healthcare professionals when this was required.

Staff we spoke with were aware of their responsibilities under the Mental Capacity Act 2005 (MCA). They had ensured people received the assessments and support they required and had made the necessary applications to the local supervisory body for Deprivations of Liberty Safeguards (DoLS).

People’s needs had been assessed and care plans developed to inform staff how to support people in the way they preferred.

People who lived in this home and where appropriate people’s relatives, told us that they were happy with the care provided and that people were treated with kindness, compassion and respect. People told us they continued to pursue individual interests and hobbies that they had enjoyed earlier in life and they were happy with the range of activities available to them.

There was a complaints procedure in place. People told us they had opportunity to raise concerns and that they were listened to. Relatives told us they knew how to raise any complaints and were confident that they would be addressed.

We received consistent feedback that Edgbaston Beaumont was a good place to live, to work and to visit. People told us the home was well-led by approachable managers.