The Epsom Beaumont provides residential and nursing care home for a maximum of 55 people some of whom are living with dementia.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good

People felt safe Their care records contained up to date risk assessments to keep them safe and retain their independence. People were protected against the risks of potential abuse because the provider followed safe recruitment practices and staff knew how to safeguard people. People were supported by sufficient staff to meet their individual needs and medicines were administered safely.

Staff worked in accordance with the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. People’s nutrition and hydration needs and preferences were met, and people’s health care needs were monitored and any changes in their health or well-being prompted a referral to their GP, community mental health team, or other health care professionals.

Staff were caring and knew people well. People were encouraged to be independent. Staff promoted people’s privacy and dignity, and people and their relatives were able to have a say in rthe running of the home.

Care plans were detailed and contained information on people’s lifestyles and preferences. They included details on peoples routines and what support people liked to receive. Peoples needs were assessed and their care regularly reviewed. People had activity plans and were able to choose what activities they took part in. People and their relatives knew how to complain and had their complaints responded to.

There was a registered manager in place who promoted a positive culture and supported their staff. Staff were involved in the running of the home, and people were empowered to contribute to improve the service. Audits were completed frequently, were thorough, and their use made improvements to the service people received. People and those important to them had opportunities to feedback their views about the home and quality of the service they received.

Further information is in the detailed findings below

The Epsom Beaumont provides nursing care, accommodation and support for up to 55 older people some of whom are living with dementia. Accommodation is arranged over two floors and has a designated ‘Memory Lane’ dementia unit on the first floor. The service is owned and operated by Barchester Healthcare Homes Limited. This inspection took place on 24 February 2015 and was unannounced.

The home is run by a registered manager who was present on the day of the 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 and associated Regulations about how the service is run.

People told us they felt safe. One said it was “The best move I have made.” Relatives told us that they felt there were not always enough staff employed to meet people’s needs. We did not find this to be the case during the inspection as there were enough suitably skilled and qualified staff employed which ensured people were well cared for. There was a robust recruitment process which ensured only suitable staff were employed

Risks that had been identified were managed well to ensure that people were protected from avoidable harm. Staff had received appropriate safeguarding training, knew how to recognise the signs of abuse and what to do if they needed to raise concerns.

People received their medicines when needed and these were administered by staff who had received the correct training to ensure they were competent to do so. Medicines were stored securely and there were systems in place to ensure their safe disposal.

People told us that staff knew them well and the care they received was good. Staff had received training and support that allowed them to effectively meet people’s needs. When new staff joined the service an induction was completed and staff received training that allowed them to develop the skills they needed to care for people.

People were provided with a choice of nutritious meals and sufficient quantities to drink. Comments about the food were positive and people were seen to be given choices where appropriate. Meal times were a pleasant experience for people, the atmosphere was calm and relaxed and staff gave support and encouragement to those that needed it. People’s weight was maintained and records kept of action taken by staff when people were at risk of malnutrition or dehydration.

There was a calm and relaxed atmosphere when we visited and we saw plenty of positive interactions. People were treated with dignity and respect and comments included that staff were “So kind” and “Attentive”. One relative said “I visit frequently at various times and am always made to feel welcome. “Mum always looks well cared for which is reassuring”. People had the choice about where to spend their time and what to do. They were encouraged to be independent and staff had spent time learning about them as people and what mattered to them.

People’s needs were assessed before they joined the service and care plans were created as a result so that their needs could be met. There were activities on offer that people said they enjoyed. People knew how to complain and who to if they had a concern.

There were robust quality assurance systems in place that helped ensure the service was well run and improvements were made. People and their relatives were complimentary about the registered manager and said there was an effective management team in place at the service.

During the inspection we spoke with eight residents, five visitors and four members of staff. Residents told us that staff were polite and helpful. One resident said of the staff, "They’re all very friendly." Relatives told us that their family members were cared for in a manner that maintained their dignity. People told us that the food provided by the home was good. They said that there was a choice of meals available and that they could have alternatives to the menu if they wished. One resident said, “There’s plenty of choice and the food is very good.”

People told us that staff provided good care. One resident told us, “We’re well looked after” and a relative said of her family member, "She's very well cared for here." However some people said that staff were not always available when they needed them and that this had an impact on the care they received. One resident told us, “The standard of care is good but I can’t always get a member of staff when I need one.” Staff told us that there were not always enough staff on duty to enable them to deliver care promptly or to spend sufficient time supporting people. One member of staff told us, “We’re often in a rush due to staffing levels."

We found that not all staff had received regular training, supervision and appraisal but that the provider had identified these issues and had put plans in place to address them.

People using the service told us that staff were available when they needed them and that they provided good care. They said that staff were polite, friendly and helpful. One person said, “The staff here are very good, very kind.” and another told us, “The carers are very good. If I want anything, I only have to ask.”

The relatives we spoke with provided positive feedback about the staff. They said that staff provided care in a professional but friendly manner and that they knew the needs of the people they supported well. One relative told us, “You can’t fault the carers – they’re all very good.”

People told us that they were supported to make choices about their daily lives, such as what time they got up and went to bed, where and what they ate and how they spent their time. They said that their privacy was respected when care was being delivered or when they wished to spend time in their rooms.

People told us that they were encouraged to give their views about the care and support they received. They said

that their care plans reflected their needs and wishes.

People using the service told us that they would feel confident in making a complaint if they were unhappy about any aspect of the service they received. One person said, “If you’re not happy with something you can complain and they’ll put it right.” and another told us, “If I had a complaint, I’d certainly tell them about it.”

We carried out this inspection to check whether the provider had taken action to address the concerns we identified at our last inspection.

At this inspection we found that although people received safe care, they sometimes had to wait for support when they needed it. For example one person said that they had to wait for support to get up in the morning and to help them eat their meals.

We observed that staff sometimes had conflicting demands placed upon their time. For example care staff had to prepare breakfasts in addition to providing care, which meant that people had to wait for support.

Staff told us that some people required two staff to support them with their care and that waiting for a second member of staff meant that people sometimes had to wait for their care.

We visited the Jubilee (dementia) Unit and observed that the staff knew people’s needs well and that people were comfortable with the staff that supported them. Staff told us that people preferred to be supported by staff who were familiar to them but that this was not always possible because agency staff were often employed.