Beach Crest residential Home offers accommodation and personal care for up to 11 older people, some living with dementia.

The inspection was unannounced and was carried out on 11 and 12 May 2017 by one inspector.

At our inspection in June 2016 we found the provider was in breach of three Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to record keeping, monitoring and assessing the quality of the service, The Mental Capacity Act 2005, and staff supervision and appraisal. At this inspection we found improvements had been made and all Regulations were being met.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

Relatives and staff told us they felt the home was safe. Staff had received safeguarding training and explained the action they would take to report any concerns.

Individual and environmental risks relating to people’s health and welfare had been identified and assessed to reduce those risks. Regular safety checks were carried out on the environment and equipment and plans were in place to manage emergencies.

Systems were in place for the storage and administration of medicines, including controlled drugs. Staff were trained and their competency assessed to ensure they remained safe to administer medicines.

There were safe recruitment procedures in place and sufficient staff were deployed to meet people’s needs.

People were supported to have enough to eat and drink and their specific dietary needs were met.

People were supported to maintain their health and well-being and had access to healthcare services when they needed them.

People’s rights were protected because staff understood the principles of the Mental Capacity Act 2005 and ensured decisions were made in their best interests. The registered manager understood the Deprivation of Liberty Safeguards and had submitted requests for authorisations when required.

People were supported by staff who had received appropriate induction, training, supervision and appraisal.

Staff were kind and caring, treated people with dignity and respect and ensured their privacy was maintained. People had access to a wide choice of activities, both at home and in the community.

Initial assessments were in place before people moved into the home to ensure their needs could be met. People and their relatives were involved in decisions about their care planning.

Quality assurance systems were in place to drive improvements. People and relatives were encouraged to give their views about the service. A complaints procedure was available and people knew who to speak to if they had a concern.

Incidents and accidents were recorded and actions taken and any learning analysed to reduce the risks of it happening again.

Staff felt supported by the registered manager who provided clear leadership and guidance. Staff felt listened to and involved in the development of the service.

We inspected Beach Crest Residential Home on 29 & 30 June 2016.

Beach Crest Residential Home is a care home for older people, some of whom are living with dementia. The home is registered to provide accommodation for up to 11 people. At the time of this inspection there were eight people living there. The house has a cosy lounge and dining room and was recently extended to provide a further three bedrooms on the ground floor. It is situated on the seafront within a short walk of a popular café which people made use of.

Following our previous inspection in October 2015, we had spoken to the provider about our concerns that the management requirements of the home, as required under the Health and Social Care Act (HSCA) 2008 (Registered activities) 2014, were not being met. A provider who is in day to charge of the running of the home does not require a registered manager to be employed. However, we had found the provider was not in day to day charge of the home and had delegated this responsibility to a manager. Following the last inspection we told the provider they must register the manager with CQC urgently. They started the application process straight away and are awaiting their registration certificate. 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 HSCA 2008 and associated regulations about how the service is run.

At this inspection we found the provider and manager had taken some steps to make the improvements required, but these had not yet been achieved. Advice had been sought from an external consultant, but systems had not yet been put in place to effectively manage, monitor and assess the quality of the service. We also found the provider and manager did not fully understand all of their responsibilities under the HSCA 2008 nor did they understand how to implement the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Records were not appropriately maintained and the manager was consistently unable to retrieve requested documents in a timely way. We had to repeatedly ask for some documents and others were not available.

People were given choices and offered a varied diet, prepared in a way that met their specific nutritional needs. People were given support and encouragement by staff if they needed help to eat.

The provider operated safe recruitment processes. Relevant checks had been carried out before staff were employed, such as previous employment references and criminal records checks. There were sufficient staff deployed to provide care to people safely. Staff were supported in their roles with regular training. However, staff did not receive regular supervision and appraisals and this required improvement.

The staff seemed to know people well and had time to sit and chat with them. There was a range of activities on offer throughout the week, such as dominoes, crafts and quiz games. However, some people said they didn’t get asked if they would like to go out, and would like to be more involved in making decisions about activities.

People living at the home, their visitors and health care professionals spoke highly of the quality of care and the management of the home. The manager was visible and worked alongside staff and had positive relationships with people and relatives. Staff told us the morale at the home was good and they felt supported.

Staff interacted positively with people and treated them with respect and dignity. They were kind and caring, and provided reassurance to people when required. People were supported at a pace that suited them and were not rushed. People and relatives commented on the homely and welcoming environment.

People told us they felt safe. Staff were knowledgeable about the home’s safeguarding processes and procedures and who to contact if they had any

We were assisted by the manager and registered provider throughout this inspection. We spoke with five people who lived at the home and with two members of staff who were on duty at the time of the inspection.

We found that people’s consent had been obtained where people were able to be involved in how they wish to be cared for. Those people who were not able to give their consent because of a diagnosis of dementia, relatives had been involved in planning people’s care so that best interest decisions were made on how to care for people.

People’s needs had been assessed using a range of assessment tools and care plans developed to inform staff on how to care and support people.

Medicines were obtained, recorded, administered and disposed of in line with best practice. There were therefore safe systems in place to manage medicines and the home.

Systems were also in place to monitor the quality of service provided to people at Beach Crest.

Records we saw were up to date and accurate. Records were also stored safely to maintain people’s confidentiality.

We were assisted throughout the inspection by one of the registered providers and a family member who deputised in running the home. There were six people living at Beach Crest at the time of our inspection and we spoke with three of them. Two people gave us a detailed account of what is was like to live at the home. The other person, however, was not able to tell us of their experiences owing to a diagnosis of dementia. We also observed care and support provided to four people. We spoke with two care workers who were on duty that day.

The two people we spoke with who were able to tell us what it was like living at Beach Crest said they were very happy at the home. One person told us, ‘The way we are looked after here is very personal’. The other person we spoke with told us, ‘Everyone here has become like my family’. They told us they were able to choose the times they got up and went to bed and how they wished to spend their day. They said their care and welfare needs were met by a staff team who were very kind and hard working. They told us that they were able to invite relatives round for a meal and that the standard of food in the home was very good.

People were protected from the risks of abuse through the home’s policies and procedures and through training provided to the staff.

The home had systems in place to monitor the quality of service provided.

Beach Crest Residential Home is a small, family run care home and provides care and support for up to eleven older people, some of whom are living with dementia. The home is on the seafront at Barton on Sea and is close to local shops and cafes. Each person has their own room which is personalised with their own belongings and furnishings.

The home had a registered manager who was also the registered provider. 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. During our inspection it was clear that the registered manager/provider was not in charge of the day to day running of the home. This role was carried out by the non-registered deputy manager. We spoke with the provider about our concerns following the inspection.

There were sufficient numbers of staff deployed to ensure the needs of people could be met. Staff recruitment procedures were robust and ensured only those considered suitable to work in social care settings were employed.

Staff were appropriately trained and skilled to deliver effective care. They all received a thorough induction when they started work and received regular training and support to enable them to carry out their duties safely. However, staff did not receive regular supervision and appraisal to support them in developing their practice and personal development.

Staff fully understood their responsibilities to report any concerns of possible abuse. People’s medicines were managed, stored and administered safely.

People were treated with respect and compassion. Observations showed staff knew people very well and considered their emotional wellbeing, choices and wishes and promoted their independence. Staff sought consent before providing any care or support. People’s hobbies and interests were documented and staff encouraged people to take part in activities they had chosen.

Care plans and risk assessments had been reviewed regularly and people’s support was personalised and tailored to their individual needs. However, changes to people’s needs had not always been recorded. Referrals to health care professionals were made quickly when people felt unwell and advice was acted upon. Health care professionals we spoke with told us the staff were responsive to people’s changing health needs and people were well cared for.

There were systems in place to gain feedback from people and relatives. Each person and relative we spoke with told us they felt able to voice their opinions about the quality of care provided and any concerns they might have.

Health and safety checks were completed to ensure the environment was maintained to a safe standard. Records relating to the management of the home, such as policies, required updating and improving.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No one at Beach Crest required a DoLS but the deputy manager understood when an application should be made.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.