This inspection took place on 12 April 2017 and was unannounced. A previous inspection undertaken in January 2016 found two breaches of legal requirements. These related to Safe care and treatment and Good governance. The provider subsequently sent us a plan detailing what action they would take to meet the breach in regulations.

At this inspection we found the matters related to these previous breaches of regulations had been addressed and the requirements of the regulations met.

Beachville West End is a residential care home based in Newbiggin-by-the-sea, Northumberland which accommodates up to 13 older people, some of whom are living with dementia or a cognitive impairment. There were 13 people living at the home at the time of our inspection.

The home had a registered manager in place and our records showed she had been formally registered with the Care Quality Commission (CQC) since October 2010. A registered manager is a person who has registered with the CQC 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.

Checks were undertaken on the safety and security of the home. We saw there were appropriate testing of small electrical items, lifting equipment, assessments for legionella risk and an assessment of any asbestos risk at the home. Regular fire drills and checks on fire safety equipment had also taken place.

The home was clean and tidy. We noted the soaking of commode pots was taking place in a shower area, but the registered manager told us infection control staff had not raised an issue about this, when they had visited the home as part of the last local authority review. We have made a recommendation about this.

The home had a safeguarding policy in place. There had been no recent safeguarding incidents at the home. Accidents and incidents were recorded and reviewed. Staffing and staff recruitment continued to be managed in an effective manner. We found some minor issues with medicines and the deputy manager said these would be addressed immediately.

The home continued to work within the requirements of the Mental Capacity Act and where people did not have capacity to make their own decisions best interests processes had been undertaken. Staff continued to have access to a range of training and development opportunities and there was regular supervision and an annual appraisal.

People continued to be supported to access health and social care services to help maintain their health and wellbeing. There was good access to a range of food and drinks and people told us they were happy with the meal choices offered.

People told us they were happy with the care they received and we saw there were good relationships between staff and people who lived at the home. People and their relatives were involved in determining their care needs, as appropriate. An annual questionnaire sent to relatives of people living at the home was overwhelmingly positive. People were supported to maintain their independence.

Care records contained good information about people as individuals. Care plans were in place that addressed people’s needs, had good information for staff to follow and were reviewed on a regular basis. Some of the reviews of care plans lacked detail. People had access to a range of activities and were supported to follow their own interests. Staff understood about the risk of social isolation. There had been no formal complaints received by the provider in the last 12 months.

A range of audits and checks had been put in place since the previous inspection. When we first arrived at the home the current quality rating was not displayed, although this was rectified by the registered manager. The registered manager confirmed the home had not notified the CQC about people who had a DoLS authorisation in place, as they

Beachville West End is a residential care home based in Newbiggin-by-the-sea, Northumberland which accommodates up to 13 older people, some of whom are living with a form of dementia. The service was last inspected in April 2014 and there were no breaches of legal requirements at that time. There were 13 people living at the home at the time of our inspection.

There is a condition on the provider's registration of this service that a registered manager must be in place. At the time of our inspection there was a registered manager in post who had been managing the service for many years and been registered with the CQC since October 2010. 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 were assisted at our inspection by both the registered manager and provider, both of whom were present on the days that we visited the home.

People told us they were happy with the care and support they received and they felt safe. Staff were knowledgeable about what constituted a safeguarding incident and confirmed how they would handle any safeguarding matters should they arise. Staff had been trained in safeguarding and we saw that historic safeguarding incidents had been handled and reported appropriately and in line with protocols and procedures. People were supported to meet their nutritional and hydration needs and staff monitored people's weights to ensure they remained healthy, seeking input from GP's and dieticians where necessary.

Risks that people had been exposed to in their daily lives had been assessed and these were regularly reviewed. Accident and incident monitoring took place and where necessary risk assessments were amended to prevent repeat events. Care records were personalised and highlighted how people should be supported safely and in line with their needs, likes, dislikes and preferences. They were regularly reviewed and up to date. Care was person-centred and there was evidence that people and their relatives were involved in their care. No person had a formal advocacy agreement in place but the manager was aware of how to arrange this should it be necessary.

People, staff and our observations confirmed that there were enough staff on duty to meet people's needs. Staff confirmed they were not rushed when delivering care. They had received training in key areas and supervisions and appraisals were carried out regularly. Recruitment processes were thorough and medicines were managed well.

Our observations confirmed people experienced care and support that protected their privacy, dignity and staff promoted people's independence. Staff displayed caring and compassionate attitudes towards people and they enjoyed good relationships. Activities were available to stimulate and occupy people. Choice was evident throughout the service; for example, people chose where they spent their time and the foods they liked to consume.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) including the Deprivation of Liberty Safeguards (DoLS), and to report on what we find. MCA is a law that protects and supports people who do not have ability to make their own decisions and to ensure decisions are made in their ‘best interests’ and it also ensures that unlawful restrictions are not placed on people in care homes and hospitals. The MCA was appropriately applied and applications had been made to the local authority for those people who required assessment for a deprivation of liberty safeguard to be put in place. There was evidence within people's care records that their consent was sought before care was delivered.

Some systems were in place to monitor the service provided and car

We considered all the evidence we had gathered under the regulations we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we have found.

Is the service safe?

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We saw risk assessments had been completed for people who were assessed as being at risk of falls.

We saw the provider had effective systems in place to manage medicines.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No applications have needed to be submitted at the service. We saw policies and procedures were in place and all staff had received training in the Mental Capacity Act 2005 (MCA) and DoLS.

Is the service effective?

People were treated with respect and dignity. People who used the service were asked about the support they received and if they understood their rights. One person said, “I am aware of my rights. The staff explain what they are doing and why. They always ask my permission before doing anything”.

Is the service caring?

People's preferences, interests and needs were recorded and staff were able to give examples of these when we spoke to them.

People's health and care needs were assessed with them and they were involved in this process.

People we spoke with were positive about the care they received from the service. Comments included, “I am happy here. The girls (care staff) are lovely. They do everything for me” and “I have everything I need”.

Is the service responsive?

There was an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.

We saw evidence that care staff identified changes in people's needs and acted to make sure they received the care they needed. For example, there was evidence that where one person’s health had declined an immediate referral was made to the correct medical professional for advice and support.

Is the service well led?

The staff we spoke with were all aware of the complaints, safeguarding and whistle blowing procedures. Staff told us they would immediately report any concerns they had about poor practice and were confident these would be addressed.

The service had a quality assurance system in place that included the use of surveys from people who used the service.

During our unannounced visit we talked to five people who used the service and two relatives. We also talked to a member of the district nursing team, the senior carer and manager of the service. The people who used the service said they were happy at Beachville and had no complaints. The relatives we talked to said Beachville was, “Excellent” and “Nothing’s a bother.” We looked in detail at three care records and saw that care and support was being provided in line with individual plans of care. The care we observed during our visit was provided in a way which promoted independence, choice and respect.

We talked to three care staff employed by the service and looked at two staff records. The staff we observed during our visit provided person-centred care and this was reflected in the feedback we read and heard from people during our visit. We found that care staff were trained and supported to meet people’s needs safely and effectively.

The people who we spoke with said staff always respected their privacy and dignity. They felt the staff were very caring and helpful. They said they the food was very good and they were always given a choice. People said the atmosphere was always friendly and there were plenty of activities taking place. They told us the manager was very approachable and they felt confident any concerns or complaints would be taken seriously.

People told us they were consulted about their care and asked for their consent before they received care and treatment. Comments included, "They always ask me if I need any help, like having a bath". Another person said, "They ask me if I will take my tablets". Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We concluded that people's care and support needs were appropriately planned and their individual care needs were met. People told us the staff were very caring and looked after them well. Comments included, "This is the best place to be" and "We are all very well looked after and the staff are wonderful".

We found the premises were clean, comfortable and suitable to meet the needs of the people who used the service. There were systems in place to ensure the premises were safe and well maintained.

We concluded the staff were well supported, they received the appropriate training for their professional development and were able to obtain further relevant qualifications.

We found the provider had an effective system to regularly assess and monitor the quality of service that people receive.