Beacon House provides accommodation and personal care for up to 34 older people who may be living with a dementia. At the time of our inspection there were 24 people living at the home. The home offers both long stay and short stay respite care. Beacon House does not provide nursing care. Where needed this is provided by the community nursing team.

This inspection took place on the 29 September and 3 October 2016, the first day of our inspection was unannounced. One adult social care inspector carried out this inspection. Beacon House was previously inspected in December 2013, when it was found to be compliant with the regulations relevant at that time.

Beacon House did not have a registered manager at time of our inspection. There had not been a registered manager in post since March 2016. Following the inspection the registered provider confirmed a new manager had been appointed and they had started the process to be registered with the Care Quality Commission. 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. The deputy manager, who had worked at the home for a number of years, managed the home on a day-to-day basis. A senior manager who was overall responsible for the management of the home supported the deputy manager.

People said they felt safe and well cared for at Beacon House, their comments included “I do feel safe” and I’m very happy”. Another said the staff were “very kind and looked after me very well”. Relatives said they did not have any concerns about people’s safety. One relative said “I have no concerns about the care [person’s name] receives, they really care about people and it shows”. Another said, “you couldn’t wish for better care”.

People were protected from abuse and harm. Staff had received training in safeguarding vulnerable adults and demonstrated a good understanding of how to keep people safe. The policy and procedures to follow if staff suspected someone was at risk of abuse or harm were displayed. This contained telephone numbers for the local authority and the Care Quality Commission. Staff told us they felt comfortable raising concerns and were confident these would be dealt with. Recruitment procedures were robust and records demonstrated the home had carried out checks to help ensure staff employed were suitable to work with vulnerable people. Everyone we spoke with felt the staff were well trained and able to meet their needs.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Some of the people who lived at Beacon House were living with a dementia, which affected their ability to make some decisions. Staff had received training and demonstrated a clear understanding of the principles of the MCA in their practice. Staff sought people's consent and made every effort to help people make choices and decisions. However, not all the records we saw demonstrated that best interest decisions were specific, made in consultation with appropriate people, such as relatives or were being reviewed. We raised this with a senior manager who agreed the way the home was currently recording best interest decisions was not as clear as it could be and told us they would change the way best interests decisions are recorded in future.

People told us they were happy living at Beacon House, staff treated them with respect and maintained their dignity. Throughout our inspection, there was a relaxed and friendly atmosphere within the home. Staff spoke affectionately about people with kindness and compassion. People and relatives told us they were involved in identifying their needs and developing the care pr

We spoke with six people who use the service, two relatives and four staff members. We also spent time observing care practice and looked at four care plans and four staff files. On the day of our inspection 26 people lived at the home.

People who lived at the home told us that they were happy and enjoyed being there. One person said "It's the best place to be, I love it here". A relative said "I can't fault it, I visit frequently and notice how kind and caring the staff are to all the residents here". Another relative said "I notice staff offering a reassuring hand or sitting chatting to residents during the day time".

Many people who use the service have dementia. We spoke with the home manager, some staff members and a visiting professional quality auditor and we were told about the training staff receive in this area and shown copies of certificates obtained by staff members who had attended courses about dementia. We felt that staff had a good understanding of this condition and how to work effectively with people who suffer from dementia.

When we visited we met the district nurse who was a regular visitor to the home and a local GP. An external quality auditor has been appointed by the homes owners to provide support to the manager and guidance to ensure that the home provides a good quality and properly run service. This demonstrated to us that the homes owners value the help of external agencies and work well with them to provide a good holistic service.

The home was inspected by the Care Quality Commission in March 2012. We found that improvements were required relating to ensuring sufficient numbers of staff were on duty to be able to meet people’s needs. Following the inspection the provider wrote to us and, in a detailed action plan, described the arrangements that would be put in to place to achieve compliance. We reviewed copies of the staff duty rotas We found that these documents provided evidence to demonstrate that suitable numbers of staff were on duty at all times.

We (the Care Quality Commission) spoke with five people, three staff and two relatives. We also spent time observing care and we looked at three care plans. On the day of our inspection 27 people lived at the home and received care from the service. One other person was in hospital.

People who lived at the home we spoke with told us they were looked after well. One said “The staff are very kind to me, they are exceptional”. People said they were treated with respect.

Many people who lived at this home had dementia. Staff had a good understanding of how to meet each person’s individual and diverse physical and mental health needs.

We saw clear evidence of the involvement of external healthcare and community support services. We saw that people had opportunities to participate in some activities of their choosing. We saw that people were consulted about what they wanted to do, and about how they wanted their care to be delivered.

We saw that people were relaxed in the company of staff. They were kept safe from abuse because staff knew about abuse and how to report this. Staff training, supervision and annual appraisals were linked to ensuring that staff had the skills to meet people’s needs.

Systems were in place to monitor the quality of the service provided and to manage risk. These included listening to feedback from people and their relatives, and arranging for independent analysis of incidents and events.

We carried out an unannounced visit to Beacon Court on Thursday 22 March 2012.

We met with or saw most of the 27 people living at the service at the time of our visit. We spoke with four people living at the home in some depth; one person told us, “I am very happy here. I have made friends.” Another person told us they enjoyed the food and the outings in the mini bus. Other positive comments related to people’s private rooms, which were personalised; the cleanliness of the home and the staff, who were described as ‘respectful and friendly’. However some people felt that ‘some staff were better than others’.

A number of people living at Beacon Court have a dementia type illness and do not have the ability to express their views on whether their privacy and dignity was respected, whether their care needs were met or if they had choice.

We observed the care delivered to people living at the home, looking at what support people got and whether they had positive experiences. We also spoke with two visiting relatives, three visiting health professionals, care and ancillary staff and the acting manager and the representative of the company.

Overall we saw that people were treated respectfully by staff. People’s privacy was maintained and basic choices, for example what people ate, were promoted. However, people's preferences in relation to their individual needs and routines were not being met or recorded consistently. People with a dementia type illness had little or no meaningful activity or occupation during the day.

Visiting family members said they were happy with the service provided. One relative told us, “The care my wife receives is excellent”.

We found that care plans did not always contain up to date and detailed information about people’s changing needs. We also found that staff had not received the training necessary to enable them to meet people’s changing needs, particularly in relation to pressure area care and pressure ulcer prevention.