Beaumont Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Beaumont Nursing Home is registered to accommodate 28 older people; at the time of our inspection, there were 28 people living in the home.

At the last inspection, this service was rated good. At this inspection, we found the service remained good. The inspection took place on the 10 January 2018 and was unannounced.

There was a registered manager in post. 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 be treated with empathy and kindness and their individuality was respected. The staff were friendly, caring and compassionate. Positive relationships had been developed between the people and staff.

Detailed personalised care plans were in place, which enabled staff to provide consistent care and support in line with people’s personal preferences and choices. End of life wishes were discussed and plans put in place.

People continued to receive safe care. Staff were appropriately recruited and there were sufficient staff to meet people’s needs. People were protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision and training that they required to work effectively in their roles. Development of staff knowledge and skills was encouraged. People were supported to maintain good health and nutrition.

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 home supported this practice. There was a variety of activities available for people to participate in if they wished to and family and friends were welcomed to take part in events at the home.

The service had a positive ethos and an open culture. The provider was committed to developing the service and actively looked at ways to continuously improve the service. There were effective quality assurance systems and audits in place; action was taken to address any shortfalls.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

This inspection took place on the 6 and 8 January 2016 and was unannounced.

The service is registered to provide accommodation for up to 28 older people who may require nursing care. The people living in the home have a range of needs including physical disabilities. The service provides both respite and long term care. At the time of our inspection there were 15 people living there.

The service has a registered manager. 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.

There were appropriate recruitment processes in place and people felt safe in the home. Staff understood their responsibilities to safeguard people and knew how to respond if they had any concerns.

There were sufficient staff to meet the needs of the people living at the home; staffing levels were kept under review. At the time of the inspection the home was undergoing refurbishment which was needed to improve the environment for the people living there.

Staff were supported through regular supervisions and undertook training which focussed on helping them to understand the needs of the people they were supporting. People were involved in decisions about the way in which their care and support was provided. Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day to day routines. People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

People received care from staff that were kind, compassionate and respectful. Their needs were assessed prior to coming to the home and person centred care plans were in place and were kept under review. Staff had taken care to understand peoples likes, dislikes and past life’s and enabled people to participate in activities either within groups or on an individual basis.

People were cared for by staff who were respectful of their dignity and who demonstrated an understanding of each person’s needs. This was evident in the way staff spoke to people and the activities they engaged in with individuals. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

There were a variety of audits in place and action was taken to address any shortfalls. Management was visible and open to feedback, actively looking at ways to improve the service. The completion of the current refurbishment programme will benefit the well-being of the people living in the home.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive to people's needs? Is the service well led?.

This is a summary of what we found.

Is the service safe?

Equipment at the home had been well maintained and serviced regularly therefore not putting people at unnecessary risk. A senior member of staff was available on call in case of emergencies. Staff knew how to make a referral when it was necessary to lawfully deprive people of some aspects of their liberty to keep them safe.

Is the service effective?

Individual plans of care identified people’s specialist dietary, mobility and equipment needs which were required to meet people’s individual needs. It was clear from our observations and from speaking with staff that they had a good understanding of the care and support needs of people that used the service and that they knew how people liked their care and support to be provided. Staff received training which enabled them to respond to people’s requirements.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. We spoke with visiting relatives that told us the care shown to people was very good. People using the service and their relatives completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service responsive to people’s needs?

We found that activities were arranged which were suitable and enjoyed by people. We looked at how complaints had been dealt with, and found that the responses had been open, thorough, and timely. People can therefore be assured that complaints are investigated and action is taken as necessary.

Is the service well led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Audits had been completed and action plans produced when changes had been required. People had been consulted in arrangements within the home, and their views had been taken into consideration. The manager regularly worked ‘on shift’ with staff providing care and support to people which ensured they were aware of the needs of people that used the service.

A person who used the service said, ‘’The staff are all very caring and assist me to do the things I can't do for myself.’’ Another person told us, ''The staff are most attentive. They give me everything I need. I know the names of the staff. I can choose when I want to get up.” Speaking about the care they received, that person told us that they were “quite satisfied, the staff do their best.” Two relatives we spoke with told us that they were confident that care staff did everything that was in their father’s care plan. Those relatives told us that they had been involved in the development of the care plan and had been kept informed of their father’s progress.

We saw that people’s care plans were detailed and took account of people’s individual needs and how this would be supported and that people were encouraged to express their views and make choices.

The provider took adequate steps to protect the people they cared for and their carers from harm. We saw that the provider had adequate quality assurance systems which made sure the safety and comfort of the people they cared for were maintained and any problems quickly resolved.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an expert by experience; people who have experience of using services and who can provide that perspective and a practising professional.

We spoke with seven people who used the service. One person told us, “Staff here are more like my friends because I've known them for a long time", but another person did not know the name of a person who had supported them. That person told us, "I'm not sure of their names" and pointed to a care worker saying "I like her the best." Staff at the home did not wear name badges.

One person told us, "I'm not sure what a care plan is", but another person told us that they had been involved in their care plan and added, "I had a lengthy review with my nurse two weeks ago." Two people we spoke with told us that they felt safe living at the home.

During lunch time one person waited an excessive period of time to be served their lunch mainly because there were not enough staff on duty to attend to all residents needs at that time.

People that used the service told us that care staff were kind and caring and treated them with respect. A person we spoke with said, “This is a homely place and I am very happy here". A visitor told us, ‘’My relative loves it here and I am very happy with this home.’’

We found people were encouraged to be as independent as possible. A visitor we spoke with said, ‘’ My relative only came to live here recently so is settling in. But they are happy and well looked after and given dignity and respect.’’ Another person said, ‘’ My relative’s personal items and furniture are here. It feels like home from home.’’

The provider took adequate steps to protect the people they cared for and their carers from harm.

We found that the provider had carried out checks on staff before they were employed to make sure they were fit to carry out their roles and responsibilities.

During our inspection we found the provider needed to make improvements to the environment where people were cared for. A visitor we spoke with told us, ‘’ I am a bit concerned that the home really could do with having new carpets, curtains and decorating as it looks very run down.’’ We found that the provider had already identified these through their quality assurance systems, and had a programme of refurbishment to be completed by March 2014.