This unannounced inspection took place on 26 November and 7 December 2018. Beechcroft Care Home provides accommodation, nursing, personal care and support for up to 30 people. At the time of this inspection 23 people were living at the service some who were living with dementia. The building is made up of two converted Victorian houses arranged over two floors with lift access.

At the last inspection on 30 August and 7 September 2017 the service was rated Requires Improvement overall and in each key question apart from Good in Caring. We found three breaches of regulations relating to safe care and treatment, person centred care and good governance. We had also made two recommendations about the accessibility of information and staffing levels. We had asked the provider to take action to make improvements to the service, and this action had not been fully completed at this inspection.

During this inspection the service remained Requires Improvement and we found breaches in relation to person centred care, the environment and safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report

There was a registered manager at the service who was employed in October 2018. 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 were not always kept safe because of the risks found in the environment. We found several areas within the home that needed decorating, and maintenance issues that posed a risk to people’s health and wellbeing. The provider addressed some issues immediately, however, further work was needed to ensure the environment remained safe and comfortable for people using the service.

There was an activity plan in place for people. There were two part-time activity co-ordinators who provided people with a wide range of activities to take part in. However, we found that people who were unable to take part or those with dementia did not have individual time or meaningful activities available for them.

Staff carried out quality checks of the service. The registered manager completed an audit of the service, however action was not always taken to resolves issues found.

People had assessments in place and these recorded risks associated with people’s health and wellbeing needs. When people’s health care needs changed new care plans were developed or existing care plans were updated. People had access to health care support when their healthcare needs changed. However, we found on one occasion a person’s health had not improved despite previous medical treatment and additional treatment was not sought in a timely way.

People said staff were kind and compassionate. We observed staff cared for people in a way that was respectful which promoted their dignity and privacy.

Medicines were administered to people as required. There were established systems in place for the safe management of medicines.

There were sufficient staff deployed to meet people’s individual needs. Safer recruitment processes were followed to ensure suitable staff were employed at the service.

People said they enjoyed the meals that were provided to them. There was a menu available that people could choose their meals they enjoyed eating.

Staff were supported through regular training, induction and supervision. The registered manager had put plans in place for staff appraisals in 2019. Nurses were supported to maintain their registration with the Nursing and Midwifery Council which is the regulator for nursing and midwifery professions in the UK.

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 sys

We carried out a comprehensive inspection of this service on 30 August and 7 September 2017. This was the first comprehensive inspection since the provider first registered in January 2016.

A focused inspection took place on 24 May 2016 after whistleblowing concerns were raised about staffing, nutrition and personal care. We did not find any concerns during this focused inspection and the provider was rated Good in relation to safety.

The first day of our inspection was unannounced. We informed the home manager we would be returning to complete our visit on 7 September 2017.

Beechcroft Care Home provides nursing care, respite and accommodation for up to 30 older people, some living with dementia and some requiring palliative care. At the time of our visit there were 26 people living in the home. The home is located in a Victorian converted terraced property, arranged over two floors. The floors were accessible by a lift.

At the time of our inspection there was no registered manager in post. The home manager was in the process of applying to become the 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 and associated Regulations about how the service is run.

People were not always protected from the risk of avoidable harm as staff were not always responsive to calls bells and there was not always learning from incidents when they occurred in the home. Some risk assessments were in the process of being reviewed and updated to reflect people’s needs.

People told us the majority of staff were kind and caring, and respected their privacy and we saw examples of this.

Some people were not always given the opportunity to socialise with other people in the home and because of this felt isolated. There were activities that were held in the home but more needed to be done for those who wished to access the community and to meet people’s individual needs and preferences.

People’s feedback about the quality of the meals was varied and not everyone could read the menus on display as the writing was too small for some people to read.

People accessed healthcare services and we saw health practitioners visiting the home.

People were supported to give consent for their care and support and where appropriate capacity assessments were carried out and DoLs applications were submitted to the local authority to ensure decisions were made in people’s best interests and protected their rights.

Some people told us there was not enough staff to meet their needs and some staff agreed with this. Staff recruitment checks were in place but verification of documents needed to be more robust to ensure that staff were suitable to work with people using the service.

Mandatory training was attended by staff who explained this was satisfactory. Regular supervision was not always carried out for some staff and the home manager acknowledged the need to address this.

People received their medicines when needed. There was a process for the safe management, storage and administration of medicines but there were some gaps in the medicines administration records.

People had access to information about how to make a complaint. The majority of people told us these would be resolved, with the exception of one person, who was unsure if their concerns would be listened to.

Audits were carried out; however they were not always effective as they failed to identify the issues we found. Records showed that people’s feedback had been sought to find out their views about the quality of care the service provided.

We made two recommendations about the accessibility of information and the deployment of staff. We found three breaches of regulations relating to safe care and treatment, person centred care and good governance.

We carried out an unannounced comprehensive inspection of this service on 2 July 2015. The service met all the regulations inspected at that time. We rated the service as good.

We undertook a focused inspection on 29 June 2016 due to concerns we had received about the service in May 2016. There were concerns that people were not receiving safe care and treatment at the service. This report only covers our findings in relation to these concerns.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Beechcroft Care Home’ on our website at www.cqc.org.uk.

Beechcroft Care Home provides accommodation for persons who require nursing and personal care for up to 26 people. On the day of the inspection, 24 people were using the service.

The service did not have a registered manager in post at the time 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 2008 and associated Regulations about how the service is run.

During this focussed inspection, we found people received safe and appropriate care. Staff had identified risks to people’s health and there were measures in place to protect them from risk of harm. The manager ensured staff followed guidance to manage the risks safely. Staff monitored risks to people’s health and made referrals to healthcare professionals when required.

We saw the action the provider had taken to ensure there were sufficient nursing and care staff at the service to meet people’s needs safely. The provider had recruited a nurse and four care staff to increase its staff complement and to replace those who had left the service. Staff had the right skills and knowledge to provide people with safe care and treatment. People received the support and care they required although some people received their care earlier than stated in their care plans if they requested so. The provider had informed us that the registered manager left the service in May 2016. The provider had made an internal appointment to the post of manager in June 2016 and were yet to submit an application to CQC for registration.