This unannounced inspection took place on 29 December 2016. Beeches Retirement Hotel provides care and accommodation for up to 20 people. 18 people were using the service at the time of the inspection.

The previous inspection of the service took place on 15 April 2014. The service met all the regulations we checked at that time.

There was a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe at Beeches Retirement Hotel. Staff understood how to protect people from the risk of abuse and knew the procedure for reporting any concerns. Staff understood the provider’s safeguarding policies and procedures in place to protect people from potential harm. Staff had identified and assessed risks to people and had up to date information about how to support them safely. Staff recorded accidents and incidents and put plans in place to prevent a recurrence. There were arrangements in place to deal with foreseeable emergencies.

People’s support was provided by staff who were recruited safely. The provider followed a robust recruitment process to ensure staff were suitable to support vulnerable adults. There were sufficient staff to meet people’s individual needs safely.

People received the support they required to take their medicines safely. Staff administered and managed people’s medicines safely. The registered manager regularly audited the administration of medicines and ensured staff followed the provider’s medicines management procedures.

Staff had the relevant skills and experience to undertake their role. Staff received training and felt supported in their work. Staff received regular supervisions and yearly appraisals to monitor their performance and review their development needs.

People received support in line with the principles of the Mental Capacity Act 2005 and the requirements of the Deprivation of Liberty Safeguards. The service had received authorisations to deprive some people of their liberty in order to provide necessary care and to keep them safe. People gave consent to care and treatment.

People enjoyed the nutritious food provided at the service. Staff ensured people’s dietary needs and preferences were met. People were supported to maintain good health and wellbeing and accessed professional healthcare services when needed. The service was responsive in managing changes to people’s health.

People were treated with kindness and respect. Staff upheld and maintained people’s dignity, privacy and confidentiality. Staff knew people well and understood their individual needs. Staff took into account people’s views and experiences when they supported them. People were supported to maintain relationships important to them.

People’s care records contained sufficient information which staff used to plan and meet people’s individual needs. People, their relatives and healthcare professionals were involved in making decisions around people’s care and the support they received. People’s needs were reviewed and their care plans updated on a regular basis to ensure they remained effective. People’s care was person centred and provided as planned.

People received the support they required to maintain relationships important to them. People took part in activities they enjoyed and received the support to maintain their interests.

The registered manager asked people and staff for their views about the service and responded to any concerns they raised.

Staff were happy to work at the service and felt supported in their work by their colleagues and by the registered manager. There was a positive and transparent culture were people, their relatives and staff were encouraged to

An individual inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people who used the service and the staff told us, what we observed and the records we looked at.

To see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly.

We saw that staff had received appropriate training and demonstrated a good understanding of safeguarding procedures.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Staff gave us an example of their understanding of DoLS and what actions they would take if they identified any concerns. The deputy manager had received training to understand when an application should be made, and how to submit one.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. It was clear from our observations and from speaking with staff that they understood people’s care and support needs and that they knew them well. One person told us. "Sometimes I wake up at night and soon a head pops round the door. It’s so reassuring to know there’s someone there”

We saw from training records that staff had received appropriate training to meet the needs of the people living at the home.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People told us they were able to do things when they wanted to. Our observations confirmed this. One person told us, “They are all round caring staff, anything you want they will do; it’s so good it’s almost embarrassing.”

Is the service responsive?

People’s needs had been assessed before they moved into the home. Records confirmed people’s preferences had been recorded and care and support had been provided that met their wishes. People had been supported to maintain relationships with their friends and relatives.

Where people had been identified as having a health related need we saw that referrals had been made to appropriate external professionals.

Is the service well-led?

The provider of Beeches Retirement Hotel is also the registered manager. The deputy manager was responsible for the day to day running of the home and is referred to throughout this report.

People told us if they had any concerns they spoke to the manager or senior member of staff on duty. They said any issues were dealt with immediately.

Staff told us they were clear about their roles and responsibilities. They said the manager and provider ensured they were aware of any changes that happened at the home. They told us it was an ‘open door policy’ and their views and concerns were listened to and taken into account.

We visited Beeches Retirement Hotel and spoke with 10 of the people who lived there. We observed staff supporting people, looked at a range of documents, spoke with two care workers, the deputy manager and the manager.

People told us they were very comfortable. One person said, "This is my home and I like living here". We observed that people were encouraged to make choices, and staff spoke with people in a respectful manner at all times.

We examined four care plans, and found that they included details of people's support needs. They were reviewed by the deputy manager on a regular basis.

We spoke with two of the care workers. They demonstrated a good understanding of people's needs and how these were met.

We examined the systems for the management of medicines. We found that a new storage system had been installed, and a pharmacy inspection had recently taken place.

We looked at staff rotas and training records. Staff told us there were usually enough staff working in the home, and they had received relevant training.

We looked at care plans, handover sheets, daily records and some of the home's policies and procedures. We found that overall the information recorded needed updating and some policies and procedures were not in place.

We used a number of different methods to help us understand the experiences of people using the service because some of the people using the service had complex needs which meant that they were not able to tell us their experience.

Those who spoke with us said they were very comfortable living in the home. One person told us they were ‘quite happy’, another said the food was lovely and they were able to choose how they spend their time. Another person said the staff were very good and ‘they look after us very well’.