We undertook an unannounced inspection of the Oxford Beaumont on 14 December 2017.

The Oxford Beaumont provides nursing and personal care for up to 49 people. The service also has two 'Memory lane' units that accommodated people living with dementia. On the day of our inspection 41 people were living at the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good overall.

Why the service is rated Good:

People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.

People had access to information about their care and staff supported people in their preferred method of communication. Staff also provided people with emotional support.

People’s nutritional needs were met and told us they enjoyed the food. Where people had specific dietary needs, these needs were met.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people. The registered manager was supported by the clinical development nurse, the area manager and provider.

This inspection took place on 3 December 2015. It was an unannounced inspection.

The Oxford Beaumont provides nursing and personal care for up to 49 people. The service also has a 'Memory lane' unit that accommodates people living with dementia. On the day of our inspection 33 people were living at the service.

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 received their medicines as prescribed. However, records of medicine stock were not always accurate. This did not impact on people’s safety.

The registered manager conducted audits to monitor the quality of service. However, audits were not always effective and had failed to identify the issues we highlighted during this inspection. Records relating to people’s assessment and care support needs were not always accurate and up to date. For example, some care plans contained conflicting information.

People were safe from the risk of abuse. Staff understood how to recognise and report concerns and the service worked with the local authority if there were any concerns. People told us they felt safe and were happy with the support they received. Staff assessed risks associated with people's care and took action to reduce risk.

There were sufficient staff on duty to meet people’s needs. Staff were not rushed in their duties and had time to chat with people and support them with activities. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff understood the needs of people and provided care with kindness and compassion. People spoke positively about the service and the caring nature of the staff. Staff took time to talk with people and provide activities such as and arts and crafts, games and religious services.

The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves.

People told us they enjoyed the food and had enough to eat and drink. Where people needed support with eating and drinking this was provided in a discreet and caring fashion. Where people required special diets this was also provided.

People’s opinions were sought and acted upon to improve the service. Regular surveys were sent to people and their relatives and the results analysed. Where people and their relatives had made practical suggestions they were adopted to improve the service.

All staff spoke positively about the support they received from the registered manager. Staff told us

they were approachable and there was a good level of communication within the home. People knew the registered manager and spoke to them openly and with confidence.

Accidents and incidents were investigated and learning shared amongst the staff to prevent reoccurrence. The service had a culture of openness and honesty where people came first.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.

At the time of our visit, thirty seven people were using the service.

We spoke with seven people who used the service. They all told us that they were happy at the home and they were content with the care they received. They told us they felt safe and involved in their care. One person said "I like it here. we are well cared for and I think it is very good". Another person said "it is a comfortable home, a very nice place".

We spoke with five care staff who told us they enjoyed working at the home and that they felt supported and well trained to carry out their roles. One senior nurse said "this is a good place, the people are comfortable and my staff are attentive and caring". Another said "I have not been here long but I love working here. The people are fantastic".

We looked at the training records and recruitment files for care workers and saw that they received appropriate and regular training and that they had been recruited and selected appropriately. This showed us that the care workers were suitable and capable to carry out their roles.

We saw that the home was clean and well presented, though the building was a little 'tired'. We also saw that the management monitored peoples' care and they listened and acted upon peoples' comments, suggestions and complaints. We saw that there was a good programme of activities for most people at the home however we did find that there was not enough activity or specialist stimulation for people living with dementia.

This was a follow up inspection to check that previous areas of non compliance had been addressed. We did not involve people living in the home for the purpose of this inspection.

We found that people’s dignity was maintained whilst care staff were delivering personal care and that all welfare risks were appropriately identified and managed. Refurbishment work was already scheduled to commence at the beginning of October 2012, to ensure that the environment was safe for people who lived in the home and the staff who worked there.

We spoke with 11 people that lived at the home and five relatives during the inspection visit. We also received an email from another relative following the inspection. Most of the people we spoke with were positive about their experience of the home. They said they were satisfied with the quality of care provided and approachability of the majority of care staff. All said the chef was "excellent" and food was "well cooked and tasty". People told us they enjoyed the activities on offer, which they confirmed, were interesting and age appropriate. People were happy with the quality of the accommodation and the level of cleanliness.

The people we spoke with were generally happy with the care they were receiving. They told us the home was always warm, clean and comfortable. They said they had "lovely" rooms which they could personalise and "make their own". People told us that the food provided was "excellent quality with lots of choice" and variety. People told us that the staff were approachable and kind. They said that staff appeared well trained and seemed knowledgeable about their needs. Relatives told us they were always kept informed of the person living at the homes progress and welfare. They told us that they could visit whenever they wanted.