The Beeches is a residential care home for up to 12 people with mental health needs, some of whom receive care and treatment under the Care Programme Approach (CPA) and Community Treatment Orders (CTO), of the Mental Health Act 2007. At the time of our inspection 12 people were using the service. The Beeches is a large house built in the early 1900’s which has been extended and is over four floors.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including Community Psychiatric Nurse’s (CPN’s), opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

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 service supported this practice.

Further information is in the detailed findings below.

The Beeches is a residential care home for up to 12 people with mental health needs, some of whom receive care and treatment under the Care Programme Approach (CPA) and Community Treatment Orders (CTO), of the Mental Health Act 2007. At the time of our inspection 12 people were using the service. The Beeches is a large house built in the early 1900’s which has been extended and is over four floors.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were also supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including Community Psychiatric Nurse’s (CPN’s), opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaints had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

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 service supported this practice.

Further information is in the detailed findings below.

During our inspection of The Beeches on 19 September 2013, we found the provider offered a service where people were supported by sufficient staff, who were knowledgeable and responsive to people's individual needs.

We saw that the needs of people who used the service had been assessed, and appropriate care and support plans were in place. We found people's care and support plans were reviewed regularly with their involvement. Where necessary, other health and social care professionals were involved in people's care and treatment. There were records to show that people had consented to their care or treatment.

People were supported to make healthy meal choices to ensure their nutritional requirements were met.

The provider had safe medication management systems in place.

People had their comments or complaints listened to and acted on, without the fear that they would be discriminated against for making a complaint

All seven people we spoke with were happy with the support they received from staff. For example one person who had lived in the home for many years said that staff were, "Very helpful and they always organise trips out for us."

When we visited The Beeches on 22 October 2012, we found that people were very satisfied with the care and support they received. They told us they felt safe and the staff were friendly and supportive. One person said "They're there when you need them to support you". They went on to talk with us about how they had been involved in the recruitment of new staff.

We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met. There was a relaxed atmosphere in the home, and the staff were friendly and polite in their approach to people and interacted confidently with them.

We noted that people were encouraged to express their views and were involved in planning their care and making decisions about their support and treatment, and how they spent their time. One person said "I'm very independent and come and go as I please". They also talked about the range of activities that they, and other people at the home were involved with. For some this involved voluntary work in the local community. Within the care files we saw that care documentation had been signed by the individual or a representative to confirm their involvement and agreement with their particular care needs.

During our visit on 20 December 2011, the people we spoke with were complimentary about the care they received at The Beeches. They told us they got on well with staff and that they felt well supported. They each had a copy of their care plan and so knew what support they needed and had agreed. They said they enjoyed going out into the community to various activities including voluntary work, shopping and local church groups. They told us they had recently taken part in a sponsored Santa walk in aid of the local hospice and had thoroughly enjoyed this.