We inspected Beach Crest Residential Home on 29 & 30 June 2016. Beach Crest Residential Home is a care home for older people, some of whom are living with dementia. The home is registered to provide accommodation for up to 11 people. At the time of this inspection there were eight people living there. The house has a cosy lounge and dining room and was recently extended to provide a further three bedrooms on the ground floor. It is situated on the seafront within a short walk of a popular café which people made use of.
Following our previous inspection in October 2015, we had spoken to the provider about our concerns that the management requirements of the home, as required under the Health and Social Care Act (HSCA) 2008 (Registered activities) 2014, were not being met. A provider who is in day to charge of the running of the home does not require a registered manager to be employed. However, we had found the provider was not in day to day charge of the home and had delegated this responsibility to a manager. Following the last inspection we told the provider they must register the manager with CQC urgently. They started the application process straight away and are awaiting their registration certificate. 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 HSCA 2008 and associated regulations about how the service is run.
At this inspection we found the provider and manager had taken some steps to make the improvements required, but these had not yet been achieved. Advice had been sought from an external consultant, but systems had not yet been put in place to effectively manage, monitor and assess the quality of the service. We also found the provider and manager did not fully understand all of their responsibilities under the HSCA 2008 nor did they understand how to implement the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
Records were not appropriately maintained and the manager was consistently unable to retrieve requested documents in a timely way. We had to repeatedly ask for some documents and others were not available.
People were given choices and offered a varied diet, prepared in a way that met their specific nutritional needs. People were given support and encouragement by staff if they needed help to eat.
The provider operated safe recruitment processes. Relevant checks had been carried out before staff were employed, such as previous employment references and criminal records checks. There were sufficient staff deployed to provide care to people safely. Staff were supported in their roles with regular training. However, staff did not receive regular supervision and appraisals and this required improvement.
The staff seemed to know people well and had time to sit and chat with them. There was a range of activities on offer throughout the week, such as dominoes, crafts and quiz games. However, some people said they didn’t get asked if they would like to go out, and would like to be more involved in making decisions about activities.
People living at the home, their visitors and health care professionals spoke highly of the quality of care and the management of the home. The manager was visible and worked alongside staff and had positive relationships with people and relatives. Staff told us the morale at the home was good and they felt supported.
Staff interacted positively with people and treated them with respect and dignity. They were kind and caring, and provided reassurance to people when required. People were supported at a pace that suited them and were not rushed. People and relatives commented on the homely and welcoming environment.
People told us they felt safe. Staff were knowledgeable about the home’s safeguarding processes and procedures and who to contact if they had any concerns. People and relatives knew who to talk to if they had any concerns. There were systems in place to manage and mitigate individual and environmental risks to people.
Medicines were managed and administer appropriately. Staff received regular training in medicines and had a good knowledge of medicines and how to administer them to people safely.
People were supported to maintain their health and wellbeing, and medical advice and treatment was sought promptly from relevant health professionals including GPs and community nurses.
We last inspected the home in October 2015 when we found concerns in relation to record keeping, the Mental Capacity Act 2005, staff supervision and appraisal and monitoring and assessing the quality of the service. We found similar issues at this inspection and identified 3 breaches of regulations. You can see what action we have told the provider to take in the main report.