Beaman House

The service is a ‘care home’ operated by P.A.K.S Trust; a non-profit and independent provider of support for people with learning disabilities, autism, mental health conditions, complex needs and behaviours that challenge. Beaman House is one of six services provided by P.A.K.S Trust and provides accommodation with personal care for up to five adults. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection visit, there were four people living at the home.

The registered manager who was in post at the last inspection had left the service. Another manager, registered for one of the provider's other services, had been managing Beaman House since the previous manager had left. The present manager thought they were registered with us to manage Beaman House. They were unaware that their registered manager's application they had submitted, had been rejected by us in December 2017 as it was not fully completed.

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.

At our last inspection in February 2016 we rated the service as Good. At this inspection, we found the quality of the care had been maintained and people continued to receive a service that was safe, caring, effective and responsive to their needs. The rating continues to be Good.

There were enough staff on shift with the appropriate levels of skill, experience and support to meet people’s needs and provide effective care. Risk management plans were in place for identified risks to people's care. Staff knew what action to take in the event of an emergency.

Staff understood their responsibilities to protect people from the risks of abuse. Staff had received ‘safeguarding’ training and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and used their skills, knowledge and experience to provide safe care to people.

People were encouraged and supported to maintain good health. Staff supported people to access healthcare services whenever needed. People received their prescribed medicines in a safe way.

Staff had received training in the Mental Capacity Act 2005 and worked within the principles of the Act. The manager understood their responsibilities under the Act and when ‘best interests’ meetings should take place. The manager had applied to the supervisory authority for the right to deprive two people of their liberty when their care and support included restrictions in the person’s ‘best interests’.

Staff supported people with kindness and in a caring way. Relatives felt staff were caring and involved them with their family member’s support.

People had individual plans of care which provided staff with the information they needed about people's care and support. People were able to take part in individual leisure activities according to their preferences. There were also opportunities for people to attend a day centre operated by the provider.

Staff were happy in their job role and felt supported by the manager through team meetings and one to one supervision meetings.

People and their relatives had no complaints about the service. They felt the manager would deal with any concern if they needed to raise something.

The provider and manager checked the quality of the service to make sure people’s needs were met safely and effectively. Feedback on a day to day basis from people was encouraged by staff. The provider and manager understood their regulatory responsibilities and worked with other organisations and healthcare professionals to ensure positive outcomes for people who lived at the home.

Further information is in the detailed findings below.

Beaman House provides accommodation, care and support for up to five people with learning disabilities, or autistic spectrum disorders. The home is located in Nuneaton, Warwickshire. There were three people using the service when we visited. Each person had their own bedroom and there was a shared lounge and kitchen diner at the home.

A requirement of the service's registration is that they have a 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. There was a registered manager in post at the time of our inspection. We refer to the registered manager as the manager in the body of this report.

People told us they felt safe and liked living at Beaman House. The atmosphere in the home was relaxed and friendly. We observed that people were comfortable with staff who were caring and kind. Staff knew how to safeguard people from abuse and were clear about their responsibilities to report any concerns to the manager. The provider had effective recruitment procedures, staff were recruited that were of good character which helped protect people living in the home.

There were enough staff at Beaman House to care for people safely and effectively. Staffing levels enabled people to have the support they needed inside and outside the home that met their individual needs and wishes. People were supported to choose how they would like to spend their day and took part in a wide range of activities. This enabled people to be part of their local community. People who lived at the home were supported to maintain links with family and friends and made choices about who visited them at the home.

The manager had some understanding of the Mental Capacity Act 2005 (MCA) and had identified they required further development to fully understand their responsibilities of the Act. The manager understood the requirements of Deprivation of Liberty Safeguards (DoLS) and had made a DoLS application when a potential restriction on a person’s liberty had been identified. At the time of our visit the manager was awaiting the outcome of the application.

Staff had a good knowledge of people’s needs and supported them to make every day decisions about their life. Staff treated people with respect and dignity, and supported people to maintain their privacy and independence.

People were encouraged to eat a varied diet that took account of their preferences and where necessary, their nutritional needs were monitored. People were supported effectively with their health needs and had access to a range of health care professionals. There were systems in place to ensure medicines were safety administered.

Each person had a care and support plan which described in detail people’s routines, and how they preferred their care and support to be provided by staff. People and their relatives were involved in planning and reviewing how they were cared for and supported. Risks to people’s health and welfare were assessed and staff followed instructions in care plans on how to reduce the identified risk.

All staff received an induction into the organisation. Staff had completed the training necessary to give them the skills and knowledge they needed to meet the needs of people they cared for effectively. Relatives thought staff were responsive to people’s needs and had the right skills and knowledge to provide care and support.

People, relatives and staff felt the manager was approachable and supportive. There was good communication between people, staff members and the manager. People and their relatives knew how to make a complaint if they needed to and were given the opportunity to share their views about how the service was run. Quality assurance procedures identified where the service needed to make improvements. Where issues had been identified the manager took action to continuously improve the service.

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

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

We saw there were good systems in place to keep people safe. We saw people's needs had been assessed and actions taken to reduce potential risks. We were told nobody who lived at Beaman House was under a Deprivation of Liberty Safeguard.

We saw the home was clean and tidy and there were systems in place to ensure people were protected from the risk of, or spread of infection.

We saw people had been assessed to determine whether they were safe to use different types of equipment in the home.

We saw people who lived at Beaman House were fully involved in their care assessments. There were regular resident meetings where people could share with staff their opinions about the service and discuss changes they would like to see.

Is the service caring?

We observed kind and supportive interaction between staff and people who lived at the home.

We spoke with the three people who lived at the home. We spoke with two at length. They were all very happy with their lives at Beaman House. One person told us, 'It's lovely here, I love it here.'

Is the service responsive?

People received help and support from other health professionals when required. This included doctors, dentists, chiropodists and community health support. On the day of our inspection one person had been to see the dentist.

People were supported to participate in activities inside and outside of the home. People told us about the holidays they had been on and the activities they enjoyed. We saw one person was supported with their love of football. Another showed us their art and craft work and the third person told us about the holiday they were going on the next day.

People told us they were able to raise any concerns they had. People we spoke with were satisfied with the service they received.

Is the service well-led?

We saw that people's needs were met in a timely way.

We saw there were systems in place to gain feedback from people who lived at Beaman House and their relatives.

Since our last visit the previous manager and the new registered manager had improved their care planning and evaluation.

We observed effective communication and good relationships between staff and the people living in the home. People's needs were assessed and care and support was planned and delivered in line with their individual care plans. People living in the home were aware of their care plans and had regular opportunities to do things they enjoyed.

People were provided with a choice of suitable and nutritious food and drink. One person told us "I like the food and can choose what I want". People's independence was encouraged through involvement in shopping, food preparation and cooking.

There were appropriate arrangements to safely store and record medicines. All staff working in the home had received training in the safe handling of medicines. We saw that medicines were monitored on a daily basis by the staff on duty so that potential errors could be investigated.

There were sufficient experienced staff to meet people's needs. Staff had regular supervision and training. This meant that staff had the right knowledge to meet people's individual needs.

We found that improvements were necessary with regards to an effective system to regularly assess and monitor the quality of service that people receive.

At that inspection visit we found that people were at risk of receiving inappropriate or unsafe care and treatment. This was because there were processes in place for the reporting, recording, reviewing and analysing of incidents, concerns or complaints, however these had not been followed.

We also found that some of the records and information we requested were not available or could not be located.

We followed up on these areas of non compliance by undertaking an inspection on 15 February 2013. During this inspection we found that all areas of non compliance identified at the previous inspection had been addressed.

People we spoke with told us that they were happy living in their home. One person commented "I like it here, I like it here." We observed that people appeared relaxed in their surroundings and were able to approach staff with confidence.

We saw that staff were respectful to people and ensured that people were included in decisions such as what to have for dinner or what activities to do. We noted that people were happy to discuss potential activities with each other in order to come to a consensus agreement. We saw that people were being supported to lead active lifestyles with a variety of outings and activities being provided.

People had care plans in place that contained information to assist staff with meeting their care and support needs. Staff appeared knowledgeable about people's needs.

We found that improvements were necessary with regards to protecting people from abuse, managing complaints and record keeping.