Beachfield

Beachfields is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

The service had a registered manager who was registered to manage this service and another one locally for six people. 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 the last inspection completed in April 2016 we rated the service as good in all areas. At this inspection we found the service continued to be good in all key areas. People were being supported by staff who were highly skilled, sensitive to their needs and who worked in a truly person-centred way. Each person was afforded opportunities to continue their interests and hobbies, but also to stretch themselves and try new things. This was inspirational as sometimes people with autism struggle to try new things or go to new places. With careful planning and skilled support, people were accessing community facilities and trying activities such shopping for their own groceries. Staff went the extra mile to find activities and social events to suit individuals wishes and preferences. They worked sensitively with people to ensure they had opportunities to live fulfilling lives.

The management team were inclusive and forward thinking. They ensured staff understood the core values and ethos of the service and provided training and support to enable them to provide the care in a way which respected people as individuals and celebrated their diversity.

There were sufficient staff with the right skills and understanding of people’s needs and wishes. People said staff were kind and helpful. Our observations showed staff respected people’s dignity and privacy and worked in a way which showed kindness and compassion.

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. People's consent to care and treatment was sought. Staff worked within the requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and understood how these applied to their practice.

Care and support was person-centred and well planned. Staff had good training and support to do their job safely and effectively. Risk assessments were in place for each person. These identified the correct action to take to reduce the risk as much as possible in the least restrictive way. People received their medicines safely and time.

Systems and audits ensured the quality of care and support were being reviewed and improved. People were enabled to have their voice heard.

Beachfield is registered to accommodate six people who have a learning disability. At the time of our inspection there were five people living at Beachfield.

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 were safe and staff demonstrated a good understanding of what constituted abuse and how to report if concerns were raised. Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.

Care files were personalised to reflect people’s personal preferences. Their views and suggestions were taken into account to improve the service. They were supported to maintain a balanced diet, which they enjoyed. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff relationships with people were caring and supportive. Staff were motivated and inspired to offer care that was kind and compassionate.

There were effective staff recruitment and selection processes in place. Staffing arrangements were flexible in order to meet people’s individual needs. Staff received a range of training and regular support to keep their skills up to date in order to support people appropriately.

Staff spoke positively about communication and how the registered manager and home manager worked well with them and encouraged their professional development.

A number of effective methods were used to assess the quality and safety of the service people received and make continuous improvements.

A single inspector carried out this inspection in one day. We spoke with the manager, six members of staff and the six people who lived at the home. The focus of the inspection was to answer five key questions:

Is the service safe?

Is the service caring?

Is the service effective?

Is the service responsive?

Is the service well-led?

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

If you want 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?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS were only used when it was considered to be in the person's best interest. There were proper policies and procedures in place and the manager had been trained to understand when an application should be made and how to submit one. Following recent guidance from the Department of Health, the home had made DoLS applications for each person in the home for assessment by the local authority. There was clear multi-disciplinary guidance when a 'best interest' decision had been made for an individual. We saw examples where this had been undertaken and the advice had been followed.

Is the service effective?

People told us they liked living at the home and told us "like it here" and "like it".

We saw that staff obtained consent before they carried out any care or support. Staff were respectful and treated people with dignity.

People's health and care needs were assessed and a plan of care followed in a consistent way. Individual needs were taken into account and care was person-centred.

People's individual risks were identified. Detailed instructions gave staff clear instructions of how to minimise any risk, trigger factors to look for and how to manage the situation in a consistent way.

People were involved in choosing their menu plans and received suitable and nutritious food. Specific dietary needs were identified and managed individually.

Following a period of unsettlement, the home now has a permanent mix of new and long standing staff. All staff felt supported by the manager and received regular supervision.

Is the service caring?

The home had a friendly and homely atmosphere. People appeared comfortable and at ease with staff. People were supported by kind and attentive staff which made people happy and relaxed. We saw that staff understood each person well, including those who were unable to verbally communicate. People moved freely throughout the home and undertook individual activities in line with their preferences.

Is the service responsive?

People's needs had been assessed before they moved into the home. Records showed that people's preferences, choices and needs had been recorded and support plans had been provided that met their needs. People had access to activities and hobbies that were important to them and were undertaken in the local community.

Specialist professionals were contacted where necessary and their advice acted upon.

Complaints and concerns were fully investigated. The group's policies and procedures were in the process of being updated.

Is the service well-led?

The home was currently without a registered manager. A senior manager, who was the registered manager from one of the other homes in the group, was working full-time at the home and carrying out management duties. Staff felt supported by the manager and felt they were approachable.

The service had a quality assurance system in place which identified any shortfalls. Whilst there were formal arrangements in place for people to feedback their views, a recent quality survey had not been sent out for some time which would allow friends, families and other stakeholders to give their feedback on the service provided. The manager was in the process of sending these surveys out.

We spent time talking with people living at the home and observing how people's care and welfare needs were met. People were spending their time planning to go out in the local community, watching television and spending time in their bedrooms. People did not appear rushed and the home was relaxed and homely. Comments included: 'I am happy here. The staff are great', 'The staff are nice' and 'Thumbs up.'

Staff demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have.

We saw that the premises were adequately maintained. We saw that health and safety checks were completed on a daily, weekly, monthly and annual basis by staff employed by the organisation and external contractors.

There were effective recruitment and selection processes in place.

People were made aware of the complaints system. This was provided in a format that met their needs.

Staff spoke of the importance of empowering people to be involved in their day to day lives. They explained that it was important that people were at the heart of planning their care and support needs.

We spent time talking to people who lived at Beachfield and observing the interactions between them and staff. Comments included: 'I am going out this afternoon'; 'I like my bedroom and helped plan it' and 'I like living here.' During our visit, we saw that people appeared relaxed and contented. For example, when we arrived a person was helping a member of staff cook breakfast and another person was relaxing doing a word search in one of the lounges.

Medicines were safely administered. We saw the medication recording records which were appropriately signed by staff when administering a person's medication.

We observed that staff were well organised, motivated and competent in their roles. Staff provided support in a caring manner making sure that people were comfortable and content.

Care plans and risk assessments demonstrated that they had been reviewed and updated on a regular basis or in response to changing needs.