We carried out a review of the data available to us about Beckford Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Beckford Lodge, you can give feedback on this service.
Beckford Lodge provides personal care support for people with a learning disability who live in their own house. Two people were receiving care at the time of the inspection. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
What life is like for people using this service
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Risks to people’s well-being and safety were assessed, recorded and kept up to date. Staff supported people to manage these risks effectively. Staff kept clear records of the support provided to help people manage their medicines. People were supported to be as independent as possible.
People had been supported to develop care plans that were specific to them. The plans set out the support people needed and how they wanted staff to provide it. Plans were regularly reviewed with people and changed where needed to keep them up to date.
The registered manager provided good support for staff. The provider’s quality assurance processes were effective and resulted in improvements to the service. There was effective oversight of the service from senior managers.
More information is in Detailed Findings below.
Rating at last inspection and update
Requires Improvement. Report published 18 July 2019. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out a comprehensive inspection of this service on 5 June 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which were rated requires improvement.
The ratings from the previous comprehensive inspection for those Key Questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beckford Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Beckford Lodge is registered to provide personal care to people in their homes. The service supports two people in shared accommodation. The accommodation was a domestic dwelling situated within the Warminster local community.
Registering the Right Support and other best practice guidance ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
People’s experience of using this service and what we found
The service didn’t consistently apply the full range of the principles and values of Registering the Right Support and other best practice guidance. People were not empowered to shape their lives. There was a perception that people’s care needs had not changed for many years. This meant that their delivery of care was not in line with changes in guidance or with legislation.
Staff supported people in the least restrictive way possible and in their best interests.
Risk assessments were not always completed for risks identified. The Registered Manager and chief executive officer (CEO) told us the expectation was that the commissioners of the placements completed these risk assessments. The CEO said it was their duty of care under the Care Act Assessment. We will be discussing with commissioners the assessments of risk that relate to fire.
Medicine systems were not safe. The staff removed medicines from the multi compartment system (MDS) and left them “potted” for one person to take at a later date. The medicine care plan did not list the prescribed medicines we saw in the MDS system. The registered manager said this will be followed up, in line with the policies and procedures.
Care plans were not person-centred for one person. The registered manager said that because it was documented staff had to ask the person, this meant they were person-centred care plans. The registered manager said that because the care plan was developed with the person this was person-centred.
People we spoke with said they felt safe in their home and when staff were present. The staff had attended safeguarding of people at risk and knew the procedures for raising concerns.
There were systems in place to assess and monitor staff performance. Staffing levels were in line with the local authority’s assessment of people's needs.
The person we spoke with said they liked the staff, they were caring and their rights were respected. The person we spoke with said they made their day to day decisions. This person told us they were able to prepare their meals and staff assisted them with shopping for food.
People had access to the GP and to community NHS facilities.
The person we spoke with said they would approach the staff with concerns. There were no complaints received
The staff said the registered manager was approachable. They said the team was stable, they worked well together and covered vacant hours between themselves.
Quality assurance systems were based on the support plans in place. There was a tick system in place used by the registered manager to indicate support plans were in place and had been reviewed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good at the inspection dated 17 October 2016 and published in 22 November 2016.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see Safe, Responsive and Well Led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beckford Lodge on our website at www.cqc.org.uk.
The inspection took place on the 17 October 2016 and was announced, which meant the provider knew before the inspection we would be visiting. This was because the location provides supported living services. We wanted to make sure the registered manager would be available to support our inspection, or someone who could act on their behalf.
A registered manager was employed by the service. 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 actively involved in developing their care and support plans. Care plans were personalised and detailed the daily routines specific to the person using the service. Where people required support with their personal care they were able to make choices and be as independent as possible.
People had a range of activities they could be involved in. People were able to choose what activities they took part in and suggest other activities they would like to complete. Staff provided support as required.
Risks to people’s safety had been assessed and plans were in place to minimise these risks. Staff received training to help them identify safeguarding concerns and understand their responsibilities on reporting any concerns identified.
We looked at the arrangements in place to manage complaints and concerns that were brought to the registered manager’s attention. The service had a complaints procedure in place setting out how complaints could be made and how they would be handled. There had not been any complaints since the service had registered.
People’s medicines were managed safely and people were able to self-administer their medicines with some support from staff. Where required people were supported to access healthcare services to maintain and support good health.
There were sufficient staff to meet people’s care needs. Safe recruitment procedures ensured people were supported by staff with the appropriate experience and character. People were supported by staff that had access to a range of training to develop the skills and knowledge needed to carry out their roles. New staff were supported to complete an induction programme before working on their own.
People were supported to have a meal of their choice. They were supported with planning their weekly menu and shopping for their chosen food. Staff encouraged people to drink sufficient fluids.
There was a registered manager in post. The registered manager carried out regular audits to monitor the quality of the service.
People referred to the service were assessed initially by the registered manager. The 'needs assessment' considered communication, accommodation and living arrangements, relationships with, and views of others, diversity, social activities and support, caring responsibilities, finance, household management, health and emotional well being, with details of medications, dental and optical arrangements, nutritional needs, end of life choices and capacity.
The registered manager explained that the care and support visits were delivered with flexibility, to suit the needs and preferences of the people receiving the support.
People receiving the service acknowledged, in response to the annual survey, that they been involved in planning their care and support plan, they received the care that was agreed, and that the staff were respectful to them.
Staff confirmed that they had received supervision sessions on a monthly basis and that they were clear about what was expected from them, and they regularly received feedback on how they were progressing within their role. Positive comments were received about the provider, one member of staff said "they are fantastic and so supportive".
The manager told us that people were encouraged to do a lot of things for themselves but had support from staff with tasks such as bathing, shopping and dealing with other agencies. We were told this sort of support helped people to be independent and 'was driven by the person using the service.'
In the recent survey by the service, people said they appreciated their keyworker and wanted to keep the same one. People said they found staff were flexible and willing to change the ways they provided their support.
Staff told us they felt supported in their work, were encouraged to develop and had good opportunities for training.
The provider had set up systems for gaining feedback from the people who used the service and for monitoring the quality of service the people received.
We saw that risk assessments were used, to help plan how people could be encouraged to become more independent.
A person we met valued support with menu planning and shopping. They and their support worker had worked out ways of safely managing how to have hot meals when at home without support.
A person chose to have their regular support worker with them in their annual reviews with a care manager. This helped the person contribute to and understand the review process.
A person told us they valued always having the same support worker, who had built up a good knowledge of their needs, likes and dislikes. They also had a close working relationship with a relief worker, who covered any absence of the main support worker.