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Inspection carried out on 9 March 2020

During a routine inspection

About the service

Beechwood is a residential care home providing personal care to eight people at the time of the inspection. This is the maximum number of people the service can support.

Services for people with learning disabilities and or autism are supported

The service is larger than recommended by best practice guidance. However, we have rated this service outstanding because the provider arranged the service in a way that ensured people received individual, person-centred care and were fully supported to maximise their independence, choice, control and involvement in the community.

People’s experience of using this service and what we found

People received highly personalised care from especially kind and considerate staff. People, relatives and professionals held the service in high regard. They praised the registered manager and staff team for the care and commitment shown to people. One relative commented, “[Family member] has been with ESPA 19 years and has made such progress. Beechwood is just wonderful, [family member] has been encouraged to be as independent as possible. It is just magic”

The registered manager and staff regularly went above and beyond to ensure they delivered person-centred care to meet people’s needs and preferences. People participated in meaningful activities and had regular opportunities to access the local community. This included attending social groups and to volunteer.

People and relatives told us Beechwood was a safe place. Staff understood the safeguarding and whistle blowing policies and felt confident to speak up if needed. The service had enough staff to meet people’s individual needs. New staff were recruited safely. The registered manager monitored incidents and accidents to help keep people safe. People received their medicines safely. Staff completed various risk assessments and health and safety checks to enhance people’s safety.

Staff received good support and had access to a comprehensive training programme. Staff supported people to have enough to eat and drink. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager showed effective leadership. People, relatives and staff felt able to speak with them at any time. The provider had an effective quality assurance process to help ensure people received excellent care which met their individual needs.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

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 (published 13 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 27 February 2017

During a routine inspection

Beechwood is a large detached house that has been converted into four spacious, fully self-contained apartments over three floors. The apartments accommodated between one and three people. The service is registered to provide up to eight places, and there were eight people living there at the time of this inspection. The service provided support for people with autism spectrum conditions. The home had been open for three years.

At the last inspection, the service was rated Good. At that time we recommended risk assessments were brought up to date as people were being supported to become more independent. During this inspection we found these had been improved and were up to date.

At this inspection we found the service remained Good.

People said the service was "brilliant". They felt the service was very good for them and helped them to become more independent. People were fully involved in planning the individual service they each received, as well as in the running of their shared apartments.

People were empowered to make all their own decisions about their daily lives. They chose which staff member they would like to support them with an activity, if this was needed and practicable.

Staff valued each person’s individuality, promoted their development and celebrated their successes.

People were involved in a wide range of purposeful occupational and vocational activities including paid and voluntary work, community-based classes and leisure activities. People felt they were engaged in meaningful occupations, such as helping at food banks, which put something back into their community.

People had information about the service and policies that were relevant to them in easy read format. This included information about how to make a complaint. People said they felt comfortable talking to the registered manager or staff about any issues they may have.

People said there were enough staff and they felt safe and comfortable with them. The provider made sure only suitable staff were recruited and people were included in the interviews for appointing new staff.

People were supported with their medicines in the right way for each person. People who could manage their own medicines were provided with the facilities to do this.

Staff had specific training in autism spectrum condition and were clear about how to support people to increase their independence. Staff had regular supervision and appraisals to help them with their professional development.

People said staff were caring and supportive. There were good relationships between people and support workers.

People were given the right information and encouragement to lead a healthy lifestyle. They were fully involved in shopping and preparing their own meals.

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.

There was a registered manager in place who was experienced in providing care services for people with autism. People and staff felt the manager was open and approachable, and listened to their views.

The provider had an effective quality assurance system which continuously identified and promoted any areas for improvement.

Inspection carried out on 8 January 2015

During a routine inspection

This was the first inspection of this new service which was registered with the Care Quality Commission on 23 February 2014.

Beechwood is a large detached house that has been converted into four spacious, fully self-contained apartments over three floors. The apartments accommodated between one and three people. The service is registered to provide up to eight places, and there were eight people living there at the time of this inspection.

Beechwood had a registered manager in place. 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 positive about the service they received. They felt safe and comfortable with staff. One person described the home as “a really lovely place to live”. There were enough staff to support people to go out to their chosen occupations and activities, and to promote people’s independence in all aspects of daily living. But risk assessments about people's independent living skills were out of date and did not reflect their current abilities.

The provider made sure only suitable staff were employed who had been checked and vetted. People were invited to be involved in the interviews of new staff so they felt included in decisions about the home.

Staff were clear about how to recognise and report any suspicions of abuse. They told us they were confident that any concerns would be listened to and investigated to make sure people were protected. Potential risks to people’s health and safety were being managed, but some people’s risk assessment records were out of date because they were more independent now. People who could manage their own medicines were supported to do so; otherwise staff managed these in a safe way for people.

People told us they had learnt to do much more for themselves since moving to this service. Social care professionals felt the service was effective at supporting people in the right way towards their individual goals. Staff also felt the service was successful in supporting people to increase their independent living skills. People described how they were fully involved in deciding what and when to eat, doing their own food shopping and preparing meals, with staff support where this was necessary.

Staff had relevant training and supervision to care for people in the right way. New staff received in-depth induction training when they started work which included the vision and values of the service. All staff received autism-specific training to help them understand the challenges faced by people with autism. Staff said they felt “supported” and “valued” by the registered manager and by the provider.

People told us they felt their privacy and dignity was respected. People had their own keys to their apartments and to their bedrooms and staff asked for permission to enter these. Staff were respectful of people’s abilities and described people as “the decision-makers”. All the people we spoke with said staff were “lovely”, “helpful” and “very nice”. Each person had a key worker and they were involved in choosing which staff member they wanted to support them.

People enjoyed a range of vocational activities outside of the home. Some people had been supported to find paid or voluntary work and staff also helped people to find activities in the local community that they might be interested in.

People had information about how to make a complaint or comment. They said they would comfortable about telling the registered manager if they had any concerns and felt confident these would be acted upon. There had been no complaints about the service since it opened.

The registered manager had an open door policy and made herself available to people and staff. People spent time chatting with the registered manager and staff about their plans. There was an open, friendly and calm atmosphere in the home where people were encouraged to say what they felt about the service. The provider had a quality assurance system that included unannounced visits to the home by other managers, as well as audits of the health and safety of the service. This meant the provider checked to make sure the care people received was safe and effective.