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Inspection carried out on 7 March 2018

During a routine inspection

Beck House is registered to provide accommodation and personal care for up to 23 younger adults with a learning disability, autistic spectrum disorder and associated complex needs. There were 18 people at the home on the day of our visit.

There was a registered manager for the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

The care service was 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. The service was homely and intimate and therefore allowed more personalised support. Its location also supported these principles by being close to shops, other amenities and public transport links that reduced risks of social isolation and strengthened links with the local community.

People, relatives and health professionals commented very positively about the caring ways that staff supported people at Beck House. We saw this through observations of people and staff together. We also saw this in the clear positive outcomes for the people at the home. Relative’s told us how their relatives was always very happy to come back to Beck house and was always greeted with warmth and kindness by the staff.

We saw how staff were very compassionate, kind and sensitive. Staff had built up warm relationships with the people they supported. People were seen to be very relaxed in the presence of staff. Relatives and professionals confirmed staff looked after people to a very high standard.

People were supported with their needs by a staff team who were skilled at understanding each person's needs and aspirations. The team had a really good understanding of each person’s complex learning disabilities and certain people’s sensory impairments. Staff supported people to be as independent as possible in all areas of their life. This was through positive engagement with them. Information was available in each person's preferred format including policies and procedures such as activity programmes and complaints.

People received a service that was flexible and adapted to their changing needs and wishes. This enabled people to have positive outcomes in their daily living. People felt a part of their community, and valued living a meaningful life both in and away from Beck House. Each person had their own very flexible timetable of activities. These were reflective of people’s hobbies and interests. They also included goals that people could achieve. People were well supported to develop confidence and social skills by interacting with peers regularly. People were also supported by staff to plan trips to visit relatives that did not live locally and to go to places and venues further afield and abroad.

The registered manager and provider were highly praised for their support. People, staff and relatives felt they were extremely open and approachable. Staff felt part of an open and empowering culture where they were respected as individuals and as part of a team. Relatives had very positive views of management. They said they always felt welcomed and kept up to date with how people were.

There was a clear person-centred culture that was fully embraced by the staff team. The staff were delivering a consistent approach and were encouraged to support people to try new things and to make positive changes in their lives. The provider, the registered manager and staff team all had a very strong understanding of positive risk taking. There were positive behaviour support plans in place. These helped ensure that staff supp

Inspection carried out on 27 January 2016

During a routine inspection

Beck House provides accommodation and personal care for 23 people. People who live at the home have a learning disability. There were 20 people living in the home at the time of the inspection. This was an unannounced inspection, which meant the staff and provider did not know we would be visiting. This inspection took place on the 27 and 28 January 2016.

There was a registered manager in post. They had managed the service for the last fifteen years. 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.

Some of the people living in Beck House had a profound physical disability and therefore did not communicate verbally. In order to understand their experiences we observed staff interactions with people during our inspection. Staff were caring and attentive to people.

People were treated in a dignified, caring manner which demonstrated that their rights were protected. Where people lacked the capacity to make choices and decisions, staff ensured people’s rights were protected by involving relatives or other professionals in the decision making process. The registered person had ensured that appropriate applications had been made in respect of the Deprivation of Liberty Safeguards and these had been monitored effectively.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the equipment, fire systems and safe recruitment processes. Suitable arrangements were in place to ensure people received their medicines safely.

People were supported by sufficient staff that had received appropriate training to enable them to support people effectively. Staff were supported by the registered manager and had regular individual supervisions sessions with a senior member of staff. Team meetings were organised monthly enabling staff to keep up to date, discuss the running of the home and the welfare of the people they supported.

People had a care plan that described how they wanted to be supported in an individualised way. These had been kept under review. Care was effective and responsive to people’s changing needs. People had access to healthcare professionals when they became unwell or required specialist equipment. People’s nutritional needs were being met. People were offered a varied and nutritious diet. Improvements were required in respect of the food and fluid charts as there were gaps in the daily recordings. The registered manager told us this would be addressed but there was no one at risk of malnutrition.

Staff were knowledgeable about the people they supported and spoke about people as individuals. People were supported to maintain contact with friends and family and take part in activities both in the home and the local community. Staff and the registered manager were looking to make improvements to the activities organised in the home. Systems were in place to monitor this.

Systems were in place to ensure that any complaints were responded to. People’s views were sought through monthly meetings and an annual survey. Surveys were sent to relatives and information collated to improve the service.

The staff, the registered manager and provider completed regular quality checks on the systems that were in operation in the home to ensure they were effective. Staff were committed to providing care that was tailored to the person.

Inspection carried out on 28 January 2014

During a routine inspection

The majority of the people living at Beck House had complex needs and some of the people we saw were unable to tell us about their care. From the observations we carried out, we saw people were treated with warmth and respect and that staff engaged with people in a positive way.

People were walking freely around parts of the home, or were spending time in communal areas, while others went out to individual activities. We spoke with one person who told us about their interests and said they were happy with the activities they were involved with.

Care plans recorded people's individual care needs, preferences and their health needs. The staff team had been trained, supervised and appraised on a regular basis. Staff we spoke with demonstrated their knowledge of people’s needs and knew how to report suspected abuse and allegations of abuse to the appropriate agencies.

We spoke with two family members who confirmed their relatives' needs were met, and that they were informed and involved in their relatives' care. Comments made included “I am never ceased to marvel at the young people who work here. Their care and feeling has always been marvellous, they are brilliant" and “Staff are approachable, I know most of them”.

There were systems in place to monitor the quality of the service being provided to people who lived in the home. We saw the outcome of questionnaires sent to family members, asking them about the care provided and these showed positive feedback.

Inspection carried out on 26 January 2013

During a routine inspection

We were introduced to people throughout the day and they welcomed us to their home. They interacted with staff in front of us and people were confident and assertive in their surroundings.

There was a happy, busy atmosphere in the home. We saw staff interact in a caring way and people living at home responded to this. Staff were confident and knowledgeable about people's past social and medical history and what care and support they required.

Their passion, knowledge and enthusiasm of the service and the people in their care was evident. Staff morale was positive and they were 'proud' of the service they provided as a team so that the quality and safety of people was maintained.

The manager came to assist us when they heard that we had arrived at the home and was available throughout the day. They were very knowledgeable about people in their care, the policies, procedures and systems in place to ensure the continued smooth running of the home.

Inspection carried out on 26 March 2012

During a routine inspection

People were unable to fully tell us how they had been involved in decisions relating to their care due to the complexity of their learning disability. However, we were able to observe interactions between members of staff and the people they support we also spoke with staff and looked at care records.

We observed staff interacting with individuals in a positive and inclusive manner and at a pace suitable to the individual. Staff were knowledgeable about the support needs of the individuals.

Staff were supporting people in a dignified and respectful manner and interacting with individuals in a positive manner. People were encouraged to participate in conversations.

Staff told us how they supported people to make decisions on a daily basis in respect of how they wanted to spend their time, giving choices in respect of what to eat and drink and what to wear. Care plans included how people communicated and how they made decisions.

People were supported with meaningful activities including attendance at day centres, swimming, shopping trips, lunch trips, skittles, arts and crafts and cooking. Staff told us that the activities were kept under review to ensure they were appropriate for the individual. People were also offered opportunities to go to the theatre, the pub or the cinema in the evenings.

People were supported to have an annual holiday with staff support. This was confirmed in conversations with staff and the records viewed. Where individuals do not have an annual holiday either through choice or health needs then day trips were organised.

People were supported to maintain contact with relatives and friends.

We observed people moving freely around their home. Some people were in wheelchairs and they were supported to move around their home by the staff and were given opportunities to sit in the garden, then later in the dining room and/or the lounge area.

People were registered with a GP and attended health care appointments including the dentist, optician and chiropody. Other health care professionals were involved in people’s care including the community learning disability team and a consultant psychiatrist.

People looked well cared for however, one person had food from lunch time on their clothes. The senior care staff responded promptly once this was pointed out in the late afternoon. We were told that people were supported to wear aprons where required and offered a change of clothing however this particular person had been missed.

People had been supported to personalise their bedrooms including pictures, furniture and were involved in the decoration of the room. Each person had a single bedroom with an en suite. Each person had a picture or a photograph beside their bedroom door to enable them to easily locate their room.

The staff we spoke with were aware of their responsibilities regarding safeguarding people who use the service and would use the whistle blowing procedure if required.

Information on reporting safeguarding concerns were available to staff including access to the local authority procedures for reporting abuse.

People were supported by competent staff. Whilst we found there was sufficient staff during the day we have asked the provider to review the night staffing arrangements.