We carried out an unannounced inspection of this service on 9 June 2015. When we last inspected the service on 26 June and 1 July 2014 we found that the provider had not taken proper steps to ensure people who used the service had access to information in a suitable format to support their autonomy and independence. We also found the provider did not have sufficient arrangements in place to ensure that people were protected from the use of control or restraint that was unlawful and there were no proper risk assessments in place relating to the care and welfare of people who used the service.
Following the inspection on 26 June and 1 July 2014 the provider sent us an action plan to tell us the improvements they were going to make.
At the inspection on 9 June 2015 we found that satisfactory improvements had been made to promote people’s autonomy and independence and found that people were protected from the use of unlawful control and restraint.
We found improvements had also been made to the format of the risk assessments although we made recommendations that they should be more person centred and enabling to support people’s autonomy and independence in line with their wishes.
Beckdale House is a residential care home providing 24 hour personal care and accommodation for 9 people from 16 years of age, with a learning disability and associated health needs. The accommodation is based over four floors which are split into six single self contained flats and one shared flat for three males. At the time of the inspection, seven people lived in the flats and there were two vacancies.
There was a registered manager in post at the time of this inspection. 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.
Support staff were confident in describing the different kinds of abuse and the signs and symptoms that would suggest a person they supported might be at risk of abuse. They knew what action to take to safeguard people from harm.
A limited system was in place to identify and assess the risks associated with providing safe care and support. We found more work was needed to ensure there were risk assessments in place to enable people to achieve their goals as well as to support them with associated risks through behaviours. We saw risks had been discussed with the people who used the service and action agreed to keep people safe from accidental harm. Where people did not agree this had also been recorded. We have made a recommendation in line with National Institute for Clinical Excellence (NICE) guidance.
Staff working in the home understood the needs of the people they supported. They supported people in making choices and their own decisions as much as possible. Three people living in the home said they were generally happy with the care provided.
Staff understood people’s communication needs and supported people to make choices about the food they wanted to eat and activities they wanted to participate in.
We observed that people were supported to carry out household tasks and two people using the services were supported to access the local community during our inspection.
People who used this service received safe care and support from a trained and skilled team of staff. New staff received a comprehensive induction along with regular support and mentoring from more senior staff following their appointment. Staff fully understood their caring responsibilities and they demonstrated respect for the rights of the people they supported. We observed positive interactions between people and staff. We saw staff being kind and thoughtful, involving people in conversations. Healthcare professionals such as general practitioners (GPs), dentists, opticians, psychologists and psychiatrists were also involved in people’s care.
During our visit we saw examples of staff treating people with respect and dignity. People using the service and their relatives were consulted and involved in assessments, care planning and the development of the service. Staff told us their managers were approachable and treated them as part of the team. We have made a recommendation about individual assessments and paperwork.
We saw evidence that many aspects of the care and support were based on best practice guidance, such as the recent appointment of infection control champions, whose responsibility was to ensure high standards were maintained by the staff team. The registered manager had developed an effective system of quality assurance, which measured the outcomes of service provision. Staff, and relatives had been included in this process and their feedback had been used to make improvements to the way the service was provided.