Beech Cliffe Grange

About the service

Beech Cliffe Grange is a residential care home providing support to adults with a learning disability and autistic people. At the time of the inspection there were nine people using the service. The service can support up to eleven people.

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

We looked at the key questions of safe and well led and found the service was able to demonstrate they were meeting the underpinning principles of Right support, right care right culture.

Right Support

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Support was planned in people’s best interests.

Risks associated with people’s care and support were assessed, monitored and managed to ensure people were safe. People were supported by sufficient staff to meet their needs and ensure people’s preferences were adhered to.

We found some minor concerns in relation to infection control; however, the provider took appropriate actions to ensure these concerns were rectified.

People’s needs were assessed, and support was provided in line with what people wanted and needed. People received good outcomes and met their health, social and emotional needs. People were supported by staff who knew them well. People received their medicines as prescribed.

Right Care

The management team and staff promoted person-centred care and ensured people’s privacy, dignity and human rights were upheld. Staff respected people and offered choices and supported them in making decisions. We found healthcare professionals had been referred to appropriately and staff ensured their support and advice was implemented.

Right culture

The ethos, values, attitudes and behaviours of leaders and care staff ensured people could lead confident, inclusive and empowered lives.

Staff felt supported be the management team and were confident when supporting people in situations where people could become distressed.

The overarching governance system included a series of audits which checked areas such as medication, infection control and the environment. Some issues identified during the environmental audit and infection control audit, had not been actioned and there was no timescale when these actions should be met. We recommended further detail and action was required to ensure the quality monitoring systems were effective.

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 12 January 2018).

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process. We also used this inspection to assess that the service is applying the principles of Right support right care right culture.

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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Beech Cliffe Grange on our website at www.cqc.org.uk’

Beech Cliffe Grange is a care home for younger people with a learning disability. It can accommodate up to eleven people. At the time of our inspection there were nine people living at the service.

The service had a registered manager. 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 received care and support from staff who understood how to keep them safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. Staff were available to meet people's needs and understood how to best support people them. Staff were knowledgeable about risks to people's well-being and knew how to manage them. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately. Infection, prevention and control systems were in place and effective.

Robust recruitment procedures ensured the right staff were employed to meet people’s needs safely.

People's rights were protected in line with the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager understood their responsibilities regarding this.

People received adequate nutrition and hydration to maintain their health and wellbeing. The premises were an older building and could be designed better; however, the provider was looking at ways to improve this.

Staff supported people with kindness, dignity and respect. People were supported to undertake a range of activities at the service and in the community.

People had the benefit of a culture and management style that was inclusive and caring. Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them.

People were asked for their views about the service, feedback received was acted upon. The registered manager, staff and senior management team undertook checks and audits of the service. Investigations of incidents and accidents occurred and any learning from these issues was implemented to help to maintain or improve the service provided.

Further information is in the detailed findings below.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Due to the complex needs of the people using the service we were unable to gain their views. Therefore we used a number of different methods to help us understand their experiences. This included observing how staff supported people, speaking with staff and a visitor and checking records.

Is the service safe?

We found people were encouraged to express their views and were involved in making decisions about their care and treatment. The staff we spoke with gave us good examples of how people were involved in making decisions about the care and support they received. We also saw staff encouraged people to be as independent as possible while offering the correct level of support needed.

The home was clean and fresh throughout. We saw there were effective systems in place to reduce the risk and spread of infection.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

We saw checks took place to ensure the service was operating safely.

Is the service effective?

People's health and care needs were assessed on a regular basis. We saw people who used the service and their relatives had been involved in writing plans of care and these were reviewed and updated.

Staff had received appropriate professional development. We saw they had access to a varied training programme that helped them meet the needs of the people they supported.

Is the service caring?

People were supported by kind, caring and patient staff. We saw staff interacting with people positively. They encouraged them to be as independent as they were able to be while providing support as needed. A visitor spoke positively about the care and support provided to their relative.

Care files contained good information about people's needs and preferences. This included the people important in their lives and their personal aims, as well as their aspirations and goals. These were clear and measurable.

Satisfaction surveys and review meetings had been used to enable people to share their views on the service provided. This helped the provider to assess if people were receiving the care and support they needed.

Is the service responsive?

Records showed people had access to a variety of social activities. During our visit we saw people going out into the community supported by staff or participating in stimulation at the home.

The home has a complaints procedure which was available to people using and visiting the service. No complaints had been recorded since our last inspection, but we saw several compliments about the service had been received.

Is the service well-led?

There was a quality assurance system in place to assess if the home was operating correctly. This included audits by the provider and external consultants.

Staff were clear about their roles and responsibilities. We saw staff had access to policies and procedure as well as a staff handbook. Most staff had received an annual appraisal of their work. However, documented staff support sessions had not been carried out on a regular basis. Staff training and development needs had been assessed to enable the provider to arrange future training sessions.

At this visit we found the provider had addressed the shortfalls we identified at our last inspection. The safeguarding policy and procedure had been reviewed and amended and all staff had received appropriate training in this subject. This had helped to make sure staff reported concerns promptly and appropriate agencies were alerted in a timely manner.

On this occasion we did not speak to people who used the service. However their experiences were captured through information received from the provider and the council, checking records and speaking with staff.

We were unable to gain the views of all the people who used the service when we visited due to their complex needs. Therefore we also observed how support was provided, reviewed records and spoke with staff to help us understand their experiences.

During our inspection we found that people received the care and support they needed. Each person had a care plan which detailed the support they needed, their preferences and any risks associated with their care. People were involved in a variety of social activities and carried out day to day living skills, such as shopping and preparing meals.

We saw that people received a varied menu and their preferences had been taken into account. We saw staff monitored what people were eating and drinking to make sure they received sufficient nourishment.

From our observations, discussions with staff and review of documentation we found there were enough staff on duty to meet people's needs. We saw people received the support they needed in a timely manner.

We saw there were systems in place to gain peoples views and check if staff were following company policies.

A complaints procedure was available to people who used and visited the service. Records we looked at showed any concerns raised had been investigated.