The Beach

Updated 12 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two adult social care inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Beach is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Beach is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

There was no registered manager in post at the time of the inspection.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 19 June and ended on 26 June 2023. We visited the location on 19 June and completed telephone surveys of people’s relatives on 22 June 2023.

What we did before the inspection

We reviewed information we had received about the services performance since its registration. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met with 7 people who the service supported and spoke with 8 staff, the deputy manager and the providers Improvement and Outstanding Lead, Interim Regional Director and Divisional Director for adults. We also spoke by telephone with 5 people’s relatives.

We looked at records relating to people’s care and the management of the service. This included 4 care plans and associated risk assessments, medicine administration records (MARs) and staff recruitment and training records.

We also reviewed information about the management of the service and quality assurance audits. This information was reviewed in detail after the site visit. We also sought written feedback from Heath and social care professionals.

Updated 12 August 2023

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

About the service

The Beach is a residential care home that provides personal care and support for up to 14 autistic people, people with a learning disability or both. At the time of the inspection there were 10 people living at the service.

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

Right Support

Staff did not have the skills necessary to support people while they were distressed and a replacement structure built on one person’s balcony did not meet their needs or ensure their dignity and privacy was respected.

Staff understood local safeguarding arrangements and knew how to raise any safety concerns. Care plans included guidance for staff on how to protect people from identified risks.

Infection control risks were appropriately managed, and people were encouraged and supported to participate in household tasks.

People were supported to access the community and their local environment regularly and to participate in a varied range of activities. People were supported to make decisions in relation to how the spent their time and their choices were respected.

Right Care

The provider had not ensured decisions were consistently made in people’s best interests and did not have systems in place to gather information necessary to demonstrate compliance with Deprivation of Liberty authorisations.

People were comfortable with their support staff and relatives told us people were happy. Staff were kind and patient. They supported people at their own pace and encourage people to do things for themselves.

People were regularly supported to meet up with friends and relatives and visiting was encouraged.

Right Culture:

The service did not employ sufficient staff to meet people’s needs and agency staff were regularly used to ensure staffing levels were safe. Relatives reported that this lack of staff consistency was difficult for people and the provider recognised this challenge. As a result, agency staff were now being booked one month in advance to enable agency staff to get to know the people they supported.

Recruitment practices were safe and 3 additional staff and a deputy manager were in the process of being appointed.

There was no registered manager in post and there were vacancies for both of the service’s senior carers and a positive behaviour support lead. At the time of the inspection the service was being led by a deputy manager who had taken on this role 5 weeks prior to the inspection.

Records had not been regularly reviewed and there was a lack of effective systems in place to ensure where learning was identified it was acted upon. People had not been supported to promptly access dental appointments when needed.

The provider’s quality assurance systems had identified issues in relation to the service’s performance prior to the inspection. An action plan had been developed to address these issues and additional leadership support was being arranged.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

In September 2022 the provider was asked by the Local Authority to take over the operation of this location from another provider. This service was registered with us on 21 November 2022 and this is the first inspection.

The last rating for the service under the previous provider was requires improvement, published on 6 August 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We needed to check on the actions taken by the new provider to improve performance since they took on responsibility for the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches of the regulations in relation to Person-centred care, the Mental Capacity Act and Good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, and we will meet with the provider regularly. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk