Beech Court

Beech Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of our inspection five people were living in individual flats within Beech Court. Beech Court supports people with different needs and backgrounds, including people with learning disabilities, physical disabilities, mental health needs, autism spectrum disorders and people who display behaviours that challenge others.

People’s experience of using this service:

The people who received support from Beech Court received personalised care which met their needs. People’s care plans contained personalised information which detailed how they wanted their care to be delivered. Staff knew people well and expressed care and affection for them when speaking with us. Staff knew people well and worked hard to enable people to share their views and live active lives as independently as possible.

The outcomes for people using the service reflected the principles and values of Registering the Right Support in the following ways; people’s support was focused on them having as many opportunities and choices as possible.

People’s relatives spoke highly of the service. The service had strong person-centred values and placed people at the heart of their work. People had access to a stable staff team they knew well and achieved positive outcomes and strong relationships.

Risks to people’s health, safety and wellbeing were assessed and management plans were put in place to ensure these were reduced as much as possible.

People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

There was strong leadership at the service and relatives and staff spoke highly of the registered manager. There was a positive culture at the service where staff felt listened to and supported.

The registered manager had quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.

People were supported by kind and caring staff who worked hard to promote their independence and sense of wellbeing. Staff were provided with the training, supervision and support they needed to care for people well.

More information is in the full report

Rating at last inspection: This service was last inspected in April 2016 and was rated good overall and in every key question. The report was published 24 June 2016.

Why we inspected: This inspection was scheduled based on the registration date of the service.

Follow up: We will continue to monitor the intelligence we receive about the service. If any concerning information is received we may inspect sooner.

The service provides care and support for up to 6 people who may have a learning disability, a mental health condition or physical disabilities. Some people using the service displayed behaviours that were challenging to others and required interventions from staff to keep them and others safe. Some people could not speak with us due to their difficulty in communicating effectively.

There was a registered manager at Beech Court. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Record showed the provider monitored incidents where behaviours challenged and responded promptly by informing the local authority safeguarding team, the Care Quality Commission (CQC), behavioural support teams and advocacy agencies.

Staff were knowledgeable about the requirements of the Mental Capacity Act 2005 and worked with advocacy agencies, healthcare professionals and family members to ensure decisions made in people’s best interests were reached and documented appropriately

People were not unlawfully deprived of their liberty without authorisation from the local authority. Staff were knowledgeable about the deprivation of liberty safeguards (DoLS) in place for people and accurately described the content detailed in people’s authorisations.

People were protected from possible harm. Staff were able to identify the different signs of abuse and were knowledgeable about the homes safeguarding processes and procedures. They consistently told us they would contact CQC and the local authority if they felt someone was at risk of abuse. Notifications sent to CQC and discussions with the local authority safeguarding team confirmed this.

Staff received training appropriate to people’s needs and were regularly monitored by a senior member of staff to ensure they delivered effective care. Where people displayed physical behaviours that challenged others, staff responded appropriately by using redirection techniques and only used physical interventions as a last resort. The provider monitored incidents where physical interventions were used and had informed the local authority and healthcare professionals when required.

Staff interacted with people and showed respect when they delivered care. Healthcare professionals consistently told us staff engaged with people effectively and encouraged people to participate in activities. People’s records documented their hobbies, interests and described what they enjoyed doing in their spare time.

Records showed staff supported people regularly to attend various health related appointments. Examples of these included visits to see the GP, hospital appointments and assessments with other organisations such as the community mental health team.

People received support that met their needs because staff regularly involved them in reviewing their care plans. Records showed reviews took place on a regular basis or when someone’s needs changed.

We consistently observed positive interaction between staff and people.

We considered our inspection findings to answer questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

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

Is the service safe?

Care plans and risk assessments provided detailed strategies in order to support people who may exhibit challenging behaviours. The provider had ensured support workers had received appropriate training in order to deliver safe and effective care.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. The manager understood when an application should be made and how to submit one; and was aware of recent changes to the legislation.

Is the service effective?

Support workers had a good understanding of people's needs and told us they felt the care plans and risk assessments in place were effective. We found the provider had effective systems in place to check and reassess the suitability of care workers to work with vulnerable people. A human resources manager said: "Staff don't start work unless they have been checked properly and we have a system in place to monitor people's eligibility to work at this service".

The provider had effective systems in place for obtaining consent and acted in accordance with the law. We saw documentation that showed the provider held "best interest" meetings to ensure people were supported effectively.

Is the service caring?

People's life style choices, preferences, interests, and different needs had been written in their plans and care and support had been provided to make sure these were upheld. We observed support workers engaged with people in a patient and respectful manner. One person we spoke with said: "It is good here, the staff do care".

Is the service responsive?

People's needs had been assessed before they received care.This included involving them in regular care reviews and keeping them or their relatives informed of changes, if appropriate. We saw that people's health needs were monitored and if necessary the support of health care professionals obtained.This helped to ensure that the delivery of care was responsive to people's needs and based on up to date information and guidance. The records showed that any concerns were followed up and relevant action was taken.

Is the service well led?

There were clear lines of accountability within the service. We saw evidence that regular audits of the quality and safety of the service were carried out. For example, there were audits of the care plans and care workers training records.

Staff were knowledgeable about the whistleblowing policy and were confident that the provider would respond appropriately to any allegation of abuse. One relative said "I am absolutely sure there is no abuse that happens it that home. I visit regularly and I am happy with what I see".

There were enough qualified, skilled and experienced staff to meet people's needs.The registered manager told us that the staffing levels were determined by the needs of the people that lived in the home.

Records were kept securely and could be located promptly when needed. We spoke with three members of staff who all told us that people's care records were located safely in the office and told us that they could access the records when necessary.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We saw information in the care planning documents that people using the service and/or their representatives had been involved in the process.

Assessments of people's needs had been completed by the registered manager who had recorded the needs and support that people required. We saw that all medicines were stored safely in people's flats in locked medicine cabinets for which staff held the keys. Appropriate checks were undertaken before staff began work.

During our visit we looked at eight staff files. These all showed that checks had taken place. Safeguards included photographic identification, previous employer references, Criminal Records Bureau (CRB) checks and a full employment history.

People who use the service, their representatives and staff were asked their views about their care and treatment and they were acted upon. Information about how to make a complaint was contained in the Service Information Pack which was also provided in an easy read version