Beaufort House

The inspection was conducted on 17 August 2018 and was unannounced.

Accommodation was arranged over three floors which could be accessed by a staircase. There was a large open plan communal area for social interaction and a quiet room for people to use if required. People also had access to an enclosed garden which had seating and tables available.

A registered manager was in post. 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.

At our last inspection in August 2017, we gave the service an overall rating of ‘Requires improvement’ and identified breaches of regulation 17 ‘Good Governance’ and Regulation 18 ‘Staffing’ of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the inspection, the provider wrote to us, detailing the action they would take to address the concerns.

At this inspection we found that appropriate actions had been taken and therefore the service was no longer in breach of these regulations.

People felt safe living at Beaufort House. Staff knew how to identify, prevent and report abuse. Safeguarding investigations were thorough and identified learning to help prevent a reoccurrence.

There were sufficient staff employed to meet people's needs; keep them safe and provide them with person-centred support. Appropriate recruitment procedures were in place to ensure only suitable staff were employed.

Individual and environmental risks to people were managed effectively. Risk assessments identified risks to people and provided clear guidance to staff on how risks should be managed and mitigated.

Arrangements were in place for the safe management of medicines. People received their medicines as prescribed. The home was clean and staff followed best practice guidance to control the risk and spread of infection.

People’s needs were met by staff who were competent, trained and supported appropriately in their role. Staff acted in the best interests of people and followed legislation designed to protect people’s rights and freedom.

Procedures were in place to help ensure that people received consistent support when they moved between services.

Staff developed caring and positive relationships with people and were sensitive to their individual choices. People were treated with dignity and respect and staff protected people’s privacy.

People were provided with individualised, person-centred care. Care plans contained detailed information to enable staff to provide care and support in a personalised way. People were empowered to make choices about all aspects of their lives. They had access to a range of activities suited to their individual interests.

People told us they were happy living at the home and had confidence in the management. People, family members and professionals reported that there had been improvements made in relation to the running of the service since the last inspection.

Staff were organised, motivated and worked well as a team. They felt supported and valued by the registered manager.

The provider was fully engaged in running the service and invited feedback from people, their families and professionals to help drive improvements. There were a clear auditing processes in place. The quality of the service was monitored and appropriate actions were taken when required.

The service worked in partnership with other agencies to help ensure that there was a team approach to providing effective and appropriate care to people.

Beaufort House provides accommodation and support for up to six people, who have a learning disability or an autistic spectrum disorder. At the time of the inspection five people were living at the home.

A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

At the time of the inspection the service did not have a registered manager in place. A temporary management team had been put into place, which had taken over the overall running of the service. The current running of the home was being overseen by a temporary manager (who will be referred to as ‘the manager’ throughout this report) and a temporary head of care (who will be referred to as ‘the head of care’ throughout this report). The manager and head of care was from a neighbouring home also owned by the provider.

Quality assurance systems had failed to address shortfalls found at this inspection. The provider had asked for feedback from people’s families but had failed to address their concerns. Families did not feel listened to or involved in the care of their relatives.

There were not effective systems in place to ensure that staff received training and supervision necessary to their roles.

Records relating to peoples' care and treatment were not fully completed and monitored to identify omissions and to analyse concerns. Family or professional contact had had not always been recorded.

Where accidents, incidents, and near misses had occurred there was not an effective system in place to ensure that appropriate action was taken to mitigate any risks or prevent reoccurrence.

The manager and provider had sought feedback from people and families using the service. However were issues and concerns were raised there was no process in place which demonstrated that concerns or issues had been addressed.

People were supported to have enough to eat and drink. However were not always encouraged or supported to have healthy diets. Staff supported people to eat and drink, when necessary in a patient and friendly manner.

People and their families told us they felt the home was safe. Staff had received safeguarding training and was able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. They were personalised and provided sufficient information to allow staff to protect people whilst promoting their independence.

There was enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff sought consent from people before providing care and followed legislation designed to protect people’s rights.

Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect.

Staff were responsive to people’s communication styles and gave people information and choices in ways that they could understand. They were patient when engaging with people who could not communicate verbally and who used a variety of signs, noises and body language to express themselves. Staff were able to understand people and respond to what was being said.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.