BEAM ABA Services

Beam ABA Services provides personal care and support to children and young adults who have a learning disability up to the age of 31. They specialise in supporting children and young people with autism. At the time of our visit BEAM ABA provided care and support to 25 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were eight children and adults receiving personal care at the time of the inspection. Most of this care was provided in London but care was also provided in Birmingham.

BEAM ABA is a specialist provider which aims to improve the lives of children and young people who have complex behavioural needs using the evidence based practice of Applied Behaviour Analysis (ABA). ABA refers to interventions that are developed from a scientific discipline called behaviour analysis. Typically, these interventions aim to build skills and help to replacing inappropriate behaviour with an alternative.

BEAM ABA uses intensive ABA techniques provided by highly trained care staff and through a detailed assessment from which a behaviour plan is developed. Work with children and young people is tracked using specific data collection applications. This allows any changes in behaviour to be analysed and behaviour plans modified at short notice. They also provide support for family members and teachers within school to enable children and young people to take part in family life, school and activities within the community.

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

None of the children and young people receiving personal care were able to communicate verbally. We visited one family home to observe and we spoke with other family members. All the family members we spoke with said that Beam ABA Services involvement meant that the quality of life of their loved ones and the whole family had improved.

BEAM ABA used an initial assessment tool which was exceptionally effective in recognising and addressing people’s needs. The assessment completed by highly trained Beam ABA consultants aimed to gather information on how people managed their needs in their usual environment, their home, school and the community they lived in. Gathered data was used to formulate detailed behavioural plans. The plans were used by allocated staff to help people to develop basic life skills and reduce behaviours that challenge. Behavioural plans were prepared in collaboration with family members and were reviewed at intervals suitable for each person’s needs. This helped people to become as independent as possible and participate in their family life more.

Staff continuously supported people to develop. BEAM ABA used a progressive online software which allowed staff to promptly exchange information about people and to gather data about the effectiveness of interventions they provided. Based on extensive observation of people staff proactively suggested new support ideas to ensure people received care that was all-rounded and effective. Staff were dedicated and engaged their own initiative and creativity to provide the most effective support to people. Because of staff interventions people were able to do things that were often difficult to do for people with Autism, behavioural difficulties and other special educational needs. This included meeting developmental goals which were similar to their age group, accessing activities in the community, participating in lessons at school and meeting their basic self-care needs. External professionals confirmed staff went over and above to ensure people lived a good life. This helped people to be an integral part of the community they lived in.

A further part of the service was supporting children and young people to express their views, so their voice was heard. Staff supported people to communicate their needs to teachers at school. Children and young people were supported to make their own decisions with the use of various electronic aids, and when possible to say what they wanted and how they wanted it. This was done gently, respectfully and with the belief that people could speak for themselves. Staff were highly enthusiastic about progress made by people. Many of them told us this was the main reason why their continued in their professional careers with Beam ABA. Family members thought staff were excellent in communicating with people and supporting people with development of their communications skills.

Another key part of BEAM ABA’s service was supporting families in developing relationships with their loved ones. This was achieved by the provision of specialist training for families on ABA techniques and through ongoing dialogue with family members on the best ways of supporting people both at home and in community settings such as schools.

BEAM ABA’s approach involved the provision of care from highly skilled and well trained staff. Staff had regular training. It included certified and degree level qualification in using ABA techniques and other accredited trainings. Families thought staff skills and experience played an important role in progress and development achieved by their relatives. One family member said, “It's very reassuring to me that many of the staff have degrees in autism and applied skills to work in the field. I've always been impressed with the calibre of the staff.” Staff had regular supervision and observations by senior staff and managers at the service. We saw that supervision focused on the observation of staff and their skill at following the ABA techniques.

Staff were caring and always ensured that people’s rights had been met and their diversity had been respected. Family members and staff told us most of the personal care provided included prompting children and young people to do things for themselves. For example, going to the toilet and washing hands afterwards. The data we were shown detailed the hours of input taken to build children and young people’s skills. One person’s plan included five years of input and we could see the progression from one personal care skill to another.

The service worked closely with other professionals so that people could receive effective and consistent support in various settings. These included working with health and social care professionals, school and community staff and other professionals working in locations visited by people who used the service. Consequently, it was easier for people to become a part of the community they lived in.

The service provided safe care to people. There was a safe recruitment process in place to protect people from unsuitable staff. Staff understood how to recognise abuse and they knew what action to take if they thought people were at risk of harm for others. Medicines were managed safely. Risks to health and wellbeing of people, staff and the public had been assessed. Staff were provided with guidelines on how to minimise these risks.

People were supported to have enough food and drink that met their dietary requirements. Staff were helping people to develop skills, so they could participate in meals and drinks preparation and as much as possible to be independent in meeting their nutritional meals. When needed people were supported to have access to health professionals to ensure their health needs had been met with no delay.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a clear managerial and staff structure at the service and each employees’ role and responsibilities had been clearly defined. Staff were effectively supported and encouraged to participate in service development. The regulatory requirements had been met. The service dealt with complaints promptly and according to the provider’s policy.

The BEAM ABA mission and vision, to improve the lives of young people with complex behavioural needs, was evident in their structure and governance. The service had a range of quality assurance systems in place to carry out continuous review of staff skills and outcomes for people who used the service. The service carried out continuous improvements to ensure they learnt from accidents and incidents and when things went wrong.

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 April 2017).

Why we inspected: This was a planned inspection based on the previous rating. The overall rating for the service has changed from Good to Outstanding. This is based on the findings at this inspection.

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.

The service was last inspected in 2013 at their old location and was meeting all of the regulations that were looked at during that time. Since the last inspection the service had re-located to new offices.

BEAM ABA Services provides personal care and support to children and young adults between the ages of two to 23 years with learning disabilities, specialising in supporting children with autistic spectrum disorder. There were 29 children and young adults using the service at the time of the inspection. Care packages were being delivered not only in London but also in Bristol and Manchester with the provider’s main office based in North London.

There was a registered manager in place at the time of the 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.

BEAM ABA Services work with individuals with Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD) and other complex behavioural needs. Applied Behaviour Analysis (ABA) therapy aims and supports to bring about meaningful and purposeful change in behaviour and teaches replacement skills and strategies that equip the individual to live a more independent and socially engaged life. The service works with children and young people across early intervention, school, university and transition years.

We received overwhelming positive feedback from parents of children and young adults who were being supported by BEAM ABA Services. They told us how the service had positively impacted on their child’s life and supported them to integrate into day to day life and activities.

Staff were aware of each child or young adult’s individual needs and how they were to meet those needs. Care packages were tailor made to each specific individual listing their strengths as well as the areas where specific support was required or outcomes were to be achieved. Each person’s care plan included detailed risk assessments that identified specific risks that were associated with the health, care and support needs of the person to ensure that staff were aware of the specific risk and how to mitigate each risk so that people were kept safe from harm.

The service encouraged, motivated and ensured that all staff were equipped with the skills and knowledge needed to deliver the outlined programme of care and support. Staff, known as Behaviour Support Therapists (BST), were provided with an in-depth induction into the principles of ABA therapy as well as training in mandatory topics such as safeguarding, Mental Capacity Act 2005 (MCA), first aid and safe restraint techniques.

BEAM ABA had clear systems and processes in place to facilitate and ensure effective transition between services once they had come to the end of the support provision that they were commissioned to provide.

The service had a number of policies and procedures which were available to help ensure people were protected from abuse and the risk of abuse. These included robust recruitment processes, staff training and guidance and direction on how to identify abuse and the actions to take if abuse was to be suspected.

Staff told us they enjoyed working for the service and felt well-supported by the registered manager and colleagues. Care staff received regular supervision, clinical supervision, group reflective supervision and annual professional development reviews.

We saw suitable and safe arrangements in place in relation to the administration and recording of medicines.

The registered manager and the staff team were highly knowledgeable about the requirements of the Mental Capacity Act 2005 (MCA) and how this applied through the service they provided. Children and young adults receiving a service were supported to make their own choices and decisions where possible.

Staff were able to demonstrate a good understanding on how to obtain consent from the appropriate individuals involved in each support package, especially as some people supported by the service were under the age of 18.

Staff members were skilled in using a variety of communication methods to ensure that the people they supported were given choices and their needs and wishes respected where appropriate.

Parents and relatives confirmed that they received regular carers who had developed positive and caring relationships with the people they supported. Parents and relatives felt that they were treated with respect and dignity.

Parents and relatives confirmed that they felt able to raise concerns or issues and had direct contact with the supervisor allocated to the support package. They also confirmed that knew the registered manager and would contact him directly if their concerns or issues were not immediately addressed.

The service had a number of quality assurance systems in place which included spot checks, feedback questionnaires and informal audits of care plans, staff files and daily recording notes.