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Inspection carried out on 4 September 2017

During a routine inspection

This inspection took place on 4 and 6 September 2017 and was announced.

Beeston Drive provides care and accommodation for up to three people with a learning disability. There were three people using the service at the time of our inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

We last inspected the service in February 2016 and rated the service as ‘requires improvement’ overall. At this inspection we found the improvements had been made and that all the regulations were being met.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager and staff understood their responsibilities with regard to safeguarding and had received training in safeguarding adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

The environment was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had a safe and effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following legal requirements in respect of Deprivation of Liberty Safeguards (DoLS). Staff knew how to protect the rights of people, who lacked mental capacity to make decisions. They also worked with others to promote people’s best interest, safety and liberty.

Staff were caring towards people and supported them to maintain the relationships that were important. People were supported to develop their independence and skills around daily living tasks. Staff treated people with respect and maintained their right to privacy.

People were supported by staff to meet their nutritional needs. Care records contained evidence of people being supported to attend visits to and from external health care specialists.

The registered provider had supported people who used the service with to access education opportunities. People were supported and encouraged to engage with activities outside of the service.

There was an effective complaints procedure in place and any concerns had been addressed appropriately

There was clear and visible leadership in the service. Staff and the registered manager understood their role and responsibilities. The provider had a range of audits in place to assess, monitor and improve the service. The registered manager involved people and staff in the running of the service. The registered manager complied with their statutory responsibility to submit notifications to the CQC as required.

Inspection carried out on 4 February 2016

During a routine inspection

The inspection was unannounced and took place on the 4 February 2016.

Beeston Drive is a service that provides support to people who have complex physical health needs and learning disabilities and is able to accommodate up to three people. People have access to an enclosed garden area which has areas where people can sit.

The service does not have 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. A manager has been appointed and they are in the process of registering with us.

There was a feedback process in place for people who used the service, however the registered provider had not made use of this. Feedback from relatives had been sought, however the registered provider’s response to feedback was not always consistent. We saw that comments and complaints records were not kept up to date in line with the complaints policy. We have made a recommendation around the management of complaints and concerns.

People’s relatives told us that they felt the service was safe. Staff had received training around safeguarding people and they were aware of how to report any concerns they may have. There were sufficient numbers of staff in place and recruitment processes were robust enough to ensure people’s safety.

The registered provider had made attempts to engage staff to determine what changes could be made to improve on staff retention. New staff had been recruited as key workers to help ensure the consistency of the care provided.

Medication records were in place and being kept up-to-date and they showed that people were supported to take their medication as prescribed.

Staff had undertaken training around the deprivation of liberty safeguards (DoLS) and had a good understanding around how to incorporate the basic principles of the Mental Capacity Act 2005 into their day-to-day practice. DoLS were in place for people who needed them which meant that people’s liberties were being protected.

Staff treated people with dignity and respect, and people’s privacy was maintained, for example, during personal care interventions frosted glass was used in people’s bedrooms and the bathroom in situations where curtains were not appropriate. Information around people’s care needs was stored in a secure office which ensured that people’s confidentiality was being maintained.

People were supported to engage in activities, such as going for walk in the morning, swimming or watching their favourite television programs. Staff had a good understanding around people’s care needs and demonstrated knowledge of their strengths.

Care records were personalised and accessible to the relevant staff members. This enabled staff to understand people’s likes and dislikes, and ensured that people could be supported in-line with their individual needs. Care records also contained information around people’s communication needs. This provided information that would enable staff to communicate effectively with people.

People were supported to access support from external health and social care professionals when required. This helped ensure that people remained healthy.

Quality assurance systems were in place to monitor the quality of some aspects of the service, and there was an effective disciplinary policy in place which had been used appropriately.

Inspection carried out on 15 May 2014

During a routine inspection

The inspection team included two inspectors and a specialist advisor. The team gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? An inspector gathered information from representatives of people using the service by telephoning them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with representatives of people who used the service and staff and from looking at records.

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

Is the service safe?

Representatives told us they felt people who used the service were safe and their rights and dignity were respected.

People's care records were accurate to ensure that they received appropriate care. Staff knew about risk management plans and gave us examples of how they had followed them. Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents.

The home was well-maintained.

Recruitment practice was safe and thorough and there were enough staff to meet people's needs.

Is the service effective?

There were systems in place for seeking and obtaining valid consent to care and people's human rights were respected.

The service worked well with other agencies and services to make sure people received care in a coherent way.

Is the service caring?

Feedback from people was positive, for example; "I'm more than happy, I can tell they genuinely care for my relative and it's never a problem if I turn up unannounced."

People�s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people�s wishes.

Is the service responsive?

People�s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Feedback included: "I am completely involved; I'm always kept in the loop and am copied into any emails regarding my relative's care".

There was investment in staff training and staff were clear about their roles and responsibilities.

There was a complaints procedure in place.

Is the service well-led?

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were taken on board and dealt with.

Staff had a good understanding of the ethos of the service and said they felt well supported.