Beachview is a residential care home for 10 young people. It provides support to people who have a range of learning disabilities, some of whom also have a physical disability. Beachview is a detached house that has also been adapted to cater for people with a physical disability and has wheelchair access throughout. All bedrooms are for single occupancy and have en-suite wet room facilities. There is a large communal living and dining area and a separate sensory room. A lift provides easy access between floors.

At our last inspection we rated the service good. At the inspection we found that the provider was in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. The provider had failed to act in line with their legal responsibilities and had failed to notify the Commission of authorisations under the Deprivation of Liberty Safeguards (DoLS). Following the inspection we received appropriate notifications and the provider had met this regulation.

At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

The service met all relevant fundamental standards.

The service had a positive culture that was person-centred, open and inclusive. There was a strong emphasis on putting people first. People were involved in the service within their capabilities. People assisted with meal preparation with staff support. Everyone spoke highly regarding the staff. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

It is a requirement of the provider's registration that they have a registered manager 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. The service had a manager in place who had started the process to become registered with us. The service was well led. The manager was aware of their legal responsibilities.

Staff were enthusiastic and keen to talk about their role. Staff were proud of the service and their work. They felt supported within their roles and held the manager in high regard. Recruitment practices were robust and staff received training appropriate to their role and the needs of the people living at the service. People were supported to maintain contact with their relatives.

People had comprehensive plans of care and risk assessments. Care was individualised and person centred. Medicines were managed safely and in people’s best interests.

Further information is in the detailed findings below.

The inspection took place on 7 November 2016 and was unannounced.

Beachview is a residential care home that provides support for up to 10 people with a physical and/or learning disability and diagnosis of autism. At the time of our inspection there were six people living at the service. They had a range of complex care needs associated with autism and communication.

Beachview is a detached house that has also been adapted to cater for people with a physical disability and has wheelchair access throughout. All bedrooms are for single occupancy. All rooms have en-suite wet room facilities and, in addition, there are two communal bathrooms with bathing facilities. There is a large communal living and dining area and a separate sensory room. A lift provides easy access between floors.

The service did not have a registered manager in post at the time of our visit. 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. Beachview has not had a registered manager in post since August 2016. The area manager was managing the service day to day.

The area manager had identified the need to improve the standard and personalisation of care planning within the service. For example, whilst we found that people received appropriate care, this was not always reflected in the care plans, which contained unclear information and guidance to staff. The management team had plans to develop the care plans and to transfer the care plans to a new electronic system from January 2017 to ensure they were comprehensive and up to date.

The provider had failed to notify the Commission of Deprivation of Liberty Safeguards (DoLS) authorisations in accordance with the registration regulations.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People told us they felt safe at the home.

Systems were in place to identify risks and protect people from harm. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Accidents and incidents were accurately recorded and were assessed to identify patterns and triggers. Records were detailed and referred to actions taken following accidents and incidents. Reference was made to behaviours, observations and other issues that may have led to an accident or incident.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed safely.

Staffing numbers were adequate to meet the needs of people living at the home. The provider used a dependency tool to determine staff allocation. This information was reviewed following incidents where new behaviours were observed which might increase or change people's dependency level.

Safe staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The staff had a good understanding of their responsibilities in relation to MCA and DoLS. Staff sought people's consent about arrangements for their care.

Staff were skilled in working with people who lived with autism. Training included autism awareness, communication and supporting challenging behaviours. Due to a lack of consistent management, we saw that some staff had only received one support and supervision in the last 12 months. However, the staff told us they felt they supported each other well

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?. Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and from looking at records.

As part of this inspection we spoke with three people who use the service, the registered manager and three care staff. We also reviewed records relating to the management of the home which included five care plans, one incident report, staff rotas and records, maintaince records and audits.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place such as feedback sessions, meetings and evaluation to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and there had been a recent assessment and implementation of this safeguard. Relevant staff had been trained to understand when an application should be made, and in how to submit one. This meant that people would be safeguarded against unlawful restriction of their activities.

Is the service responsive?

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. We saw evidence of the use of the Speech and Language Therapist (SALT) to help staff prepare specialist textured diet for a person who had difficulty in swallowing.

People’s needs were taken into account as the layout of the service enabled people to move around freely and safely. There were ramps for wheelchair users. The premises had been sensitively adapted to meet the needs of people with physical impairments. We saw ceiling hoists and specialist beds to support people's mobility needs. Staff demonstrated how to use them this ensured people were moved safely.

Is the service caring?

People were treated with respect and dignity by the staff.

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One person used an electronic notepad to communicate with staff. We saw staff taking time while they completed their communications.

Is the service effective?

People attended schools and clubs and completed a range of activities in and outside the service regularly. The home had its own adapted minibus, which helped to keep people involved with their local community. People from other homes within the provider joined those at Beachview for special events and celebrations.

The service worked well with schools, clubs and health care professionals such as physiotherapists and dieticians to ensure people received their care in a joined up way. Care plans showed the involvement of other agencies, therefore care was up to date and any problems could be identified quickly.

Is the service well led?

The service had a quality assurance system. We saw records that confirmed the daily staff skill mix to ensure there were sufficient numbers of trained and skilled staff on duty. We also saw the home's maintenance audits, to show that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times.

Due to the nature of people's disabilities we did not speak to them specifically about maintenance issues that related to the building. However, we did observe that people appeared comfortable in their surroundings. We did speak with a member of staff. They told us that works had been undertaken to address outstanding issues, that made the building a better place for people to live. As they explained, "The kitchen has been totally revamped and other issues have been sorted. There are still some things to be addressed but there are plans in place for these". Our evidence supported the comments made by the member of staff.

We spoke with four of the nine people who lived at the service. Everyone told us that they were happy with the support they received. For example, one person told us, "Staff help me, I love them". Another person said, "I am very happy living here".

We were not able to speak with some of the people who lived at the service due to their complex needs and learning disabilities. Instead we spent time observing the interactions between staff and people. We found this interaction to be positive and friendly. Staff spent time with people engaging in activities and providing reassurance and support. We found that people's care needs were being managed safely by the service and that staff had a good understanding of their roles and responsibilities in this area.

People's rights with regard to consent were being promoted by the service and staff understood how people's capacity should be considered.

Everyone that we spoke with told us that they could approach the staff and management if they were unhappy or had issues to discuss.

People also told us that they were happy with the environment that they lived in. However, we found that the provider had not taken sufficient steps to ensure the building was maintained to an acceptable standard.

We spoke with one person who lived at the home. We were unable to speak to others as they had either gone out for the day or their disabilities prevented them from sharing their experiences with us. The person we spoke with told us that they were “very happy” living at the home and felt safe and well looked after. They told us that they engage in a variety of social activities and that staff were always trying to find them “new things to do”.

We spoke with two relatives, both of whom visited the home unannounced. They told us that their family members all enjoyed living at Beachview. One relative told us that it was “home”.

Both relatives we spoke with were happy with the quality of care and felt that staff would listen to and act upon complaints should they occur. One relative told us that their family member had “come on in leaps and bounds” since coming to live at the home.

Due to the nature of people’s learning disability we were not always able to ask direct questions to people. We did however chat with them and were able to obtain their views as much as possible. We also spoke to family members and they told us that their relatives are supported by the staff to receive the care they need.

Relatives said that the home supports people to make choices by using pictures and signs to enable them to indicate their preferences as much as they are able.

We spoke with the families of people who use the service and they told us that they knew what action they should take if they had any cause for concern and they said that they felt that the home would respond appropriately to any concerns that may be raised.

Staff said that they would always respect people’s wishes and when asked what they would do if they felt there may be a conflict between a person’s wishes and their care needs they told us that they would speak with the manager.