The inspection took place on 1 June 2018 and was unannounced. At our last inspection in March 2016, the service was rated as ‘Good’ in all questions asked.

Beaconhurst 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. Beaconhurst accommodates three people in one adapted building.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Although it was acknowledged that the service provided had links to the community, the service required a level of repair and refurbishment in order to provide a more homely environment

There was 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.

Systems were in place to audit, assess and monitor the quality of the service provided. However, repair and improvement work identified was outstanding and had not been completed in a timely manner. Works had been delayed and put on hold whilst the provider looked at other, more suitable premises. The service did not employ dedicated housekeeping staff to maintain the cleanliness of the service. There was an expectation that staff would not only support people, but would also ensure the service was kept clean.

People were supported by staff who were aware of the risks to them on a daily basis. Staff had received training in how to safeguard people from abuse and were aware of their responsibilities to report and act on any concerns.

People were supported to take their medicines as prescribed by their doctor. Where accidents and incidents took place, action was taken and individual analysis took place, but overall analysis of this information did not routinely take place.

People were supported by a group of staff who had been provided with training to meet their needs. People’s healthcare needs were met by having access to a variety of healthcare professionals. People were supported to choose their meals they wanted.

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 supported this practice.

Staff presented as kind and caring and were respectful of people’s choices. People benefitted from positive interactions with staff.

People were supported by staff who knew them well and what was important to them. People were supported to take part in activities they enjoyed.

This inspection took place on 5 February 2016, was unannounced and was carried out by one inspector. The provider is registered to provide accommodation and personal care for up to three people.People living at the home have a learning disability, autism and some people had additional sensory impairments. On the day of our inspection three people lived at the home.

At our last inspection in March 2014, the provider was meeting all the regulations we assessed.

There was a manager in post and she was present during our inspection. She was in the process of applying to be the 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 and associated Regulations about how the service is run.

People showed us that they felt safe in the company of staff. Staff knew how to identify harm and abuse and had been trained on how to report and protect people from harm or abuse.

People were supported to take part in everyday living tasks and to do the things that they enjoyed. The risks associated with these activities were well managed so that people could undertake these safely and without any restrictions. Staff told us their training was up to date and that they had the support that enabled them to deliver care safely. We saw staff understood people's needs and helped them to follow their chosen lifestyles and achieve their goals.

Staff supported people to remain healthy and well and to have their medicines at the right time to promote good health. Everyone had a health action plan which supported people in accessing the services they needed. People liked the food and had choices of what they ate. They were involved in the preparation of their meals and ate at the times they preferred.

People were asked for their permission before staff provided care and support so that people were able to consent to their care. Where people were unable to consent to their care because they did not have the mental capacity to do this decisions were made in their best interests. Staff worked in a way that meant people received care and support in the least restrictive way to meet their needs. The manager had considered where people’s liberty may need to be restricted to keep them safe.

People had positive and meaningful relationships with staff who knew them well. We saw staff were attentive and caring towards people. Staff used people's preferred communication to ensure their individual choices were fully respected. Staff promoted and protected people's dignity and privacy while they supported people with their needs.

People's care plans described their needs and abilities and people had contributed to these. Staff supported people to follow their own daily routines and interests. Staff had supported people to express their views on the care provided and this had led to their care being tailored to meet their needs.

There was a complaints policy in place and staff were aware how they could support people to communicate if they were unhappy about something. We also saw that people had named family or representatives to advocate for them.

Regular checks had been undertaken to maintain the quality of the service.  The manager had actively looked at ways to benefit the lives of people living at the home.  Staffing was organised to accommodate people’s lifestyles and choices. Staff had the support and training they needed to be able to understand and meet people’s complex needs and promote their quality of life.

There were three people living at the home at the time of our inspection. We spoke with two people, two members of staff and the registered manager.

On a previous inspection we undertook on 14th June 2012, we found some issues with the repairs and decorative state of the home that required refurbishment, replacement or redecoration. The manager sent us an action plan which demonstrated how the required improvements would be made.

This inspection was carried out to see what action had been taken and to see that an effective system of maintaining the property was in place. We found that appropriate measures had been taken to improve the suitability and safety of the premises.

During our visit we spoke with one person and four members of staff. Later by telephone we spoke with one relative and a visiting health professional. We observed care and support being given and looked at records.

People at the home are consulted and offered choices about the things they want to do.

A relative we spoke with was very complimentary about the home and the staff. They said, "I am quite happy with it. They are looked after very well.”

Staff know about the individual care needs of the people they are supporting and are able to describe in detail what those needs are.

One person told us that they enjoyed the food that was prepared for them. We saw that people’s preferences as to what they ate are accommodated as far as is possible by staff.

Staff, are very enthusiastic about the work they do and of the care they provide. One of them said, “I like helping people. You must have empathy.”

The provider has robust quality assurance processes in place to monitor and improve the service.

There is an effective complaints system available. Concerns and complaints are responded to in a timely manner by the manager.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. For example we spent time observing how staff supported people. We looked at care records and also spoke with staff to gain an understanding of how they supported people who lived there.

We saw examples where staff communicated well with people who lived at home. We observed staff provide direction and support to people throughout the inspection.

Staff had a good understanding of the needs of the people they supported. We found an example where one member of staff was not trained to meet certain needs of one of the people but had been included within the rota. This meant that there was a risk of this person receiving inappropriate care.

We saw that there were areas where the environment needed investment to make it more homely for people who lived there.

We were told by staff that people were supported as much as possible to undertake activities in the community and we saw this happening during our visit.

We saw records which showed that people who lived at the home were involved in regular meetings to discuss what they would like to do and where they would like to go on holiday.