This inspection took place on the 10 January 2017 and was unannounced.

Beatrice House is registered to provide accommodation with personal care to three people with a learning disability, and autistic spectrum disorder. At the time of our inspection three people were using the service.

There was a manager in post and she was present during our 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 and associated Regulations about how the service is run.

At our last inspection in January 2016 we found that the provider was meeting the regulations of the Health and Social Care Act 2008. However some improvements were needed which we found had been made at this inspection.

Relatives we spoke with told us they had no concerns about the safety of their family members. Staff were aware of their responsibilities to report any concerns about people’s safety, and they confirmed they had received training in relation to safeguarding people from abuse. There was enough staff on duty to meet people’s needs and preferences. People received their medicines as prescribed by their doctor.

Staff felt supported and had received training to enable them to have the skills and knowledge for their role. People’s human rights were respected by staff because staff applied the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards in their work practice.

People were treated with kindness, and respect and staff promoted people’s independence and right to privacy. People were supported to maintain good health; we saw that staff alerted health care professionals if they had any concerns about their health or well-being. People were supported to eat and drink in accordance with their preferences and dietary requirements.

There was a complaints policy in place and staff and the registered manager were aware of the signs to look out for which may indicate people were unhappy. Relatives knew how to raise any concerns they may have, and they had confidence that any issues would be addressed.

Relatives thought the service was managed well and in people’s best interests. They described the registered manager as approachable, open and transparent. Systems were in place to gain feedback from relatives, staff and professionals so that any improvements could be made. Audits were undertaken regularly to monitor the quality of the service provided.

This inspection took place on the 10 January 2017 and was unannounced.

Beatrice House is registered to provide accommodation with personal care to three people with a learning disability, and autistic spectrum disorder. At the time of our inspection three people were using the service.

There was a manager in post and she was present during our 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 and associated Regulations about how the service is run.

At our last inspection in January 2016 we found that the provider was meeting the regulations of the Health and Social Care Act 2008. However some improvements were needed which we found had been made at this inspection.

Relatives we spoke with told us they had no concerns about the safety of their family members. Staff were aware of their responsibilities to report any concerns about people’s safety, and they confirmed they had received training in relation to safeguarding people from abuse. There was enough staff on duty to meet people’s needs and preferences. People received their medicines as prescribed by their doctor.

Staff felt supported and had received training to enable them to have the skills and knowledge for their role. People’s human rights were respected by staff because staff applied the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards in their work practice.

People were treated with kindness, and respect and staff promoted people’s independence and right to privacy. People were supported to maintain good health; we saw that staff alerted health care professionals if they had any concerns about their health or well-being. People were supported to eat and drink in accordance with their preferences and dietary requirements.

There was a complaints policy in place and staff and the registered manager were aware of the signs to look out for which may indicate people were unhappy. Relatives knew how to raise any concerns they may have, and they had confidence that any issues would be addressed.

Relatives thought the service was managed well and in people’s best interests. They described the registered manager as approachable, open and transparent. Systems were in place to gain feedback from relatives, staff and professionals so that any improvements could be made. Audits were undertaken regularly to monitor the quality of the service provided.

During our visit we spoke with three members of staff. We were unable to speak with people because of their difficulty communicating. Later by telephone we spoke with three relatives and a visiting health professional. We observed care and support being given and looked at records.

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

Relatives we spoke with told us that people received the care and support they needed. One told use, “It’s great. We have no problems.”

People looked relaxed around staff. All staff members had been trained in safeguarding and those we spoke with knew how identify possible abuse and what the reporting procedures were.

There were sufficient numbers of staff to meet the needs of people. Staff knew about the individual care needs of the people they were supporting and were able to describe in detail what those needs were. A relative said, “The staff try very hard.”

People within the home had limited communication skills due to their learning disabilities. We saw that staff interacted with them and provided guidance and reassurance. People looked relaxed in the company of staff and were enjoying putting up Christmas decorations.

During our inspection, we spoke with two staff, and the care manager. Improvements had been made to people’s care plans so that these reflected their needs as well as their preferences. Care plans provided guidance as to how to meet people’s specific needs, and staff understood people’s needs.

We found that improvements had been made to protect people from harm. Staff were aware of their responsibilities and action had been taken to ensure that staff were confident with the procedure they should follow.

Staff training records showed that some improvements had been made in the availability of training. Gaps in training had been identified and planned for. One staff said, “We are doing lots of training, communication has improved and we have regular supervision, generally things have improved”.

We found that improvements had been made in assessing and monitoring the quality of the service.

We visited this home as part of our annual schedule of inspections. This visit was unannounced.

We spoke with four members of staff and one person living in the home. People within the home had limited communication skills due to their learning disabilities. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spent time observing how staff interacted with and cared for people. We observed positive interactions between staff and people within the home. We saw that people were treated with respect and staff were attentive to people's individual needs and preferences.

We found that risks to the safety and wellbeing of people were not always being managed effectively. Documentation was not up to date within care plans and assessed risks not followed up. The staff we spoke with were aware of people's needs.

Staff training was out of date and formal supervision of staff was not always taking place. Staff told us that they did not feel supported by the management team.

The home's system of quality monitoring required improving. There were outstanding actions from a safeguarding investigation which had taken place in December 2011.

Some of the people living there were unable to verbally communicate their views about the home, so we spent time observing how staff interacted with them and spoke to staff about how they support people. Due to people's behaviours it was sometimes difficult to observe without disrupting them, so we spent time in the office looking at their records and listening to what was going on in the home.

We saw that staff used different ways to understand what people wanted, such as using pictures, signs and objects to help the person say what they wanted. Where people could say what they wanted they were given the opportunity to do this.

On the day we visited there was a shortage of day care staff due to sickness and one person's car was being repaired. This had a big impact on the well being of the people living there, as they could not go out and do the things they wanted. We saw in records and staff told us that this was unusual and happened rarely.

Other professionals are involved in people's care. We saw that generally staff followed the advice of other professionals to ensure people were supported and respected.

Staff knew how to safeguard the people living there from abuse and harm to ensure their safety and well being.

People's medication is kept securely and given to them as they need it, to help to meet their health needs.

Staff have the training and support they need so they know how to support the people living there to meet their needs and achieve their individual goals.

We saw that the views of the people living there and their relatives were listened to and where needed improvements are made.

Regular audits are done to ensure that the home is well run and benefits the people living there.