Byron Court provides accommodation and personal care for up to seven people with learning disabilities and autistic spectrum disorders. It is situated in Bedford, close to local amenities. On the day of our inspection there were seven people living in the service.

The inspection took place on 9 and 10 May 2017.

The service had 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.

Staff had been trained to recognise signs of potential abuse and keep people safe. People had risk assessments in place to enable them to be as independent as they could be whilst remaining safe. Staff knew how to manage risks and balanced these against people’s rights to take risks and remain independent.

There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs. Robust recruitment processes were in place and staff were not employed until satisfactory checks had been completed. Systems were in place to ensure people’s medicines were managed in a safe way.

Staff received a robust induction programme. They were provided with on-going training to update their skills and knowledge to effectively support people with their care and support needs.

Staff understood the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People were supported to eat and drink sufficient amounts to ensure their dietary needs were met. Staff supported people to attend healthcare appointments when required and liaised with their GP and other healthcare professionals as needed.

People were treated with compassion and kindness by staff. Each person was supported in a way that was individual to them and were encouraged to identify their own support networks in order to improve their independence.

People's needs were assessed and care records gave clear guidance on how people were to be supported. Staff were knowledgeable about how to meet people’s needs and understood how people preferred to be supported. There was an effective complaints system in place which was used to drive future improvement within the service.

People and staff were positive about the leadership of the service and the support they were able to provide for people with complex healthcare needs. Staff engaged consistently and meaningfully with people who said they felt wholly involved in their care. Ideas for change were always welcomed, and used to drive improvements and make positive changes for people.

Byron Court is registered to provide accommodation and support for up to seven people with learning disabilities and complex needs. On the day of our visit, there were six people living in the home.

Our inspection took place on 14 May 2015 and was unannounced. At the last inspection in November 2013, the provider was meeting the regulations we looked at.

The service had 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.

Staff had been trained to recognise signs of potential abuse and keep people safe. People felt safe living at the service.

Processes were in place to manage identifiable risks both for people and within the service.

There were sufficient numbers of staff who had the right skills and knowledge to meet people’s needs.

The service had a recruitment process which ensured that suitable staff were employed to look after people safely.

Systems were in place to ensure people’s medicines were managed in a safe way and that they received their medication when they needed it.

Staff received support and training to perform their roles and responsibilities. They were provided with on-going training to update their skills and knowledge.

Staff understood the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People were provided with a balanced diet and adequate amounts of food and drinks of their choice.

The service had developed positive working relationships with external healthcare professionals to ensure effective arrangements were in place to meet people’s healthcare needs.

People were looked after by staff that were caring, compassionate and promoted their privacy and dignity.

We saw that people were given regular opportunities to express their views on the service they received and to be actively involved in making decisions about their care and support.

Staff were knowledgeable about how to meet people’s needs and understood how people preferred to be supported.

There were effective systems in place for responding to complaints and people and their relatives were made aware of the complaints processes.

Quality assurance systems were in place and were used to obtain feedback, monitor service performance and manage risks.

Prior to this inspection the Care Quality Commission (CQC) had received information of concern about the systems in place for the management of nutrition within Byron Court. Although we had no information to suggest that harm had been caused to people, it was alleged that there had previously been some issues in respect of the availability of monies to purchase food for people living in the home and that a member of staff had to supplement funds to buy food. It was therefore suggested that the services processes for purchasing and monitoring people's nutritional needs could pose a risk of harm to people.

We visited Byron Court on 21 November 2013, and spoke with two people and three staff, including the newly appointed manager. People told us they were happy with the food choices they were given but the staff we spoke with told us they were concerned that the food that was used, may not be as nutritionally balanced as it could be.

We saw that there was sufficient food within the home for people and noted that people were given a choice of food options, with this being discussed as regular service user meetings. We were told by the manager (who was in the process of applying to be the registered manager) that there were future plans to improve the process of buying food for people and the way in which this was managed.

We visited Byron Court on 18 July 2013 and found a friendly, welcoming environment. We spoke with four of the six people currently living in the home, who told us they enjoyed living there and staff were always kind, caring and helpful. We were told, "I really like being here and I have lots of friends."

We observed positive engagement and interactions between staff and the four people in the home at the time of our visit, and saw that people were treated respectfully and given choices at all times. One person said. "Staff look after me very well. They are great."

We looked at four people's care records and found these to be regularly reviewed and relevant for people's assessed needs. We spoke with three members of staff on duty who had worked at the home for a number of years. Staff were knowledgeable about people's needs and likes and dislikes.

We saw that processes were in place to safeguard vulnerable people, and staff had a good understanding about the process to take if they had concerns.

We looked at staff training and the support provided for staff and saw evidence that staff received training relevant for their role. Staff said they were given the opportunity to discuss issues at staff meetings.

We found that both people's and staff members records were maintained securely and appropriately and protected people's confidentiality.

When we visited Byron Court on 6 December 2012 we found that people were very happy with the care and support they received. People told us they felt safe and that staff were friendly and supportive. One said "I love it, I'm very happy here, they look after us very well."

We observed that people were offered support at a level which encouraged them to be independent and ensured their individual needs were met. There was a relaxed atmosphere in the home and people were at ease in the company of the staff supporting them. The staff were friendly and polite in their approach, and interacted confidently with people.

We noted that people were encouraged to express their views and were involved in planning their care and making decisions about their support and how they spent their time. Some people were out at day centres at the time of our visit, and others were involved in carrying out tasks to support their personal development. People talked about the range of activities and entertainment that were available to them, and in particular plans that were in place for the Christmas celebrations. One person said "It's good, I can go out to the shops on my own."

Within the care files we saw that care documentation had been signed by the individual to confirm their involvement and agreement with their particular care needs. There were also clear records to reflect how people were encouraged to discuss their weekly activities and plan for forthcoming events such as holidays.

During our visit to Byron Court on 12 March 2012 we met all six people living at the home. We spoke at length with two people who told us how much they liked living there, that they were happy and that they felt safe. We observed that in their different ways, everyone communicated that they were content living at this home and that they had good relationships with the staff. They showed that they felt safe, and were satisfied with the service being provided.