39 Beaconsfield Road is a residential care home for three people with learning disabilities. The home is a spacious four bedroomed large terraced house with. There were three people living in the home at the time of the inspection.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good

Why the service is rated Good?

Risk assessments were in place specific to people's individual needs.

Medicines were managed safely and people received their medicines as prescribed.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. There was sufficient staff on duty to meet people's needs. Most of the staff team had worked in the home for over three years.

The home was well maintained and in good decorative order. Measures were in place to ensure the environment was safe and suitable for the people who lived there. Repairs to the building were reported to the landlord and attended to in a timely way.

People's needs were assessed and care plans were completed to demonstrate the support required. People’s health care needs were addressed. People saw their local health care professional when they needed to.

Staff received a programme of mandatory and optional training relevant to the people they supported. Regular supervision and annual appraisals took place. Staff meetings were held to keep staff informed and support them in their role.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People made decisions and choices in relation to their care, support received and daily activities. Staff knew the people in the home well and how they communicated their needs and choices. This information was well documented to assist new staff.

Staff knew people's dietary needs and preferences. They supported people to eat and drink enough to maintain a balanced diet.

Staff showed kindness towards the people in the home. People were supported to maintain their independence with activities of daily living. People went out for social events and were supported to attend health appointments. The home had access to a minibus which enabled them to visit places safely.

Care plans were written for the individual and informed staff of their preferences and wishes. These documents were regularly updated to reflect people's change in need or preference. People enjoyed a range of activities.

A complaints policy was in place and displayed in the home. No complaints had been received since the last inspection in 2015.

There was a person-centred and open culture in the home. Staff reported that manager was supportive and made themselves available to support staff when they needed it. Staff worked as a team and supported each other. Absence and annual leave was covered by the staff team. This ensured a consistent staff team that people in the home knew and staff were familiar with their support needs.

Quality assurance and governance systems were in place to help the registered manager and provider to monitor standards and drive forward improvements.

The registered manager and provider met their legal requirements with the Care Quality Commission (CQC). They had submitted notifications relating to incidents and the rating from the last assessment was clearly displayed.

Further information is in the detailed findings below.

The inspection took place on 20 October 2015 and was announced.

39 Beaconsfield Road is registered to provide accommodation for up to three adults with learning disabilities, who require personal care. It is a large four bedroom terraced property, situated in a residential area, close to local amenities and transport links. There were three people living at the service on the day of the inspection.

There is a registered manager in post at the service. ‘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 supported people to make decisions about their daily life and care needs. This was in accordance with the Mental Capacity Act (MCA) (2005) Code of Practice.

Medication was stored safely and securely. Staff had completed training in medication administration.

The systems we saw ensured people received their medications safely.

People’s nutritional needs were monitored by the staff. People’s dietary requirements and preferences were taken into account.

Each person who lived at the home had a person centred plan. The plans we looked at contained relevant and detailed information. This helped to ensure staff had the information they needed to support people in the correct way and respect their wishes, their likes and dislikes.

A range of risk assessments had been undertaken depending on people’s individual needs to reduce the risk of harm. Risk assessments and behavioural management plans were in place for people who presented with behaviour that challenges. These risk assessments and behavioural management plans gave staff guidance to keep themselves and people who lived in the home safe, whilst in the home and when out in the community.

Sufficient numbers of staff were employed to provide care and support to help keep people safe and to offer support in accordance with individual need. This enabled people to take part in regular activities both at home and in the community when they wished to.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff were only able to start work at the home when the provider had received satisfactory pre-employment checks.

Staff received an induction and regular mandatory (required) training to update their practice and knowledge. Records showed us that staff were up-to-date with the training. This helped to ensure that they had the skills and knowledge to meet people’s needs.

Staff felt supported in their roles and responsibilities.

Staff had good knowledge of people’s likes and dislikes in respect of food and drinks and people’s routines in respect of meal times. We saw that people who lived in the home had plenty to eat and drink.

People at the home were supported by the staff and external health care professionals to maintain their health and wellbeing.

People who lived in the home took part in a variety of activities both in the home and in the community.

During our visit we observed staff supported people in a caring manner and treat people with dignity and respect.

Staff understood people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people.

A procedure was in place for managing complaints. We found that complaints had been managed in accordance with the home’s complaints procedure.

Systems were in place to check on the quality of the service and ensure improvements were made. This included carrying out regular audits on areas of practice.

We looked around the building. We found it was clean and well maintained. Staff had a rota in place to ensure cleaning was completed daily.

We used a number of different methods to help us understand the experiences of some of the people living at 39 Beaconsfield Road. This was because some of the people who lived at the home had complex needs, which meant they were not all able to verbally tell us about their experiences.

On the day of our visit three people lived at the home. Two people went out for lunch and to a disco shortly after we arrived. We carried out some short observations between staff and the people who lived in the home. We observed some examples where staff supported people well, such as encouraging people with their morning routine and using appropriate communication with people.

We looked at three people’s care records in the office. We found they contained relevant and current information about the person's needs.

On checking medication records we found that people received their medicines as prescribed. Records regarding medication were completed correctly.

We spoke with two staff about how they supported the people who lived at the home and the activities they did each week.

We used a number of different methods to help us understand the experiences of some of the people living at 39 Beaconsfield Road. This was because some of the people who lived at the home had complex needs, which meant they were not able to verbally tell us about their experiences.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We observed staff assisting people when they needed support and accepting their decisions if they chose not to do something.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We observed one person being supported by staff with what they needed.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We saw that people who lived at the home were very relaxed and confident around staff. This showed that people felt safe in the home.

There were effective recruitment and selection processes in place to ensure staff could

work with vulnerable people.

Staff received appropriate professional development. We observed people were supported well by Expect Ltd and staff were always available to assist and help as needed.

People who use the service, their representatives and staff were asked for their views

about their care and treatment and they were acted on. All of the people we met with were living in accommodation that suited their needs.