We carried out an unannounced comprehensive inspection at The Beach on 26 July 2018. The previous inspection took place on 13 June 2017. At that time we found action to make improvements to the environment were not carried out in a timely manner. People sometimes felt unsafe because of last minute changes to staffing arrangements. Staff did not always feel valued or well supported.

At this inspection we found improvements had been made in all the areas identified at the previous inspection. This meant the service had met the outstanding legal requirement from the last inspection and is now rated as Good.

The Beach provides care and accommodation for up to fifteen people who have autistic spectrum disorders. The service is part of the Spectrum group who run several similar services throughout Cornwall, for people living on the autistic spectrum. At the time of the inspection 11 people were living at the service. The Beach is a modern property based on the outskirts of Newquay and overlooks a beach.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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 the service is able to accommodate fifteen people the accommodation is situated in three adjacent properties and is set up as self-contained flats. Two people shared a flat and others had their own accommodation. Everyone had keys to their own front door. This meant people had access to their own private spaces and could choose who they spent their time with or whether they wished to spend time on their own. One of the three buildings had a shared living and dining area where people could spend time socialising together if they wished.

The service is required to have a registered manager and at the time of the inspection there was no registered manager in post. The previous registered manager left in August 2016. 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 manager had applied for registration. Staff, people and relatives were all positive about the management of the service. Comments included; “It’s a much happier place all round”, “[Manager’s name] is a good man he is” and “People are happy, staff are happy and so there are less incidents.”

People were comfortable and at ease with staff and within their environment. Staff were supportive and caring in their approach. They spent time chatting to people and checking on their well-being.

Activities provided were varied and met people’s individual preferences and interests. People were able to go on spontaneous trips out as well as taking part in planned activities.

There was a stable and experienced staff team in place. Staff told us they were well supported and worked together as a team. Some staff had not had formal supervision for some time. We have made a recommendation about this in the report. Roles and responsibilities were clearly defined and understood by all. Systems for communicating changes in people’s needs were effective.

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.

Care plans were detailed and informative. Staff recorded information about how people spent t

We inspected The Beach on 13 June 2017, the inspection was unannounced. The service was last inspected in November 2015, we had no concerns at that time.

The Beach provides care and accommodation for up to fifteen people who have autistic spectrum disorders. The service is part of the Spectrum group who run several similar services throughout Cornwall, for people living on the autistic spectrum. At the time of the inspection 11 people were living at the service. The accommodation is situated in three adjacent properties and consists of eight self-contained flats. Some people shared a flat and others had their own accommodation. One of the three buildings had a shared living and dining area where people could spend time if they wished. The Beach is a modern property based on the outskirts of Newquay and overlooks a beach.

The service is required to have a registered manager and at the time of the inspection there was no registered manager in post. The previous registered manager left in August 2016. 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 manager told us they were in the process of applying for the position. However, they were not intending to stay in the role for very long and a new manager was due to start at the service in August. Following the inspection we were informed the manager had withdrawn their application due to the short length of time they would have been in post.

Relationships between some members of the staff team and the manager were strained. This had left staff saying they felt undervalued and insecure. Arrangements for the management of the service were changing and we will continue to monitor the situation.

People did not always feel safe when receiving care and support. The systems in place to help ensure people received consistent support were not well established. Arrangements for support sometimes changed with very little notice leading to people becoming anxious and distressed. We have made a recommendation about this in the report.

There were sufficient numbers of qualified staff to meet people’s identified needs. Recruitment practices helped ensure staff working at the service were fit and appropriate to work in the care sector. Staff told us the induction processes and training provided were thorough and gave them the knowledge required to carry out their roles.

People were assessed in line with the Deprivation of Liberty Safeguards (DoLS) as set out in the Mental Capacity Act 2005 (MCA). DoLS provide legal protection for vulnerable people who are, or may become deprived of their liberty. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals when appropriate. 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.

The Beach was situated on the sea front and people, staff and relatives were unanimously positive about the location and access to local amenities. Some internal and external work was being carried out to improve the appearance of the building. At our previous inspection we identified a problem with the bathroom flooring in one person’s flat. At this inspection we found no action had been taken to address the problem. Following the inspection we were sent evidence to show this work had now been completed.

People’s support plans included clear and detailed information about their health and social care needs. There was

We inspected The Beach on 19 November 2015, the inspection was unannounced. The service was last inspected in January 2014, we had no concerns at that time.

The Beach provides care and accommodation for up to fifteen people who have autistic spectrum disorders. At the time of the inspection ten people were living at the service. The accommodation is provided within three adjacent properties and consists of eight flats. Two of the flats were shared by two people and the rest were single occupancy. One of the three buildings has a shared living and dining area where people could spend time if they wished. The Beach is a modern property based on the outskirts of Newquay and overlooks the beach.

There was 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.

There was a relaxed and friendly atmosphere and we saw staff and people laughing and chatting together. Staff told us they liked and respected the people they supported and enjoyed their work. Relatives told us; “He’s very happy there, always well looked after” and; “She is generally supported by people she likes and trusts.”

Staff had received training in how to recognise and report abuse, and all were confident any concerns would be taken seriously by the manager. Recruitment practices helped ensure staff working at the service were fit and appropriate to work in the care sector.

There were sufficient numbers of qualified staff to keep people safe. Staff demonstrated a shared approach to supporting people which emphasised helping people to develop and maintain independent living skills. A relative told us; “[Name] has progressed very well with Spectrum.”

People, where appropriate, were assessed in line with the Deprivation of Liberty Safeguards (DoLS) as set out in the Mental Capacity Act 2005 (MCA). DoLS provide legal protection for people who are, or may become deprived of their liberty. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals when appropriate. Staff demonstrated a good understanding of the main principles of the Mental Capacity Act (MCA).

People’s support plans included clear and detailed information about their health and social care needs. Information about people’s needs were regularly discussed and updated so that staff had accurate information when providing care. We saw that, when necessary, support patterns were amended to reflect sudden changes in people’s needs. For example, one person required additional support during the night for a short period following an event which had led to an increase in their anxieties. A waking night care worker had been put into place until the person had become more settled.

People had access to a range of activities. Staff supported people to access the local community regularly and told us they saw this as valuable. One said; “It’s helping people to live their lives the way they want to.”

The registered manager had a good understanding of the day to day running of the service. There were clear lines of responsibility and accountability within the service which were understood by all. Quality assurance systems were in place to help ensure the safety and effectiveness of the service.

We found that since our last visit to The Beach in November 2013, there had been improvements in the care planning, supporting staff and a review of the quality of care, records and facilities that the home provided. Since the last inspection a new manager had been appointed to oversee the home. They told us they would submit a registered manager application with us to adhere to the Care Standard Act regulations.

Four people who used the service were present during the visit. We spoke with three people who told us they were “happy to live here” and “this was the best decision, coming here to live”. People told us they had no concerns regarding their care and that they liked the staff.

We observed how staff interacted with people and saw there was relaxed atmosphere in the home. We saw people who used the service approached staff without hesitation. We observed staff interacting with people who used the service in a kind and calm manner. We saw that staff showed, through their actions, conversations and during discussions with us, empathy and understanding towards the people they cared for.

We found all people who used the service had a care plan and found the information was up to date and had been reviewed regularly.

We found that people who used the service were involved in making day to day decisions and participated in tasks at home, such as cleaning and doing their laundry. During the visit we noted that people attended a variety of activities so that they had opportunities to pursue their interests.

We spoke with the manager, Spectrums’ divisional manager and seven members of staff. Staff told us that since the previous inspection they had received more support from Spectrum senior management team, changes to the delivery of care had been made and additional support for staff had been introduced. These changes were viewed positively by the staff team. We also spoke to two care professionals who do not work for Spectrum. They told us that since the previous inspection the home “seems more organised, staff happier and the care provided to people remains good.”

The provider had reviewed the facilities that the home provided to people who used the service, staff and visitors. An action plan had been developed to ensure that the quality of care and support would be to an appropriate standard.

We spoke with two people who used the service. People we spoke with were complimentary about living at The Beach. They told us they liked living at The Beach and that staff were supportive. In addition we observed how people interacted with staff and saw they appeared to be satisfied with the care they received and approached staff freely without hesitation.

We observed staff interacted with people who used the service in a kind and calm manner. We saw staff showed, through their actions, conversations and during discussions with us empathy and understanding towards the people they cared for.

We examined two people’s care records. We found that one person did not have a care plan in place and another care plan did not reflect the person’s current care needs. Therefore staff had limited guidance or direction in how to support or provide care for the people living at The Beach.

We found that people who used the service were involved in making day to day decisions and participated in tasks at home, such as cleaning and doing their laundry. During the visit we noted that people attended a variety of activities so that they had opportunities to pursue their interests.

Staff told us, confirmed by records that they had not had regular one to one meetings with their line manager for sometime. In addition some training for staff was out of date. This meant that staff work practices had not been monitored sufficiently to ensure they could carry out their roles competently.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others. However procedures had not been followed which left people who used the service, visitors and staff at risk of harm.

We spoke to two people who used the service. They told us they liked living at The Beach. Other people were out attending work or college placements.

We observed staff interacting with people who used the service in a kind and calm manner. We saw that staff showed, through their actions, conversations and during discussions with us empathy and understanding towards the people they cared for.

We saw that people's privacy and dignity was respected by the way that staff assisted people with their personal care.

We examined people’s care file and found the records were up to date and reviewed as the person's needs/wishes changed.

We found that people who used the service were involved in making day to day decisions and participated in tasks at home, such as cooking, cleaning and doing their laundry. The records showed that they went out frequently and saw healthcare professionals when they needed to.

Staff said they had received sufficient training and support to enable them to carry out their roles competently and felt there was sufficient staff on duty.

Systems for safeguarding people from abuse were satisfactory. Legal safeguards, which protect people unable to make decisions about their own welfare, were understood by staff and used to protect people’s rights.

The provider was reviewing recording systems to ensure that all information was kept accurately.