Our inspection of Beacon House took place between 16 and 23 April 2018 and was unannounced. At our last inspection in March 2017, we found breaches of legal requirements relating to person centred care. At this inspection we found improvements had been made to assessments of care needs and activities and the service was no longer in breach of Regulations.

Beacon House 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.

The home is located in Bradford and provides accommodation for up to 16 people with learning disabilities who require varying levels of care and support. Accommodation is spread over six units, each with its own living space including a kitchen and lounge.

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.

There was a registered manager in place. 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.

People told us they felt safe. Correct safeguarding reporting procedures were followed. Staff were aware of the actions they would take to keep people safe. Correct procedures were followed to keep people’s money safe.

Overall risks to people’s health, safety and welfare were identified and action taken to manage the risk. Staff demonstrated a sound awareness of infection control procedures.

There were enough staff deployed. All the required checks were done before new staff started work and this helped protect people.

Medicines were managed safely and staff had good knowledge of the medicine systems and procedures in place to support this. The support people received with their medicines was person centred and responsive to their needs.

People were provided with care and support by staff that had received appropriate training. Staff told us they had received induction and training relevant to their roles.

People were supported with their health care needs. We saw a range of health care professionals visited the service when required and people were supported to attend health care appointments in the community.

We recommended provider implements robust systems to ensure people’s nutritional needs are met.

People told us they were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

The service was acting within the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, best interest processes were followed. People were given choices and involved in decision making.

People were supported to access activities both within the home and in the wider community. This was person centred.

People's nutrition and hydration needs were well catered for. People received a range of food which met their individual needs. However, nutritional risks required some improvements.

Care records contained sufficient detail so staff knew what support to offer people. People felt they participated in planning their care. Care records included information about preferences, likes and dislikes.

A complaints procedure and easy read version was in place, which enabled people to raise any concerns or complaints about the care, or support they received.

There was an open and transparent culture at Beacon House. People respected the management team a

Beacon House is located in Bradford and provides accommodation for up to 16 people with learning disabilities who require varying levels of care and support. Accommodation is split into six units, each with its own living space.

The inspection took place on the 6 March 2017 and was unannounced. At the time of the inspection 16 people were living in the home.

At the last inspection in August 2015, we rated the service ‘Good’ overall and ‘Requires Improvement’ in the ‘Safe’ domain. At this inspection we found improvements had been made to the ‘Safe’ domain, however shortfalls were found in some other areas; for example care records were not always up-to-date and did not demonstrate complete assessments of people’s individual needs.

A registered manager was in place. 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.

People and relatives spoke positively about the service, its staff and the quality of care and support provided. People and relatives said people were safe in the company of staff. Staff understood how to identify and act on any concerns and we saw safeguarding procedures had been followed to keep people safe. Risks to people were well managed by the service. Incidents were investigated and action taken to help prevent a re-occurrence.

There were sufficient staff available to keep people safe and staff were recruited in a safe way to help ensure they were of suitable character to work with vulnerable people.

Staff received a range of training relevant to their role caring for supporting people with learning disabilities. Staff were provided with support, supervision and appraisal by the management team.

Overall the service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). However, we found a lack of evidence that people had consented for their photographs to be used by the service.

People were supported to source, and prepare a range of food products. Action was taken where people were deemed nutritionally at risk. However care plans were not always updated following changes in people’s weights.

People had access to a range of health professionals. However health action plans were not kept up-to-date, which meant the latest information on people’s needs was not always recorded.

People received care and support from a kind and compassionate staff team. We saw good, positive relationships had developed between people and staff. Staff knew the people they were supporting well.

People’s needs were assessed and detailed care plans put in place. However these were not always kept up-to-date and care plan documentation required better organising.

A range of activities were available to people and we saw examples where people had gone on holiday and on a range of trips out with support from staff. However records showed, some people that required 2:1 support did not always receive a range of appropriate activities.

The service worked with people to achieve goals and objectives to help maintain or develop independence. Some paperwork surrounding goals and achievements needed bringing up-to-date.

Relatives we spoke with praised the way the service was managed and said communication was good. Staff told us they felt supported by the management team.

A range of audits and checks were undertaken by the service. However we concluded some of these systems needed improvement to ensure care plans did not become outdated and ensure management documentation was better organised.

We found one breach of the Health and Social Care Act (2008) (Regulated Activities) 2014 Regulations. You can see what action we asked the provider to take at the back of th

The inspection took place on 24 August 2015 and was an unannounced inspection. On the date of the inspection there were 16 people living in the home. Beacon House provides accommodation for up to 16 people with learning disabilities who require varying levels of care and support. Beacon House is split into two distinct units, Beacon House Upper and Beacon House Lower. These are run separately with different staff and management within each unit.

A registered manager was in place. 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.

Most people received their medicines in a timely way in line with the prescribers’ instructions and appropriate records were kept. However this was not consistently the case, as we noted one person did not receive all their medicines at the correct time. Medicines were correctly stored and arrangements were in place to order and dispose of medicines.

Most risks to people’s health, safety and welfare were appropriately managed. Robust risk assessments were in place detailing how staff should help keep people safe whilst delivering care and support. However we noted one instance where hazardous items were not appropriately locked away. Once we pointed this out to management; they took immediate action to address.

People and relatives told us that people felt safe in the service and staff had a good understanding of how to recognise and act on allegations of abuse.

We concluded, overall staffing levels were sufficient and matched with the agreed contracted hours for each person living in the service. However whilst staff on Beacon House Lower told us staffing levels were sufficient, staff on Beacon House Upper all told us they felt at times staffing levels were not sufficient within certain areas of the unit. We asked the management to investigate this and address the concerns raised by staff.

Robust recruitment procedures were in place to ensure people were cared for by staff of suitable character.

The service was acting within the legal framework of the Mental Capacity Act, including meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). A number of DoLS applications had been made where the service judged it was depriving people of their liberty. This helped to ensure people’s rights were protected.

People and relatives told us the food was good. We saw people had individual menus to ensure the food provided met their preferences. Some people were appropriately supported to cook for themselves to increase their independence.

People’s healthcare needs were assessed by the service. Specific plans were in place to support and maintain the health of the people who used the service.

Staff received a range of training tailored to their role working in learning disabilities. We saw this had been effective, for example staff had received training in autism and had used that knowledge to develop specialist care plans for people with autism.

People and their relatives all said staff were kind and caring. We saw this was the case in the interactions with observed. People appeared comfortable and relaxed in the company of staff. Staff demonstrated a good knowledge of the people they cared for, for example able to confidently describe their likes, dislikes and preferences. A range of communication techniques were used by staff to ensure people were listened to and their views and choices heard.

People had a range of highly personalised care and support plans in place which provided detailed information on how staff should meet their needs. Staff we spoke with were familiar with people’s plans of care and how to help them maximise their independence and develop life skills.

Staff supported people to undertake a range of activities and opportunities, including providing employment, trips into the community and holidays.

An appropriate system was in place to manage complaints and bring it to the attention of people who used the service.

The service was committed to continuous improvement of the service and a number of initiatives had been put in place to help deliver high quality care. For example the service was working towards recognised autism accreditation and we found this had resulted in a good level of expertise in this area.

A range of audits and checks were undertaken by the service for example medication audits and regular monthly audits by the clinical services manager. Where action was required robust plans of action were put in place to address.

People were involved in the running of the service through regular meetings and the service user forum where people were encouraged to get involved in the creation and review of policies including fire and safeguarding.

Beacon House is split into two units. Beacon House Upper accommodates eight people in two units and Beacon House Lower accommodates eight people in four units. Each unit has its own front door, communal lounge, dining room, kitchen and bathroom.

We saw before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. One person who used the service told us they made choices and were fully involved in planning their care and were always asked for their consent.

We found peoples’ needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We talked with four people who lived at Beacon House two people said they “Liked” Beacon House. One told us “It was a good place to live”. The fourth told us they wanted to move but they did not have any complaints about the house.

We saw people were protected from the risks of inadequate nutrition and dehydration. We talked to three relatives and asked about the food, they all told us it was very good and there was plenty to eat. Two relatives described how staff helped their relatives eat a nutritious and balanced diet.

We found people 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. A person who used the service told us they “Felt safe” and the relatives confirmed they had felt Beacon House was a safe place to live.

We found there were sufficient staff to meet people’s needs because one person and three relatives told us there were enough staff and when the call alarms went off during the night staff did respond. The managers also explained to us how they regularly reviewed the amount of support people needed to make sure there was enough staff to support them.

Some of the people who used the service had complex needs and were unable to tell us about their experiences. Therefore, we used a number of different methods to help us understand the experiences of people who used the service, such as reviewing care records and speaking with relatives.

We spoke with one person who lived at Beacon House. They said they made decisions about the care they received and staff listened to them when they made their wishes known. They said “I get the help and support I need but staff also give me my personal space”.

We spoke with two relatives of people who lived at Beacon House. They told us they felt involved in their relatives care and attended yearly reviews of their care plan. They were positive about the care and support staff provided. One relative said “Beacon House is a marvellous place, they provide the best care I could have imagined”.

We saw people received medicines when they required them and there were processes in place to ensure medicines were managed safely.

The person we spoke with who lived at Beacon House said staff treated them with respect and listened to what they wanted. One of the relatives we spoke with said “staff are fantastic, they treat people with respect and I have a very good relationship with them”.

The three people we spoke with were aware of how they could make a complaint. They said if they did complain they were confident staff would listen to and act upon their concerns.

Some of the people that were at home when we visited could not tell us directly about their care. The three people that we did speak to told us that they were happy at Beacon House, liked the staff, the food and had good opportunities to go out and do the things they like.