This inspection took place on 29 March 2017. The service was last inspected on 15 January 2015 and the service was rated Good. At this inspection we found the service remained Good.

Beaufort house provides residential care for up to five adults with autistic spectrum condition and associated learning disabilities. Beaufort house is a large terraced house in a residential area of Redcar which is close to local amenities. At the time of our inspection four people were living at the service.

Since the last inspection a new manager had been appointed and was in the processing of registering with the Care Quality Commission (CQC).

Risks to people arising from their health and support needs as well as the premises were assessed, and plans were in place to minimise them.

There were systems in place to ensure that people received their medicines as prescribed. Staff supported people to take their medicines when they needed them and recorded when they were taken. Staff had received medicines training and there were arrangements in place for managing people's medicines in a safe way.

There was enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff received effective supervision and a yearly appraisal.

Staff understood the importance of ensuring people agreed to the care and support they provided and when to involve others to help people make important decisions. The manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). The manager had submitted the appropriate applications where they had assessed that people were potentially receiving care that restricted their liberty.

People were cared for by staff that were trained in recognising and understanding how to report potential abuse. Staff felt confident to raise any concerns they had in order to keep people safe.

People enjoyed a good choice of meals and were supported to maintain a healthy diet.

The service worked with external professionals to support and maintain people’s health.

The interactions between people and staff were cheerful, fun and supportive. Staff knew people well and were kind and respectful.

Care was planned and delivered in way that responded to people’s assessed needs. Care plans contained detailed information about people’s personal preferences and wishes

Staff showed us that they knew the interests, likes and dislikes of people and people were supported to enjoy various activities. We saw that staff ensured that they were respectful of people's choices and decisions.

Relatives said they were involved in reviews of people's care and said staff listened to them. Relatives and staff felt confident they could raise any issues should the need arise and that action would be taken as a result. The service had a clear complaints policy that was applied when issues arose.

The manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice. The service had quality assurance systems in place which were used to drive continuous improvements.

Further information is in the detailed findings below:

The inspection visit took place on the 15th January 2015 and this was unannounced.

We last inspected the service on 12th January 2014 and found the service was not in breach of any regulations at that time.

Beaufort house provides residential care for up to five adults on the autistic spectrum condition with associated learning disabilities. Beaufort house is a large terraced house in a residential area of Redcar which is close to local amenities.

At the time of our inspection there was no registered manager in place. The area manager and senior carer were overseeing the service. The previous registered manager left in December 2014 and they were in the process of recruiting a new 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.

People living at the service received good, kind, attentive care and support that was tailored to meet their individual needs. Staff ensured they were kept safe from abuse and avoidable harm. People we spoke with were positive about the care they received and said that they felt safe.

There were procedures in place to keep people safe. The service had processes in place to minimise risks to people whilst ensuring their independence was promoted. Staff were trained and understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Staff said they would be confident to whistle blow (raise concerns about the home, staff practices or provider) if the need ever arose.

Accidents and incidents were monitored each month to identify trends. The area manager explained that if trends were to be found remedial action would be taken. At the time of our inspection there were no significant accidents and incidents to alert to trends.

We found people were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers and we saw evidence that a Disclosure and Barring Service (DBS) check had been completed before they started work in the home. The Disclosure and Barring Service carry out a criminal record and barring check on individuals who intend to work with children and vulnerable adults, to help employers make safer recruiting decisions and also to prevent unsuitable people from working with children and vulnerable adults.

We saw medicines were being managed and stored appropriately. Daily room temperatures had been missed seven times so far in January 2015. Room temperatures need to be recorded to make sure medicines were stored within the recommended temperature ranges.

The service was very clean and tidy. We observed the cleaning rota that highlighted how cleaning should be carried out. We saw there was plenty of personal protection equipment (PPE) such as gloves and aprons. Staff we spoke to confirmed they always had enough PPE. One member of staff was the infection control lead.

Staff received training to enable them to perform their roles and the service looked at ways to increase knowledge to ensure people’s individual needs were met. Staff had regular supervisions and appraisals to monitor their performance and told us they felt supported by the area manager and senior carer.

The area manager and staff had been trained and had a good knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They understood when an application should be made, and how to submit one. At the time of our inspection the service had three DoLs authorisations in place for people who lived there.

We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met.

We saw people had access to advocacy services. Advocacy seeks to ensure that people, particularly those who are most vulnerable in society, are able to have their voice heard on issues that are important to them).

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. Information was person centred with information that included how I like to communicate and what I enjoy doing. Person-centred care sees people who use the service as equal partners in planning, developing and assessing care to make sure it is most appropriate for their needs. It involves putting people at the heart of all decisions. The care plans included risk assessments which were sufficiently detailed for each individual.

We saw people being given choices and encouraged to take part in all aspects of day to day life at the service, from going to the shops to helping make dinner.

Although three people needed one to one support with outings, the service encouraged people to maintain their independence and people were supported to be involved in the local community as much as possible using public transport and accessing regular facilities such as the cinema or local leisure centre.

We were shown an excellent transition plan for one person who started using the service in November 2014. This was due to a step by step transition programme being implemented.

The service had a system in place for the management of complaints.

There were effective systems in place to monitor and improve the quality of the service provided.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced such as fire equipment and water temperature checks.

During the visit, we met all three people who were living at at Beaufort House during the time of the inspection. People had limited verbal skills and found it difficult to make direct comments about many aspects of the service therefore we spent time observing the practice.

We saw examples of decisions people had been involved in making and we could see the procedures which staff followed where people did not have the capacity to make decisions for themselves.

We spoke to staff and found that they were very knowledgeable about people's likes and dislikes and how they wished to be supported. One staff member told us, “It can be a challenging job at times, but it is extremely rewarding. It is nice to see that you make someone’s day.”

Where people were highlighted as being at risk, for example, with epilepsy, care plans had been developed. We found that care records contained up to date assessments, care plans and risk assessments. We found that care plans were reviewed monthly.

People were supported with accessing health and social care professionals and had a hospital passport in place for emergencies. This meant that people’s health and social care needs were addressed.

Regular supervision and staff meetings had taken place since the new manager came in to post in September 2013.

There was an effective complaints procedure in place.

Although the home has been registered with CQC for over a year it had remained empty until 30 July 2012. At the time of our inspection one person had started the process of moving into the home. We found that this person did not have personal care needs, as defined by the Health and Social Care Act 2008. The manager told us the intention was to continue to admit people to the home and they expected that the other people would require assistance with personal care needs.