Beaufort House is a care home providing accommodation, personal care and support for up to seven adults who have a learning disability, physical disability or mental health conditions. There were six people living at the home at the time of our inspection.

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.

At the last inspection on 6 October 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People were supported by sufficient numbers of appropriately skilled staff to meet their needs and keep them safe. Robust recruitment procedures were followed to ensure only suitable staff were employed. Staff understood their responsibilities in safeguarding people from abuse and knew how to report any concerns they had.

Risks to people’s safety were identified and action taken to keep people as safe as possible. Accidents and incidents were reviewed and measures implemented to reduce the risk of them happening again. Health and safety and fire safety checks were carried out regularly to ensure the home was safe and well maintained. The provider had developed a contingency plan to ensure that people’s care would continue in the event of an emergency.

People received their medicines safely and as prescribed. Staff maintained appropriate standards of hygiene and cleanliness and followed safe infection control procedures.

People’s needs had been assessed before they moved into the home to ensure staff could provide the support they required. Staff had the training and support they needed to carry out their roles effectively. All staff attended an induction when they started work and had access to ongoing training. Specific training was provided if people developed needs that required it. The provider supported staff to achieve further qualifications relevant to their roles.

People’s rights under the Mental Capacity Act 2005 were respected. Staff understood the importance of gaining people’s consent to their care and how people communicated their decisions. People who lacked capacity received appropriate support when decisions that affected them were made. The provider ensured that all relevant people were consulted to ensure decisions were made in people’s best interests. Applications for DoLS authorisations had been submitted where restrictions were imposed upon people to keep them safe,

People were able to make choices about the food they ate and were supported to maintain a healthy diet. Staff ensured that individual support guidelines around diet and nutrition were followed. People were supported to maintain good health and to obtain treatment when they needed it. Staff were observant of any changes in people’s healthcare needs and responded promptly if they became unwell. Each person had a health action plan which detailed their health needs and the support they needed.

The home provided bright and spacious accommodation. People had been encouraged to choose the décor and were able to personalise their bedrooms. Equipment and adaptations were in place to meet people’s mobility needs.

Staff were kind, caring and compassionate. People had positive relationships with the staff who supported them and there was a homely, caring atmosphere in the home. Staff treated people with respect and maintained their dignity. They respected people’s individual rights and promoted their independence. People were supported to make choices about their care and to maintain relationships with their friends and families.

People received care that was personalised to their individual needs. Support plans reflected people’s needs, preferences and ambition

This was an unannounced inspection which took place on 06 October 2015.

Beaufort House provides support and accommodation for a maximum of seven adults with a physical and/or learning disability. At the time of this inspection there were four people living at the home. People had varied communication needs and abilities. Some people were able to express themselves verbally using one or two words; others used body language to communicate their needs. Everyone who lived at the home required full support from staff for all aspects of their life including emotional and physical support.

During our inspection the registered manager was present. 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 and associated Regulations about how the service is run.

Medicines were managed safely and staff training in this area included observations of their practice to ensure medicines were given appropriately and with consideration for the person concerned.

People appeared very happy and at ease in the presence of staff. Staff were aware of their responsibilities in relation to protecting people from harm and abuse.

People were supported to take control of their lives in a safe way. Risks were identified and managed that supported this. Systems were in place for continually reviewing incidents and accidents that happened within the home in order that actions were taken to reduce, where possible reoccurrence. Checks on the environment and equipment had been completed to ensure it was safe for people.

Staff were available for people when they needed support in the home and in the community. Staff told us that they had enough time to support people in a safe and timely way. Staff recruitment records contained information that demonstrated that the provider took the necessary steps to ensure they employed people who were suitable to work at the home. Staff were sufficiently skilled and experienced to care and support people to have a good quality of life. Training was provided during induction and then on an on-going basis.

Beaufort House was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of people by ensuring if there are any restrictions to their freedom and liberty these have been authorised by the local authority as being required to protect the person from harm.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Records included the use of photographs and symbols which supported people's involvement and understanding in the care planning process. Capacity to make decisions had been assumed by staff unless there was a professional assessment to show otherwise. People were supported to access healthcare services and to maintain good health.

People were routinely involved in the review of their care packages and regular house meetings took place that helped people to express their views. The minutes of house meetings had been produced in an easy to read format to aid communication for people. People played an active role in planning their meals and had enough to eat and drink throughout the day. People who were unable to communicate verbally were supported to make choices by using picture cards and objects of reference.

The home had suitable equipment and other adaptations to the premises had been made, which helped to meet people’s needs and promote their independence.

Positive, caring relationships had been developed with people. We observed people smiling and choosing to spend time with staff who always gave people time and attention. Staff knew what people could do for themselves and areas where support was needed. Staff appeared very dedicated and committed.

People received personalised care that was responsive to their needs. During our inspection we observed that staff supported people promptly in response to people’s body language and facial gestures. Activities were offered which included those aimed for people with complex needs. People were also supported to maintain contact with people who were important to them.

Staff understood the importance of supporting people to raise concerns who could not verbalise their concerns. Pictorial information of what to do in the event of needing to make a complaint was displayed in the home.

People spoke highly of the registered manager. Staff were motivated and told us that management at Beaufort House was good. The registered manager was aware of the attitudes, values and behaviours of staff. She took responsibility for maintaining her own knowledge and shared this with staff at the home.

A range of quality assurance audits were completed by the registered manager and representatives of the provider that helped ensure quality standards were maintained and legislation complied with. Quality assurance processes included obtaining and acting on the views of people in order that their views could be used to drive improvements at the home.

During our inspection we spoke with four members of staff as well as the registered manager. We carried out some observations as we were not able to speak to most people who used the service due to their complex communication needs. We also spoke to a local doctor who was visiting the service on the day of our inspection.

We saw that staff asked people for their consent before providing any care or support. For example, at lunchtime a staff member asked “Would you like me to peel your orange for you”?

We saw that care records were reviewed and up to date. We observed the care that people received and saw that this was in line with their assessed needs in their care plan. For example, adapted cutlery was provided as described in one person’s care plan.

We carried out a visual inspection of the home and saw that the home was clean and tidy. We saw that staff had received infection control training and that they were knowledgeable about infection control procedures.

We saw that there were sufficient staff on duty and that they were suitable qualified to carry out their roles. One staff member told us “There are always enough staff.”

We saw that the provider had a complaints policy and that information about how to complain was available to people in a format that met their needs. We were told that the service had not received any complaints.

There were six people living at the home at the time of the inspection. People were unable to speak with us due to their complex needs. To help us understand peoples experiences we used our Short Observational Framework for Inspection (SOFI) tool as part of our observations methods. The SOFI tool allowed us to spend time observing interactions and identify the type of support they received and whether people using the service had positive experiences.

We spent 30 minutes observing an activity before lunch. We saw that staff used a range of communication methods to communicate with people and we saw reciprocal warmth between people using the service and the staff. We saw that staff were communicating with people at a suitable pace and were relaxed and unhurried during their interactions. We observed that people were offered choice and were spoken to respectfully.