This inspection was carried out on 24 May 2018 and it was announced. We gave the provider 24 hours’ notice so we could be sure the right people would be available when we visited the service. At the last inspection, the service was rated ‘Good.’ At this inspection we found the service remained Good.

Beckley Close 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 service provides accommodation and personal care to up to six people living with a learning disability and other complex health needs.

The 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 using the service can live as ordinary a life as any citizen.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The service continued to be well managed by the provider, long standing registered manager and staff team.

The provider did not always make sure people’s money was managed as safely as it could be. There was a minor risk that people would pay for staff meals and drinks when out, when they should not do so. Otherwise, people were safe and had the support they needed to express and achieve their goals and aspirations for the future. Positive risk taking was encouraged, and risk assessment and risk management practices to support this were robust. People were supported to eat and drink enough, and specialist dietary needs were met. People were able to access the healthcare they needed to remain well and their medicines were safely managed.

People continued to be supported to have maximum choice and control over all aspects of their lives, and staff supported people in the least restrictive way possible. People led the lives they wanted to and were able to maintain contact with those people who were important to them. People were also able to participate in a wide range of activities, educational opportunities and holidays.

People experienced care that met their needs, and were supported by kind and caring staff. People had their privacy and dignity respected, and staff knew what to do to make sure people’s independence was promoted. People experienced person centred care and were given every opportunity to express their choices and preferences. People were supported to make their end of life care wishes known, and staff knew to involve people in making decisions about their care if they became unwell.

As far as possible, people were protected from harm and abuse. Staff knew how to recognise the signs of abuse and what they should do if they thought someone was a risk. The home was clean, and people were protected from the risks of poor infection and prevention control.

Staff were properly supported with training, supervision and appraisals to make sure they had the skills they needed to provide good quality care. Specialist training had been arranged where needed, for example, dementia care. There were enough staff to support people to stay safe and meet their needs. Staff knew how to report incidents and accidents, and if these did occur, they were properly investigated. Information about these types of incidents were shared, so managers and staff could learn from mistakes.

People had their care needs regularly assessed, and all of the relevant people were involved in care reviews. People experienced care and support that was in line with current guidance

The home had a very relaxed, calm and happy atmosphere. The staff appeared unhurried. We observed them interacting in a very respectful and kind manner. They communicated in a very sensitive and clear way using basic language that encouraged people who use the service to engage in activities and maintained their dignity at all times. The people who use the service appeared very relaxed and happy with the staff and were seen to go to them to initiate interventions.

The staff had received training and a clear understanding of issues around capacity. They were able to tell us about the individual’s likes and dislikes and how they helped them to make choices in their daily lives. Care plans were very detailed and were reviewed every six months at least. This process involved the person, their relatives and other professionals.

They had a clear policy on medication within the service. We looked at medication charts and found no errors. However the staff told us that there had been some issues around documentation. The service had been proactive about this and there was now a monitoring system in place to address this. The manager had also had discussions with the local authority regarding in the investigation process of errors.

We saw that there was a robust monitoring system in place reviewing all aspects of care including record keeping, training, staff supervision, appraisal and the maintenance of the building.

We used a number of different methods to help us understand the experiences of people at Beckley Close, because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed staff interacting courteously and communicating effectively with people. We saw that people appeared happy and at ease around the staff.

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service. This was confirmed by our observations and the record keeping.

Care records showed that people had been supported and involved to make decisions about their lives, including their care and support. When people’s needs changed, we found that records had been updated to reflect this.

Staff spoken with demonstrated good understanding of how to safeguard people from harm. We saw there was a comprehensive induction programme in place which included shadowing experienced staff, training and being observed. We found that staff had the training to support people who lived at Beckley Close.

Records showed the provider regularly assessed and monitored the quality of the service. We saw that people and their representatives were asked their views about the home and information from other professionals were sought.

We inspected Beckley Close on 1 and 2 December 2015. Beckley Close provides accommodation and support for up to six people. Accommodation is provided from a building which was purpose built as a care home for people with learning disabilities. The building is located within a residential area.

The age range of people living at Beckley Close is 35 – 67. The service provides care and support to people living with a range of learning disabilities and a variety of longer term complex healthcare needs such as cerebral palsy, epilepsy and diabetes. Most people living at Beckley Close were unable to communicate verbally. Several people have been living at the service for over 11 years. There were six people living at the service on the day of our inspection.

We last inspected Beckley Close on 13 December 2013 where we found it to be compliant with all areas inspected.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People appeared happy and relaxed with staff. There were sufficient staff to support them. When staff were recruited, their employment history was checked, references obtained and comprehensive induction completed. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding and knew what action they should take if they suspected abuse was taking place. A wide range of specialist training was provided to ensure staff were confident to meet people’s needs.

It was clear staff and the registered manager had spent considerable time with people, getting to know them, gaining an understanding of their personal history and building rapport with them. People were provided with a choice of healthy food and drink ensuring their nutritional needs were met.

People’s needs had been assessed and detailed care plans developed. Care plans contained risk assessments for a wide range of daily living needs. For example, seizures, falls, and skin pressure areas. People consistently received the care they required, and staff members were clear on people’s individual needs. Care was provided with kindness and compassion. Staff members were responsive to people’s changing needs. People’s health and wellbeing was continually monitored and the provider regularly liaised with healthcare professionals for advice and guidance.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one. Where people lacked the mental capacity to make specific decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

People were provided with opportunities to take part in activities ‘in-house’ and to regularly access the local and wider community. People were supported to take an active role in decision making regarding their own routines and the routines and flow of their home. One family said, “Really can’t praise the home enough for getting the residents out and about.”

Staff had a clear understanding of the vision and philosophy of the home and they spoke enthusiastically about working at Beckley Close and positively about senior staff. The registered manager and operations manager undertook regular quality assurance reviews to monitor the standard of the service and drive improvement.