Our unannounced inspection of Beckly House took place on 1 November 2017. At our last inspection we rated the service as ‘requires improvement’ and identified breaches of regulation relating to the premises and good governance. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions ‘safe’ and ‘well-led’ to at least good. At this inspection we found the provider had taken action to improve infection control, maintenance of the premises and governance systems to measure monitor and improve quality. We have now rated these key questions and the service overall as ‘good’.

Beckly 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.

Beckly House accommodates up to 12 people in one adapted building consisting of two units. The care service has been developed and designed in line with the values that underpin ‘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, and Beckly House specialises in providing care and support to people with learning disabilities. At the time of our inspection 11 people used the service.

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.

Beckly House was clean, well maintained and people told us they felt safe living there. Staff were recruited safely and were present in sufficient numbers to provide timely care and support, including ensuring people could maintain their independence as much as possible.

Risk was well assessed and we saw guidance in place to ensure risks were minimised with as little impact as possible on people’s independence.

Medicines were generally well managed, although we have made a recommendation about managing the temperature in the medicines storage room. ‘As and when’ medicines were well managed, including a minimal use of medicines to manage behaviours which challenged people and others.

Staff understood how to manage challenging incidents safely, and understood how to recognise and report any concerns about potential abuse.

Staff received effective support in the form of induction, on-going training, induction and appraisals.

People’s rights to choose and make decisions were supported in accordance with good practice and legislation. Staff asked people’s consent before any care or support was given, and we saw people had access to health and social care professionals when needed.

Menus were planned by people who used the service, and we saw people were able to choose and prepare meals for themselves. Culturally appropriate diets were supported.

People were treated with kindness and compassion, and care placed a clear emphasis on people’s individuality, dignity and independence. There was a lively and homely atmosphere and we saw people and staff knew each other well. People’s cultural and communication needs were well met.

Care plans were person-centred and kept up to date. Staff were well informed about changes in people’s needs or health.

There was a good approach to planning and supporting activities which people wanted to participate in. People were provided with information about how to make complaints, however the service had not received any since our last inspection.

There was a clear vision for the service, and we saw records and practice which demonstrate

This was an unannounced inspection which we carried out on 8 August 2016.

We last inspected Beckly House in March 2014. At that inspection we found the service was meeting all of the legal requirements in force at the time.

Beckly House is a care home that provides accommodation and personal care for up to 12 people with learning disabilities. Nursing care is not provided. The home is divided into two separate units and supports three people in one unit and eight in the other.

A manager was in place who was not yet registered with the Care Quality Commission. 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.

Due to their health conditions and complex needs not all of the people were able to share their views about the service they received. There was a lively and friendly atmosphere and people appeared contented and relaxed with the staff who supported them. Staff knew the people they were supporting well and care was provided with patience and kindness. People's privacy and dignity were respected.

People told us they felt safe but we had concerns that there were not enough staff on duty at all times to provide safe and individual care to people. Risk assessments were in place and they identified current risks to the person. Beckly House was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had a good understanding of the Mental Capacity Act (MCA) 2005 and Best Interest Decision Making when people were unable to make decisions themselves.

Staff had received training to give them understanding of people's care and support needs. Staff had also received some training about safeguarding and knew how to respond to any allegation of abuse.

The premises were not all clean and well maintained for the comfort of people who used the service. The home had a quality assurance programme to check the quality of care provided. However the systems used to assess the quality of the service had not identified the issues that we found during the inspection to ensure people received safe and individual care that met their needs

People told us they were supported to go on holiday and to be part of the local community. They were provided with opportunities to follow their interests and hobbies and they were introduced to new activities. People had food and drink to meet their needs. Some people were assisted by staff to cook their own food. Other people received meals that had been cooked by staff. People had access to health care professionals to make sure they received appropriate care and treatment. People received their medicines in a safe way.

Staff said the management team were supportive and approachable. The manager monitored the quality of the service provided and introduced improvements to ensure that people received safe care that met their needs. However, their quality assurance system had not identified the issues we highlighted at inspection.

You can see what action we told the provider to take at the back of the full version of the report.

When we visited the home in November 2013 we found there were issues with the cleanliness of the home and infection control management. We said we were concerned about this and that improvements were needed. We went back on this inspection to check whether improvements had been made.

The manager told us that since our last visit the ensuite shower room areas of the home had undergone deep cleaning. They also told us areas of badly stained grouting and sealant had been replaced. We looked at the ensuite shower rooms of six people and saw the work which had been done. The rooms were clean and fresh and people living at the home told us they were very happy with these areas.

One person told us "It looks really nice and I'm really pleased." Another person told us "My ensuite is always clean, I do it myself."

At the time of our visit there were 11 people living at the home. We spoke with two people who lived at the home and three members of staff. One person told us they had not lived there long but they liked their bedroom and thought the home was alright. Another person told us they liked the staff who worked at the home. Staff we spoke with told us they felt the people living at the home received good care and were actively involved in their care. We saw each person living at the home had a personal activity timetable which showed how they spent their week. This included attending work, college, shopping, seeing relatives and spending time relaxing. We looked in the communal areas of the home such as the lounges and kitchen area and we found them to be comfortable with a homely feel. At the time of our visit people were busy organising their day and getting ready to go out with staff into the local community. We looked in people bedrooms and saw people had personal items such as photographs and soft toys displayed. We saw that ensuite areas of the bedrooms we looked in were not clean. We also saw that communal bathrooms and shower rooms were also not clean. We discussed this with the manager of the home and they told us they would take immediate action to ensure areas were cleaned.

During our inspection we spoke with two people who lived at the home. One of them told us they are very happy living at the home, that they liked the local area and also spending time with staff engaging in activities. Another person living at the home told us that the staff were great.

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