At the last inspection in December 2015 the service was rated Good. At this unannounced inspection on the 28 November 2017 we found the service remained Good. The service met all relevant fundamental standards.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Beech Cliffe Grange on our website at www.cqc.org.uk’

Beech Cliffe Grange is a care home for younger people with a learning disability. It can accommodate up to eleven people. At the time of our inspection there were nine people living at the service.

The service had a 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 received care and support from staff who understood how to keep them safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. Staff were available to meet people's needs and understood how to best support people them. Staff were knowledgeable about risks to people's well-being and knew how to manage them. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately. Infection, prevention and control systems were in place and effective.

Robust recruitment procedures ensured the right staff were employed to meet people’s needs safely.

People's rights were protected in line with the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager understood their responsibilities regarding this.

People received adequate nutrition and hydration to maintain their health and wellbeing. The premises were an older building and could be designed better; however, the provider was looking at ways to improve this.

Staff supported people with kindness, dignity and respect. People were supported to undertake a range of activities at the service and in the community.

People had the benefit of a culture and management style that was inclusive and caring. Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them.

People were asked for their views about the service, feedback received was acted upon. The registered manager, staff and senior management team undertook checks and audits of the service. Investigations of incidents and accidents occurred and any learning from these issues was implemented to help to maintain or improve the service provided.

Further information is in the detailed findings below.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Due to the complex needs of the people using the service we were unable to gain their views. Therefore we used a number of different methods to help us understand their experiences. This included observing how staff supported people, speaking with staff and a visitor and checking records.

Is the service safe?

We found people were encouraged to express their views and were involved in making decisions about their care and treatment. The staff we spoke with gave us good examples of how people were involved in making decisions about the care and support they received. We also saw staff encouraged people to be as independent as possible while offering the correct level of support needed.

The home was clean and fresh throughout. We saw there were effective systems in place to reduce the risk and spread of infection.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

We saw checks took place to ensure the service was operating safely.

Is the service effective?

People’s health and care needs were assessed on a regular basis. We saw people who used the service and their relatives had been involved in writing plans of care and these were reviewed and updated.

Staff had received appropriate professional development. We saw they had access to a varied training programme that helped them meet the needs of the people they supported.

Is the service caring?

People were supported by kind, caring and patient staff. We saw staff interacting with people positively. They encouraged them to be as independent as they were able to be while providing support as needed. A visitor spoke positively about the care and support provided to their relative.

Care files contained good information about people’s needs and preferences. This included the people important in their lives and their personal aims, as well as their aspirations and goals. These were clear and measurable.

Satisfaction surveys and review meetings had been used to enable people to share their views on the service provided. This helped the provider to assess if people were receiving the care and support they needed.

Is the service responsive?

Records showed people had access to a variety of social activities. During our visit we saw people going out into the community supported by staff or participating in stimulation at the home.

The home has a complaints procedure which was available to people using and visiting the service. No complaints had been recorded since our last inspection, but we saw several compliments about the service had been received.

Is the service well-led?

There was a quality assurance system in place to assess if the home was operating correctly. This included audits by the provider and external consultants.

Staff were clear about their roles and responsibilities. We saw staff had access to policies and procedure as well as a staff handbook. Most staff had received an annual appraisal of their work. However, documented staff support sessions had not been carried out on a regular basis. Staff training and development needs had been assessed to enable the provider to arrange future training sessions.

This inspection was to check if the provider had taken action to address the shortfalls we found regarding the processes to safeguard people from abuse when we carried out our last inspection in June 2013.

At this visit we found the provider had addressed the shortfalls we identified at our last inspection. The safeguarding policy and procedure had been reviewed and amended and all staff had received appropriate training in this subject. This had helped to make sure staff reported concerns promptly and appropriate agencies were alerted in a timely manner.

On this occasion we did not speak to people who used the service. However their experiences were captured through information received from the provider and the council, checking records and speaking with staff.

We undertook this inspection due to concerns raised that included allegations that people were not supported in the correct way.

We were unable to gain the views of all the people who used the service when we visited due to their complex needs. Therefore we also observed how support was provided, reviewed records and spoke with staff to help us understand their experiences.

During our inspection we found that people received the care and support they needed. Each person had a care plan which detailed the support they needed, their preferences and any risks associated with their care. People were involved in a variety of social activities and carried out day to day living skills, such as shopping and preparing meals.

We saw that people received a varied menu and their preferences had been taken into account. We saw staff monitored what people were eating and drinking to make sure they received sufficient nourishment.

From our observations, discussions with staff and review of documentation we found there were enough staff on duty to meet people’s needs. We saw people received the support they needed in a timely manner.

We saw there were systems in place to gain peoples views and check if staff were following company policies.

A complaints procedure was available to people who used and visited the service. Records we looked at showed any concerns raised had been investigated.

Due to the complex needs of the people using the service we were unable to gain their views so we used a number of different methods to help us understand their experiences. We walked round the home, looked at records, spoke with staff and observed them providing care and support.

We saw that people experienced care delivered in an unhurried manner, and that staff talked things through with them. We saw staff supporting people to get ready to go out for the morning. They spoke with them while this was taking place to help them understand what was happening, and took time to ensure they supported them in a way the person appeared to be comfortable with. We saw staff respected people’s preferences while encouraging them to be as independent as possible.

We saw there was a wide range of social activities for people to take part in, as well as opportunities for them to be involved in everyday tasks like shopping, cleaning and preparing meals.

We spoke with three members of staff who told us that people were encouraged to be as independent as possible.

We spoke to one person who told us they had enjoyed opening their Christmas presents and their Christmas dinner. Another person told us they were “Happy”. We observed people socialising together in the lounge and some people going out for a walk.

At the last inspection in December 2015 the service was rated Good. At this unannounced inspection on the 28 November 2017 we found the service remained Good. The service met all relevant fundamental standards.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Beech Cliffe Grange on our website at www.cqc.org.uk’

Beech Cliffe Grange is a care home for younger people with a learning disability. It can accommodate up to eleven people. At the time of our inspection there were nine people living at the service.

The service had a 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 received care and support from staff who understood how to keep them safe. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. Staff were available to meet people's needs and understood how to best support people them. Staff were knowledgeable about risks to people's well-being and knew how to manage them. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately. Infection, prevention and control systems were in place and effective.

Robust recruitment procedures ensured the right staff were employed to meet people’s needs safely.

People's rights were protected in line with the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager understood their responsibilities regarding this.

People received adequate nutrition and hydration to maintain their health and wellbeing. The premises were an older building and could be designed better; however, the provider was looking at ways to improve this.

Staff supported people with kindness, dignity and respect. People were supported to undertake a range of activities at the service and in the community.

People had the benefit of a culture and management style that was inclusive and caring. Staff were clear about their roles and responsibilities and had access to policies and procedures to inform and guide them.

People were asked for their views about the service, feedback received was acted upon. The registered manager, staff and senior management team undertook checks and audits of the service. Investigations of incidents and accidents occurred and any learning from these issues was implemented to help to maintain or improve the service provided.

Further information is in the detailed findings below.