Beech Gardens is a care home without nursing that provides a service to up to eight people with learning disabilities who may also be on the autistic spectrum. At the time of our inspection there were seven people living at the service.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated any risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

The service continued to meet all the fundamental standards and had a registered manager as required. The registered manager was present and assisted us with the inspection.

People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. Medicines were handled correctly and safely.

People received effective care and support from staff who knew them well and were trained and supervised. We have made a recommendation related to reviewing the ongoing staff training at the service.

People received care and support which was personalised to meet their individual needs. They knew how to complain and staff knew the process to follow if they had concerns.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's right to make their own decisions were protected.

People benefitted from a service which had an open and inclusive culture. Staff were happy working at the service and people benefitted from having staff who felt well managed and supported.

People were treated with care and kindness and their right to confidentiality was protected. People were treated with respect and their dignity was upheld. People's diversity needs were identified and incorporated into their care plans where applicable.

Further information is in the detailed findings in the full report.

This inspection took place on 24 and 25 May 2016 and was unannounced. We last inspected the service in July 2014. At that inspection we found the service was compliant with all essential standards we inspected.

Beech Gardens is a care home without nursing that provides a service to up to eight people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection there were seven people living at the service.

The service had a registered manager as required. A registered manager is a person who has registered with the 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 2008 and associated regulations about how the service is run. The registered manager was present and assisted us during this inspection.

People told us they felt safe living at the home. Staff understood their responsibilities to raise concerns and report incidents and were supported to do so.

People told us staff were available when they needed them and staff knew how they liked things done. Staffing levels and skill mixes were planned, implemented and reviewed to ensure there were enough staff to meet people's needs.

People were encouraged to do things for themselves and staff helped them to be as independent as they could be. Risk assessments were person-centred, proportionate and reviewed. Staff recognised and responded to changes in risks to people who use the service.

People received effective personal care and support from staff who knew them well and were well trained and supervised. People received support that was individualised to their personal preferences and needs. Their needs were monitored and care plans formally reviewed every six months or as changes occurred.

People received effective healthcare. People saw their GP and other health professionals, such as dentists and chiropodists, when needed. Medicines were stored and handled correctly and safely. Meals were nutritious and varied and people told us they enjoyed the food at the service.

People's rights to make their own decisions, where possible, were protected. Staff were aware of their responsibilities to ensure people's rights to make their own decisions were promoted.

People were treated with care and kindness. During our inspection people were busy going about their daily lives. Staff supported them, where needed, to carry out activities in the home and going out to college or other day time activities. People's wellbeing was protected and all interactions observed between staff and people living at the service were respectful and friendly. Relatives and social care professionals confirmed staff respected and upheld the privacy and dignity of people living at the service.

People benefitted from living at a service that had an open and friendly culture. People felt staff had a good relationship with them, each other and the management. Staff told us the management was open with them and communicated what was happening at the service and with the people living there. People and their relatives told us they felt the service was managed well and that they could approach management and staff with any concerns.

The inspection team consisted of an adult social care CQC inspector. On the day of our inspection seven people used the service. We spoke with four people who use the service and three people’s relatives, four care workers and the registered manager.

We observed how staff supported people, and looked at documents including care plans, staff records and management reports. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask; is the service caring, responsive, safe, effective and well led?

This is a summary of what we found.

Is the service caring?

We found the service was caring. One person told us “I like the staff, they are very nice and help me”. They told us that they enjoyed the activities and tasks they had been supported to complete, including washing, going out shopping and having a cup of tea in the community. Another person told us they had recently been supported to take a friend out for a meal. “I love it here, I can go to the pub or have a barbeque for my birthday”.

One relative told us “They know X well. I can tell from their voice that X is settled and calm there”. Another relative said “There is an extremely high level of care. Staff can only be described as sheer niceness. They show X love, kindness and gentleness. I have never seen them lose their patience”.

All the care workers we spoke with told us they cared about the people they worked with. One care worker told us “I really enjoy coming to work”.

Is the service responsive?

The service was responsive to people’s needs and wishes. One person told us they had chosen the colour of the walls in their room, and these had been painted “my favourite colour”. Another person explained how they had been supported to visit their GP, and had been visited by the district nurse to ensure a health need was supported appropriately. They understood the actions necessary to promote their healing.

People told us staff listened to their comments. They said staff understood when they wanted to go out, but listened and respected their wishes if they changed their mind. They told us staff helped them to maintain their friendships with people in another service. One care worker told us “The residents are brilliant. They always want you to be there. They tell you and show you what they want you to do”. This meant staff understood people’s wishes, and responded appropriately to support these.

A relative told us their loved one appeared happier and more content since living at Beech Gardens. They explained how the staff had taken actions to promote the person’s wellbeing, and provided reassurance to help them to manage their anxieties.

We found the service met the requirements of the Deprivation of Liberty Safeguards. The manager was reviewing whether any applications needed to be made in response to the recent supreme court judgement in relation to Deprivation of Liberty Safeguards.

Is the service safe?

We found the service was safe. One person told us “Everything is as it should be”. We saw people had attended training about safeguarding, and understood the actions to take to report any concerns about their safety or care. People told us they had undertaken fire drills to ensure they understood the actions to take in the event of fire. This meant people understood the actions to take in the event of potential harm.

The provider identified risks and hazards, and had taken appropriate actions to reduce the impact of these. We saw risks had been identified in relation to each person’s activities, hobbies and behaviour. Records documented how risks had been discussed with people, and measures taken to reduce identified risks in agreement with each individual. This meant people and others had been protected from potential harm.

The service had been well maintained. The maintenance team and care workers ensured checks and servicing had been completed in accordance with the provider’s and manufacturers’ guidance. This showed us the provider understood appropriate actions to follow to protect people and others from an unsafe environment.

Is the service effective?

We found the service had effective processes in place to ensure people received quality care. One person told us “There is nothing that isn’t good about my home”. A relative told us “They [staff] take good care of X. They know how to handle things". They told us staff understood their loved one, and knew how to support them.

We observed and saw evidence to demonstrate that staff ensured people received the care and support they wanted. People’s needs had been assessed, and were regularly reviewed, to ensure they received the care they required. Feedback had been sought from people and their relatives to ensure staff effectively implemented changes requested when it was appropriate to do so.

Staff attended training to ensure they learnt and maintained the skills required to support people. We saw this training had been refreshed and assessed to ensure staff implemented training effectively.

Is the service well led?

One person told us “X [the registered manager] is a nice man”. We observed people living at Beech Gardens smiled when they saw the manager, knew them by name and approached them for support. This indicated to us that they liked and trusted the manager. Staff told us they felt supported, and commented that the manager had an “Open door policy”. This meant that staff knew they could ask for assistance and guidance when this was required.

We saw records demonstrated that staff had been supported through supervisions and appraisal to identify topics where they required additional support, training or development. Staff told us supervisions provided an opportunity for two way discussions. Mandatory training had been kept updated. This meant staff had been supported to learn, and ensured that people were supported by people with the skills to safely do so.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

The home is registered for up to eight people. On the day of our inspection we were told there were seven people in the home.

We looked at the care planning of four people we found they had been involved in planning their care and staff were familiar with people's needs. Staff had received appropriate induction and training and their manager provided them with regular supervision. Staff were also supported through a system of supervision and appraisals.

Four people we spoke with told us staff gave them the help they needed. One person told us, "I like it here" another told us that it was “all good here”. All four people who use this service told us they felt safe living at Beech Gardens and they would tell a staff member if they were worried about anything.

We saw minutes from meetings people had with their key workers where they could discuss any problems or worries they had.

People were encouraged to discuss their care and whether they wanted to change anything. Three staff members and the registered manager also told us about key worker meetings and forums where people could have their say about the home. The four people we spoke with said their opinions on how the home was run were taken into account.

We looked at three care plans and found people who use the service had signed to agree their plan was accurate. Three staff members and two people who use the service told us some decisions about the management of the home were made as a result of forums which included everyone who worked and lived at the home.

Three people we spoke with told us staff gave them the help they needed. One person told us, "This is a lovely home". Three people who use this service told us they felt safe living at Beech Gardens and they would tell a staff member if they were worried about anything. We saw minutes from meetings people had with their key workers where they could discuss any problems or worries they had.

People were encouraged to discuss their care and whether they wanted to change anything. Three staff members also told us about key worker meetings and forums where people could have their say about the home. Three people we spoke with said their opinions on how the home was run were taken into account.