This unannounced inspection took place on 18 and 19 September 2017. The home provides residential care for up to eight adults with learning disabilities and /or autism. At the time of the inspection there were eight people living in the home. Most of the people had complex needs and behaviour that could challenge the service.

The home had 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.

The service was registered with us in October 2016. This was the first inspection since registration had taken place.

Staffing levels were determined based on people’s needs. Staff recruitment was carried out safely; this was to prevent unsuitable people from working with the people at Beech Tree House. Staff were trained and received support to ensure they had the skills and knowledge to carry out their roles. They were encouraged to feedback ideas to assist with the improvement of the service, through supervision, meetings and general discussion

We found some areas of the home required thorough cleaning. Plans were immediately put in place to rectify the situation. We have made a recommendation about cleanliness and hygiene in the home.

Staff were trained to identify signs of abuse and how to report concerns. Medicines were administered by trained staff. Records showed people received their medicines in a safe and appropriate way. Where people required additional support with maintaining their health, health professionals such as psychologists and GPs were referred to.

People’s consent was sought for aspects of their care. Where people were not able to make decisions for themselves, their mental capacity was assessed and the best interest process was followed. 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. Where people required restrictions to be put in place these were authorised by the local authorities supervisory body.

People were supported with their nutritional and hydration needs. This included providing food and drink that was safe for them to consume in line with their preferences and cultural needs.

People and their relatives spoke positively about the caring nature of staff. We observed how staff supported people with their care in a dignified and sensitive way. People’s communication needs were identified and staff had the skills and knowledge to work in an inclusive way with each person.

People’s relatives told us where appropriate they were kept up to date with changes to people’s needs and their day to day lifestyle choices. Relatives told us there was an honest and open culture in the home, and they felt part of the service provision to their family members.

People were supported to remain as independent as possible; involvement in the community was encouraged. Activities were available to people to protect them from the risk of social isolation.

Care plans and risk assessments were in place to ensure staff knew how to support people appropriately and safely. Amendments were planned to be made to the structure of the care plans to ensure all information could be easily located. Maintenance checks and health and safety audits had been completed to ensure the environment was safe for people and staff.

All people were treated equally with a strong emphasis on supporting people's diverse needs, including their religion and sexual orientation. People with protected characteristics had been assisted by the service to achieve their own goals and their preferences and their lifestyles were respected.

People, relatives and staff spoke positively abou