This inspection took place on 12 January 2017 and was unannounced. Beechwood provides accommodation and personal care for up to eight people with autism and learning disabilities. On the day of our inspection eight people were using 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.

Staff worked to protect people from the risk of abuse and the provider was committed to reducing the use of any restrictive practice. Risks to people’s health and safety were assessed and plans put into place to reduce risks.

People were supported by a sufficient number of staff and staffing levels were flexible to meet people’s needs. Effective recruitment procedures were operated to ensure staff were safe to work with vulnerable adults. People received their medicines as prescribed and they were safely stored.

Staff were provided with a wide range of knowledge and skills to care for people effectively and staff felt supported by the registered manager. Regular supervision was not always provided to staff but plans were in place to address this. People received support from health care professionals when needed. People had access to sufficient quantities of food and drink and were able to choose the food they wanted.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received.

Positive and caring relationships had been developed between people and staff and staff had developed individualised communication techniques with each person. Staff ensured people were fully involved in decision making and respected their choices. Staff treated people with dignity and respect and ensured that people’s right to privacy was respected.

People were provided with care that was responsive to their changing needs and personal preferences. Staff encouraged people to be as independent as possible and worked with people to develop their skills. There was a comprehensive and individually tailored programme of activities available. There was a clear complaints procedure in place and any complaints received had been appropriately responded to.

There were systems in place to monitor the quality of the service and these were well utilised and resulted in improvements being made. The registered manager led by example and staff felt able to speak with them about any concerns. However, staff commented that recent management changes had been unsettling for them. There was an open and honest culture in the home.

We inspected Beechwood on 10 February 2015. This inspection was unannounced.

The service provides accommodation for up to eight people who have support needs associated with autism spectrum conditions. At the time of our inspection there were eight people living at the service.

The last inspection took place on 20 June 2013. As a result of the inspection we asked the provider to take action to improve the arrangements in place for people to give consent to their care and treatment. We also asked the provider to improve the frequency of reviews in place to check on any changes to the care provided and the supervision systems in place to support staff. During this inspection we found that the appropriate actions and improvements had been completed by the provider.

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.

People’s rights were protected by the registered manager and staff who understood the Mental Capacity Act 2005 Code of practice and the Deprivation of Liberty Safeguards, and followed the correct procedures when these were applied.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves.

People said they were happy with the care they received and that staff helped them maintain their privacy and dignity. We found staff had a good understanding of people’s needs and they were kind and respectful to people when they provided support.

The registered manager and staff promoted an open and inclusive culture within the home. People had the opportunity share their views and opinions and were involved in planning and reviewing their care. People and their relatives also understood how to raise any complaints or issues they had and were confident the right actions would be taken to resolve them.

We found that people’s health care needs were assessed and met in the right way and people had access to other social and healthcare professionals when they needed them.

People were given choices about what they wanted to eat and about when and where they had their meals. They were also supported to eat and drink enough to keep them healthy.

The registered manager and staff encouraged people to maintain strong links with their family members and to keep developing their community hobbies and interests.

Staff were trained and supported to meet people’s needs appropriately. There were enough staff available to meet people’s needs and staff had a good understanding of how to manage risks and protect people from avoidable harm. They also knew how to raise any concerns they may have and report them appropriately.

The registered manager ensured there were clear arrangements were in place for ordering, storing, administering and disposing of medicines.

People and their relatives were consulted regularly about the development of the service. The provider had completed quality checks to make sure that people received the care they needed in a consistent way.

We spoke with five people who were using the service. Some people were able to indicate that they were involved in their care planning and giving consent to the care plan that was in place. One person was in the process of writing their own care plans to indicate to staff how they wished to be supported. The manager told us that some people would lack the capacity to be able to consent to a particular aspect of their care. Where this was the case, an assessment of their capacity to make a decision had not been carried out under the Mental Capacity Act (2005) (MCA).

We spoke with five people who were using the service. People told us what activities they would be doing on the day of the inspection. We saw that this matched with the timetables on display and the activities happened as described. There was not always detailed information available to staff about every aspect of a person’s care.

On the day of our inspection the home appeared bright and clean. We saw staff and people using the service carrying out various cleaning duties throughout the day.

We saw that a lot of training had been provided to staff since our last inspection. Some training was in need of a refresher and we were provided with a list of scheduled dates for training courses that were planned. Not all staff had received supervision recently.

We saw that there was an appropriate complaints procedure in place which described the actions that may be taken to investigate a complaint.

We spoke to two people who were using the service during our visit. The people we spoke with told us they thought the staff were nice and treated them well. One person told us, “Yes the staff are nice, they give me support when I need it but respect my independence as well.”

We spoke with two people who were using the service during our visit. The people we spoke with indicated they were happy with the level of support they received. During our visit most people went out with staff to take part in an organised activity. People's care plans were in the process of being reviewed and updated. At the time of our visit not all care plans had been reviewed.

We spoke to two people who were using the service during our visit. The people we spoke with did not indicate any concerns or tell us that they felt unsafe. There was a poster displayed in the entrance hall which gave information on who to contact should anybody have a safeguarding concern.

We spoke with two people who were using the service during our visit. The people we spoke with told us they liked the staff who supported them. One person told us, “The staff seem to know what they’re doing, they are very helpful.”