Beehive 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. Beehive is a residential care home for six adults with learning disabilities or on the autistic spectrum. The service is on one floor and all areas of the home are accessible to people. At the time of our inspection six people were using the service.

At our last inspection on the 29 October 2015 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 on-going monitoring that demonstrated serious 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.

The service carried out an assessment of people’s needs before they commenced using the service. However, this did not cover needs related to ethnicity, culture or sexuality and we have made a recommendation about this.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Medicines were managed safely and steps had been taken to reduce the risk of the spread of infection.

Staff received on-going training and supervision to support them in their role. The service operated within the principles of the Mental Capacity Act 2005. People were able to choose what they ate and drank. People were supported to access relevant health care professionals.

We observed people were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place.

Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place which included seeking the views of people who used the service.

This inspection took place on 29 October 2015 and was unannounced. At the last inspection in June 2014, the provider was meeting the regulations we looked at.

Beehive Care Home is registered to provide accommodation and support for six people with learning disabilities and complex needs. People are accommodated in a spacious purpose built house which is a single floor building with wheelchair access. The home is located close to public transport and other local amenities. On the day of our inspection, five people were using the service.

The service has 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 felt safe and were protected from the risk of harm by staff who knew how to respond to allegations of abuse.

There were suitable arrangements for the administration, storage and management of medicines.

People had risk assessments which identified hazards they may face and provided guidance to staff about how to manage any risk of harm.

The service had a robust recruitment process, which ensured that suitable staff were employed to look after people safely.

There were enough qualified and experienced staff on duty, to meet people’s needs safely.

Staff received appropriate support and training to perform their roles and responsibilities. They were provided with on-going training to update their skills and knowledge.

Staff understood the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People received a nutritionally balanced diet to maintain their health and wellbeing.

People were supported to see healthcare professionals in order to ensure their general health was well maintained.

People were looked after by staff who were caring, compassionate and promoted their privacy and dignity.

Staff were knowledgeable about how to meet people’s needs and understood how people preferred to be supported.

People’s care plans were based upon their individual needs and wishes. Care plans contained detailed information about people’s health needs, preferences and personal history.

There were effective systems in place for responding to complaints. People and their relatives were made aware of the complaints procedure.

Quality assurance systems were in place and were used to obtain feedback, monitor service performance and manage risks.

A single inspector carried out this inspection.The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, 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 relatives of people who used the service, staff supporting them and from looking at records.

Is the service safe?

We met with people who used the service but due to the degree of their learning and physical disabilities they were unable to give us any feedback about the quality of the service. We spent time with them and observed how they were supported by the staff. We saw that people were treated with respect and dignity by the staff. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. The manager organised the staff rotas and took people's care and support needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met. Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents and concerns. This reduced the risks to people and helped the service to continually improve. Staff had received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards training. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. The manager told us that one application for deprivation of liberty had needed to be submitted and this is continually monitored.

Is the service effective?

People were supported by caring and attentive staff. Staff we spoke with knew about people's care and support needs and their individual preferences. Their health and well-being were monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with other health care professionals to make sure people received prompt, co-ordinated and effective care. Staff worked to a key worker system to oversee people's care and had been trained to deal with specific conditions that they had.

Is the service caring?

We saw that staff showed patience and gave encouragement when supporting people. They were able to interpret what people indicated and responded accordingly. People's preferences and interests had been recorded and care and support had been provided in accordance with people's wishes. Staff offered people choices and talked to them about what was happening or what they needed to do. A relative had commented in a survey "very hard working (staff), very good at what they do and provide a lot of care and support."

Is the service responsive?

Staff we spoke to were knowledgeable about the needs of people they supported and how to meet them. Care plans included information about people's preferred routines and healthcare needs as well as their likes and dislikes. This ensured that they received an individualised service. Care plans were reviewed and updated monthly or when people's needs had changed. Senior staff referred people to appropriate professionals for assessment and advice. Any actions advised by them were implemented by staff. People were supported to access a range of healthcare professionals to promote their wellbeing.

Is the service well-led?

The service had a quality assurance process in place. Annual customer satisfaction questionnaires were completed by people and their representatives to seek their views and opinions about the service in order to find out where improvements were needed. Staff told us they were clear about their roles and responsibilities. They were supported by the management team to provide good, quality care and were encouraged to complete relevant training. Relatives and service users' views were also sought at meetings which were held regularly. We found a number of audits were undertaken by staff, the manager and by the registered provider to ensure that people received safe, quality care.

At our previous inspection of this service in September 2013 we found that people were not provided with a suitable choice of food and drink. During this inspection we found that improvements had been made. One person nodded and smiled when asked if he was happy with the food provided. We found that people were able to plan their weekly menus and that they had choice over what they ate.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were not able to tell us about their experience of the service due to their communication needs. However, one person nodded and smiled when asked if they were happy with the home and the support provided. We found that care plans were in place which set out how to meet the assessed and individual needs of people. Records showed that people had access to health care professionals.

We found that people were supported to eat sufficient amounts of food, and that they were not at risk of malnutrition or dehydration. However, we found that people were not able to have choice about what food they ate.

We found that the service had robust staff recruitment procedures in place. This included staff providing written employment references and undertaking a Disclosure and Baring Service check. This is a check to see if the person has any criminal convictions or are on any list that bars them from working with children or vulnerable adults. Staff told us they had regular access to training, and we found certificates in place for various training courses including safeguarding vulnerable adults and medication administration. Records were stored securely, and staff were able to access records as required.

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke with two members of staff, observed the practice in the home and looked at care records.

We observed people being supported to engage in activities in the community. One person went out with a member of staff during our visit to go for lunch and another person was supported by staff to go to the shops to buy some magazines. We observed staff responding to people's needs in a respectful and sensitive manner. For example, staff were observed explaining what was going to happen next and offering people choices.

People's needs were assessed and care plans developed that ensured people's needs were met effectively. Any identified risks to people's welfare were assessed and plans put in place to minimise these while enabling people to maintain their independence. People's healthcare needs were monitored and met with the support of healthcare professionals.

The home was well maintained, clean and warm at the time of our visit and health and safety checks were taking place at the required intervals to ensure the environment was safe.

There were adequate numbers of staff to meet people's needs effectively and staff told us that there were always enough staff on duty.

There was an effective complaints management system in place.

People did not talk directly to us about their experiences at Beehive. We, however, observed how they were cared for and found that they were involved in decisions about what they do and how they spend their time at the home. Where possible, their relatives were involved in their care and welfare including their social and leisure pursuits. We saw that people were happy in the home as on many occasions they smiled during their engagement with staff. The staff we met had a good understanding of people’s specialist needs including their communication and nutritional needs. They spent most of their time with people caring for and supporting them. There was a person centred approach to care and people were encouraged to personalise their individual spaces and engage with the wider community.