This inspection took place on 8 June 2016 and was unannounced.

The Beach House is registered to provide accommodation and personal care for up to 14 people. Care is provided to adults aged between 18 years and 65 years of age with a learning disability and/or a physical disability. However, two people who use the service were over 65 years of age. The registered manager told us they were now getting requests for people over 65 years of age, and has subsequently provided an updated Statement of Purpose to detail this change.This is a short breaks or respite service where people can have weekend or midweek breaks. There are two bedrooms which are used for emergency placements for people who are in crisis situations in the community. People are supported to live as independently as possible whilst alternative accommodation is sought. The purpose built accommodation is on three floors and a passenger lift gave level access to all parts of the building. Each person has their own bedroom the majority of which have an ensuite bathroom. There are lounges, dining areas, and shared bathrooms and toilets for people to use. The service is situated in a residential area with easy access to local amenities, transport links and the city centre.

At the time of the inspection there were 56 people were being supported with respite care or an emergency placement whose behaviour could be complex. Eight people were living at the service on the day of the inspection. Four people had been in the service for a period of time whilst waiting for their long term accommodation needs to be met.

The service had a registered manager, who was present throughout the inspection. They were new to the post, but they had worked in the service for a number of years and knew the service well. 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 going through a significant period of review, where the provider and local stakeholders were looking at the service provision and what was needed and how the service would best be provided in the future.

Relatives told us people were safe in the service. One relative told us, “I have no concerns they are generally very good.“ People were supported by staff that were trained in safeguarding adults at risk procedures and knew how to recognise signs of abuse. There were systems in place that ensured this knowledge was checked and updated. Medicines were managed and administered safely. Accidents and incidents had been recorded and appropriate action had been taken and recorded by the registered manager.

Care and support provided was personalised and based on the identified needs of each individual. People were supported where possible to develop their life skills and increase their independence. People’s care and support plans and risk assessments were detailed, up-to-date, and had been or were in the process of being reviewed . One relative told us when they visited the service, “Staff always welcome you. When you go in they (the people) always seem happy and there is a good atmosphere.” A member of staff told us, “Everyone does a good job here. Everyone is jolly. We help each other out and are all very professional. It’s a really good group.” Care staff were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. People were supported by kind caring staff.

Consent was sought from people with regard to the care that was delivered. Staff understood about people’s capacity to consent to care and had a good understanding of the Mental Capacity Act 2005 (MCA) and associated legislation, which they put into practice. Where people we

Our inspection team was made up of an inspector. We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

Below is a summary of what we have found. The summary is based on our observations during the inspection, where possible discussions with people using the service (as people had complex needs which meant they were not able to tell us about their experiences), their carers, the staff supporting them and looking at records.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they or their relative were safe. One carer told us, "100%." Staff had received training and had an understanding of their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). They knew who to contact should further guidance and support be required to ensure people’s best interests. People had been asked for their consent for any care or treatment.

There was a system in place to make sure that the provider, manager and staff learnt from events such as incidents and accidents, complaints, and concerns.

The service was clean and hygienic. We found that shortfalls highlighted at the last inspection of the service had been addressed. Staff had been provided with training to undertake their roles in the service, systems developed and recording and monitoring systems put in place. This helped to ensure people were not put at any unnecessary risk.

A staff rota was set, which had taken into account people’s care needs when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people’s needs were met.

Is the service effective?

People’s health and care needs had been reviewed and where possible people and their carers had been involved in the writing and review of the care documentation. Their specialist care needs such as dietary requirements and behavioural support needs had been identified and guidance for staff to follow was in place. People were able to move around the service freely and safely. A carer told us, “They make sure his bedroom is safe.”

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and offered encouragement when supporting people. People commented,” “They went out of their way to help him settle in,” "I am very, very happy he goes to The Beach House. I would be lost without it," "I am really pleased the staff there love him. They are wonderful," and “I like it here.”

We saw people using the service, their relatives and carers had been involved with the service and had completed an annual satisfaction survey in 2013.

People’s preferences, interests, aspirations and diverse needs had been recorded. People told us care and support had been provided in accordance with people’s wishes. One carer told us,"They ring me up to find out if there are any changes in his care needs. They ask about his likes and dislikes."

Is the service responsive?

People completed a range of activities in and outside of the service regularly. Weekly meetings had been held with people to discuss what activities they would like to participate in during their stay in the service.

There was a complaints policy and procedure in place if people were unhappy, which was monitored by the provider. No complaints had been received since the last inspection. The carers told us they aware who to speak with if they had any concerns. One carer told us, "I would complain if necessary. I would know who to speak to if necessary." People could therefore be assured that complaints were investigated and action taken as necessary.

Is the service well lead?

The service had quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all time.

There were 10 people who used the service at the time of our visit. We spoke with four people who used the service. We also used a number of different methods to help us understand the views of the people, who had complex needs, which meant they were not all able to tell us about their experiences. We observed the care provided, looked at supporting care documentation, we spoke with the registered manager who is referred to as manager in the report, two senior care workers, two care workers, one of whom was one of the organisation’s bank staff, and two relatives and a friend of three people who used the service. This told us:

People or their representatives had been able to express their views about the care provided if they wished to, and where possible people who used the service had been involved in making decisions about their care and treatment.

People’s care needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan. Care workers had a good understanding of people’s care needs.

Appropriate arrangements were in place in relation to obtaining, storing, administering handling and recording medicines.

The records needed for the management of the home had not always been maintained to ensure they were accurate and complete.

People who use services with whom we met had special communication needs. They expressed themselves using short sentences, words, sounds and signs. They said or indicated that the staff treated them with respect and supported them to raise any concerns they had. They said or indicated that they received the health and personal care they needed and that they were comfortable in their temporary home.

One person said, 'good, good' when asked about staying in the service. A carer (relative) said, 'My son loves to go to Beach House. He has a great time because he loves the activities like going out and being in the games room where they have a pool table and computer games. I don't mention he's going too early because otherwise he won't rest until his suitcase is packed'.

There were seven people who used the service at the time of our visit. We used a number of different methods to help us understand the views of the people, who had complex needs, which meant they were not all able to tell us about their experiences. We observed interaction between staff and people who used the service. We reviewed records including staff training records, quality assurance documentation, menus, incidents and accidents records, the complaints log and documentation in relation to the running of the service. We looked at systems and looked at the environment and how this impacted on the service delivery. We observed the care provided, and looked at supporting care documentation. We spoke with the registered manager who is referred to as manager in the report, two senior care workers, three care workers, and the domestic assistant. We spoke with one person who used the service, and two relatives and a shared lives carer of three people who used the service and who are referred to as carers in the report.

This told us people or their carers had been able to express their views about the care provided, and where possible had been involved in making decisions about their care and treatment. People’s care needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan. Care workers had a good understanding of people’s care needs. Comments from carers included, “They all seem to enjoy themselves here,” “They are life savers,” "She is so at home here,” “I can’t praise them enough,” “It’s 100% here,” and “Very satisfied with the care.”

People were provided with a choice of suitable and nutritious food and drink.

All feedback received confirmed that the service was clean However, infection control policies and procedures were not in place to fully protect people.

Robust recruitment procedures were in place to protect people.

We found that the processes in place to respond to complaints had ensured information provided was used to improve the service.