East View Housing Management Limited 5 High Beech Close is a care home providing social and residential care for up to four people with learning disabilities. On the day of our inspection there were four people living in the home. People had varied needs related to their learning disabilities and general health needs, associated with an ageing client group. 5 High Beech is a two storey property with bedrooms located on the first floor. The provider runs a number of care homes locally and is also a national provider of care.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 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 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.

People told us they felt safe. Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. Incidents and accidents were well managed. People’s medicines were managed safely. There were good recruitment procedures and enough staff to meet people’s individual needs.

People’s needs were effectively met because staff had the training and skills they needed to do so. Staff attended regular supervision meetings and received an annual appraisal of their performance. Staff supported people in the least restrictive way possible. People were encouraged to be involved in decisions and choices when it was appropriate. Mental Capacity Act 2005 (MCA) assessments were completed as required and in line with legal requirements. Staff had attended MCA and Deprivation of Liberty Safeguards (DoLS) training.

People were treated with dignity and respect by kind and caring staff. Staff had a good understanding of the care and support needs of people and had developed positive relationships with them. People were supported to attend health appointments, such as the GP or dentist. People had enough to eat and drink and menus were varied and well balanced. People’s meals were served in a way that respected their specific needs. One person needed food served in a particular way to meet their health needs and through additional planning staff made sure this did not have an impact on the person’s social life.

People were supported to take part in a range of activities to meet their individual needs and wishes. All attended day centres for varying numbers of days each week. Activities were also arranged at home and people told us they enjoyed having meals out, theatre trips and holidays. People also told us they enjoyed visiting their friends and inviting friends and their family members to their house.

The environment was clean and well maintained. The provider had ensured safety checks had been carried out and all equipment had been serviced. Fire safety checks were all up to date.

The organisation continued to have good quality monitoring systems. Feedback was regularly sought from people, relatives and staff to hear their views of the service. People were encouraged to share their views on a daily basis. People and relatives were given information on how to make a complaint and said they would be

This inspection took place on 16 November 2015. To ensure we met staff and the people that lived at the service, we gave short notice of our inspection.

This location is registered to provide accommodation and personal care to a maximum of four people with learning disabilities and people with an autism spectrum disorder. Four people lived at the service at the time of our inspection.

People who lived at the service were younger and older adults with learning disabilities. People had different communication needs. Some people communicated verbally. Other people communicated using sign language, gestures and body language. We talked directly with people and used observations to better understand people's needs.

The home 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 were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear control measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Risk assessments took account of people’s right to make their own decisions.

Accidents and incidents were recorded and monitored to identify how the risks of reoccurrence could be reduced. There were sufficient staff on duty to meet people’s needs. Staffing levels were adjusted according to people’s changing needs. There were safe recruitment procedures in place which included the checking of references.

Medicines were stored, administered and recorded safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed and were continually reviewed.

Staff were competent to meet people’s needs. Staff received on-going training and supervision to monitor their performance and professional development. Staff were supported to undertake a professional qualification in social care to develop their skills and competence.

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when a DoLS application should be made and how to assess whether a person needed a DoLS.

Staff supported people to make meals that met their needs and choices. Staff knew about and provided for people’s dietary preferences and needs.

Staff communicated effectively with people, responded to their needs promptly, and treated them with kindness and respect. People were satisfied about how their care and support was delivered. People’s privacy was respected and people were assisted in a way that respected their dignity.

People were involved in their day to day care and support. People’s care plans were reviewed with their participation and relatives were invited to attend the reviews and contribute.

People were promptly referred to health professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. Staff promoted people’s independence and encouraged people to do as much as possible for themselves. People were involved in planning activities of their choice.

People received care that responded to their individual care and support needs. People were provided with accessible information about how to make a complaint and received staff support to make their views and wishes known.

There was an open culture that put people at the centre of their care and support. Staff held a clear set of values based on respect for people, ensuring people had freedom of choice and support to be as independent as possible.

People and staff were encouraged to comment on the service provided and their feedback was used to identify service improvements. There were audit processes in place to monitor the quality of the service.

When we inspected this service in June 2013 we found that people living there were well cared for. However, the records of their support needs and associated risks assessments had not been reviewed and updated. This posed a risk that new and agency staff would not have access to the most recent information about how they should be supported, and this could impact on the quality of care they experienced.

The provider had told us that they would ensure these shortfalls were addressed. Our follow up inspection was to assess the progress they had made towards this.

We met three of the four people living in the house and were able to speak with two although their comments did not relate fully to the outcome we were inspecting. We also spoke with two staff on duty and to the manager on the telephone. We reviewed the security and content of records including support plans, risk information and medication records.

We found that although the service had not met its own deadline for achieving full compliance they were able to evidence that more than 50% of support profiles and risk information had been updated with evidence of planning on those outstanding to achieve full compliance.

Four people lived in the house and we met them all during our visit. We found that people were of a similar age and staff reported that they got on well together. Due to communication difficulties only two people were able to tell us about their experience of living in the service. One person told us ‘I am alright’ and a second person told us they liked the house they lived in and told us about some of the things they did, including a favourite holiday they had the previous year. This person told us that staff always asked them what they wanted to do. Staff said people living in the house were able to consent to everyday things in their lives and also to say ‘no’. Staff told us that they always consulted people about the things they might need to make a decision about.

We spoke with two staff including the acting manager. They demonstrated familiarity with the support needs of everyone living in the house. They had access to detailed information about people’s needs but this was not always kept updated. Staff told us they felt well supported and that staffing levels were appropriate to meet the needs of the people in the house, but they could do with additional time to update records. From discussion with staff it was clear that they liked to spend time with the people in the house, engaging in everyday conversation, completing tasks together or participating in activities.

We met and spoke with three people who lived in the home. A fourth person had moved to a more appropriate placement within the organisation on the day of inspection.

People we spoke with told us that they liked living at the home; they expressed some sadness that their friend had moved on. We observed one person with staff support making a good luck card and a picture for the person that had moved.

People told us that staff were ‘nice’ and spoke with them about their care and support. People told us they felt able to approach staff with concerns.

We observed people in the home going about their domestic routines when they returned from their day time activity. We asked one person if they were happy with doing some of the household chores. They told us that they liked to help with drying up dishes, laundry, laying tables and meal preparation. They said that sometimes they cooked cakes.

People said they liked living in the house. They told us about some of the things they liked to do each week.

They said they were kept informed of changes in the house and were involved in their care plan.

One person said they would like a key to their bedroom.