East View Housing Management Limited 6 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. Some had more specialist needs associated with Asperger’s syndrome and epilepsy. 6 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.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

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 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 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.

There were enough staff who had been appropriately recruited, to meet people’s needs. People told us they felt safe. Staff had a good understanding of the risks associated with supporting people. They knew what actions to take to mitigate these risks and provide a safe environment for people to live. Staff understood what they needed to do to protect people from the risk of abuse. Incidents and accidents were well managed. People’s medicines were managed safely.

People’s needs were effectively met because staff attended regular training to update their knowledge and skills. Staff attended regular supervision meetings and told us they were very well supported by the management of the home. People were encouraged to make decisions and choices. The registered manager and staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS are regulations that have to be followed to ensure people who cannot make decisions for themselves are protected. They also ensured people were not having their freedom restricted or deprived unnecessarily.

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.

Staff had a very good understanding of people as individuals, their needs and interests. 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 and one person had a work placement. Activities were also arranged at home, for example arts and crafts and pamper sessions. People told us they enjoyed having meals out, theatre trips and holidays. People also told us they enjoyed visiting the

This inspection took place on 17 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 for 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 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 an 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 treatment 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 care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The 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.

Our inspection team was made up of one inspector. We set out to answer our five key questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well-led?

Below is a summary of what we found. The summary describes what people using the service and staff told us, our observations during the inspection and the records we looked at. At this inspection, we spoke with all of the people who lived at the service, two care staff, the deputy manager and the manager as well as the maintenance staff and one of the owners of the service.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. We saw that care plans were sufficiently detailed to allow staff to deliver safe and effective care that reflected the support required for people’s assessed needs. One person commented “It’s fantastic living here, I love it”.

People lived in safe, maintained accommodation which presented a comfortable environment.

People were protected from bullying, harassment, avoidable harm, abuse and breaches of their human rights. Staff we spoke with knew about safeguarding of vulnerable adults and what action to take if they needed to. Records showed that all staff had received training about this. People who lived at the service said that they felt safe. One person told us, “I’m very happy, I feel very safe".

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted, we found that suitable policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

We asked people if they were happy with the support they received. People told us that they were and felt that their support needs had been met. One person commented “I couldn’t be happier, the support I get really suits me”.

Our observations and discussions with staff showed that they had a good understanding of people’s care and support needs and that they knew them well. This was reflected by the clear guidance in people’s care plans and the support staff provided.

Is the service caring?

We asked people who used the service if staff were kind and gentle when they supported them. People told us that they were. One person said “All of the staff are great, they care about us all”. Care records contained personalised information which helped staff to know the people they supported and how to meet their needs.

We saw that staff showed patience, compassion and understood how to support people as individuals. Our observations found that staff knew how to communicate effectively with people. We saw that staff sometimes used hand signs and picture reference cards to help them do this. One person communicated with the help of a tablet computer.

Is the service responsive?

People’s needs had been assessed before they moved to 6 High Beech Close. This meant the manager could be certain that the service had the skills and facilities to meet the identified needs of the people who lived there. People told us that they met with their key workers at least once a month to talk about the things that were important to them. People had access to activities that were important to them and had been supported to maintain relationships with friends and relatives where possible. Records confirmed that people had access to other health care professionals. This meant that there was access to specialist help when needed.

Is the service well-led?

Staff had a good understanding of their role within the service and felt supported by the manager. The manager showed a good knowledge and oversight of the running of the service. There were quality assurance processes in place to maintain standards in the service. We saw that staff and people who used the service had been given opportunities to express their views about how it was run.

Throughout the inspection, the manager and staff demonstrated that they placed the needs of the people who lived at 6 High Beech Close at the heart of the service. Discussion with staff found that they had a good understanding of their responsibilities and of the values of the service.

When we inspected this service in June 2013 we found that the people living in the house were well cared for. However, records relating to their support needs and any risks associated with these had not been reviewed or updated to reflect changes. Longer serving staff were familiar with any changes. However, there was a risk that new or agency staff would not have access to updated information to inform their support, and this could therefore impact on the quality of care they delivered.

The provider had given assurances that all relevant records would be updated by the end of August 2013. Our visit was to assess whether sufficient progress had been made to achieve compliance in regard to record keeping and security of records.

The people living in this house were younger and had developed a range of independence skills. They led an active lifestyle and took part in activities on week days. However, most people had a home day during the week. We chose to visit on a day we knew some people had previously been home. However, on this occasion everyone was out. We were however, able to speak with two staff members that supported the people in the house at various times, we also spoke with the manager on the telephone.

We were able to review records we had seen at the previous inspection and found that these had been updated and that the provider had taken the necessary steps to address outstanding shortfalls.

Three people lived in the house and we met all three during our visit. This house provided a service for a group of younger women. We saw that people lead active lifestyles, took an active part in the community and had developed relationships outside of the house. All were able to tell us about living in the house and reported that they liked living there. Two people told us they felt they had not been given enough opportunities to be more independent. We discussed this with the acting manager.

People told us about the activities they attended during the week, evenings and at weekends. They also told us they had some home time when they could do things they wanted to do. They felt that they were always consulted about matters that related to them, and said they informed staff when they wanted to do things, or needed things. One person told us they had recently consented to some medical treatment.

Staff spoken with demonstrated knowledge and understanding of the people they supported. They had access to detailed information about people’s needs but acknowledged 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.

We met and spoke with three people who lived in the home.

People told us about the range of activities they liked to do both during the day and in the evenings. They said that staff were mostly available to support activities, although they had not been out to a night club for a while owing to staff availability.

One person said that staff were supportive of a friend staying for dinner on occasion.

One person said they could do more or less what they liked. They said they liked the fact that they were kept informed by staff, and involved in improvements to the home.

Another person said staff were friendly and that they felt able to talk with them. People told us they felt able to approach staff with concerns

People said they enjoyed living in the home and felt involved in changes to the environment and their daily routines