The inspection took place on 15 June 2017 and was unannounced. The last comprehensive inspection took place in August 2014, when the provider was meeting the regulations.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Stoneybeck’ on our website at ‘www.cqc.org.uk’.

Stoneybeck is a care home providing support for up to seven people living with a learning disability, autistic spectrum disorder, dementia, mental health needs or sensory impairment who require personal care. Accommodation is provided in two buildings on the same site. The home has its own grounds with a rear garden which is private and secure.

At the time of our inspection 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 Regulation about how the service is run. The service also had a house manager, who managed the day to day running of the service.

We spoke with staff who were knowledgeable about safeguarding people from abuse. Staff told us they would report anything of this nature, to the registered manager without delay.

We looked at four recruitment files and found the provider had a safe and effective system in place for employing new staff. Pre-employment checks were sought and had to be satisfactory prior to the new staff member commencing their role.

People received their medicines as prescribed and medicines were stored appropriately. Safe procedures were followed for the administration of medicines. This was to ensure people received their medicines in a safe way.

Support plans we looked at contained risk assessments which identified risks associated with people’s care. Risk assessments gave guidelines on how to minimise the risk occurring.

We spoke with staff and they told us they received training and support to help them do their job well. We looked at records in relation to training and found they reflected what staff had told us. Training certificates were available in staff files we looked at. Staff also informed us that they received one to one sessions with their line manager to discuss work related issues.

We found that the provider was meeting the requirements of the MCA and DoLS. We saw support plans in place identified where people lacked capacity and what support they required with various decision making.

People were supported to eat and drink enough to maintain a healthy and balanced diet. People were involved in deciding what they would like to eat and assisted staff in shopping for food and in food preparation where possible.

People had access to health care professionals as required and staff supported people to keep appointments.

We observed staff interacting with people and found they were respectful, kind and caring. Staff were knowledgeable about people’s preferences and knew people well.

We looked at support plans belonging to people who used the service and found they were person centred and incorporated people’s individual needs and preferences.

People were supported to have an active social life and engaged in a variety of different activities. People also enjoyed going on holiday.

The provider had a complaints procedure in place and any concerns raised were dealt with in a timely way. Complaints received were used to reflect on practice and develop the service.

The service was led by a management team which comprised of a registered manager, a house manager and a team of senior support workers. We saw that audits were used as a tool to ensure policies and procedures were being followed and to ensure people received a good standard of care and support.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection carried out on 5 August 2014.

Stoneybeck provides personal care for up to seven people with a learning disability, including autism. Seven people lived in the home when we visited. Accommodation is provided in two buildings which are opposite each other and share a garden. Five people lived in one building and two in the other. All of the bedrooms are single en suite and there are communal areas in both buildings.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People were safe as staff knew how to manage people’s care needs so that risks were managed in a way which ensured people had as much freedom as possible. Ample staffing levels meant people received the support they needed to follow their chosen routines and go out into the community.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and knew procedures to follow when people lacked capacity to make a decision. Staff knew about safeguarding and we saw concerns reported had been dealt with appropriately, which kept people safe.

Robust recruitment processes were followed and staff received the induction and training they required to meet people’s specialist needs. People’s nutritional needs were met and they received the health care support they required.

Staff had developed good relationships with people and were kind and caring. We saw they encouraged and promoted positive behaviour in the way they praised and encouraged people. People were given choices and their privacy and dignity was respected.

People were supported to be as independent as possible which included leading active lives out in the community. People’s views were listened to and acted upon.

Leadership and management of the home was good. Systems were in place to monitor the quality of the service and promote continuous improvement, which included learning from incidents by reviewing what had happened and learning from any mistakes. There was an open culture which encouraged all involved in the home to voice their views and concerns.  

We used a number of different methods to help us understand the experiences of the people who used the service, because the people who used the service had complex needs.

We spoke to three people who lived in the home. One person said “I like living here. The staff are nice and I can choose what I do”. Another person said “I like the staff. I like going on the bus. I like phoning my mum and dad”.

Care records recorded information on people’s daily routine. They described what time people liked to get up, what they liked to eat and drink, and how they liked to spend their day. One care plan had information on a person’s cultural needs and how these were being addressed.

People’s needs were assessed and care and treatment was planned in line with their individual care plan.On the day of the inspection one person was out visiting her mother. This was recorded in the care plan as something the person did every week. This helped the person to maintain contact with her family and also to help her meet her cultural needs. Another person was observed getting ready to go out to do some shopping.

We spoke to two members of staff and two managers. The two members of staff demonstrated a good understanding about the different forms of abuse,what their responsibilities were if abuse was suspected, and how they would respond. Staff were able to explain how they would raise concerns if they observed any changes in a person’s behaviour that could indicate possible abuse.

The staff we spoke to said that they felt able to speak out if they had any concerns and felt supported by managers.

We saw that training records had information on staff attending training in areas such as safeguarding, fire safety, first aid, food safety, infection control, autism awareness and Mental Capacity Act ( MCA) awareness.

We saw information on staff having regular supervision. This helpedt to ensure that staff were competent and/or highlighted when further training or support was needed to ensure high standards of care were met.

We saw that the home had policies and procedures in place to safeguard people from abuse. We spoke to two service managers who described a serious safeguarding incident that had occurred during the summer. We saw that policies and procedures had been followed and that three members of staff had been dismissed because of the incident. We saw that the home had addressed a number of issues raised by the local safeguarding team in relation to re- training on restraint techniques, reporting procedures and staff training.

We asked how the provider monitored the quality of the care they delivered. We spent time observing the care and interaction between staff and people who used the service. We spoke with staff, the managers and the registered provider about the care and wellbeing of people who use the service. We also gathered evidence of people’s experiences of the service by reviewing care records and quality assurance documentation.

People who used the service could not communicate clearly so we observed staff providing support and we spoke with staff about the people who used the service. This gave us assurances that staff knew the needs of people and knew how to deliver the care and support effectively.

Our observations of the service showed that care staff spoke with and interacted with people who used the service in a patient and pleasant manner. Care staff supported people in a sensitive way using differing methods of communication to ensure that people who used the service understood what was going to happen.

There were good systems and processes, policies and procedures in place. Report writing in the care records was good and reflected the changes in care and treatment that people received. We also found that staff were supported and monitored in their working practice and had training and appraisals programmes in place.

The people who used the service appeared happy and comfortable with their surroundings. They appeared to be relaxed with the staff in their interactions with them. We noted that people who used the service had access to a wide range of activities which were personalised to their individual needs and documented clearly in the care plans.

One person said they enjoy living in the home. Although we could not communicate with others using the service, they appeared to be relaxed and happy. Positive relationships were observed being fostered between those living in the home and those supporting them.

One person living in the home said they like living there and they feel safe. Although we could not communicate with some people using the service they appeared to be very relaxed and comfortable.

One person said they enjoy living in the home. Another person enjoying an introductory visit said the home is nice and staff are great. Those people we could not communicate with appeared to be relaxed and comfortable.

People say they like the people caring for them. One person says they like their support worker as they help them do things. Some people we could not communicate with appeared to get on well with those supporting them.

People say they like the people caring for them. Some people we could not communicate with appeared to be happy and positive relationships were observed being fostered between those living in the home and those caring for them.

People living in the home say they like the people caring for them. People we could not communicate with appeared to be relaxed and comfortable with those supporting them.

People living in the home say they are happy with their bedrooms and with those caring for them and supporting them.