The inspection took place on the 29 November and 06 December 2018 and was unannounced. At our last inspection in July 2016 we rated the service as 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. The service was moving in an upward trajectory and as a result we have rated ‘caring’ as Outstanding, the overall rating continues to be good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The Beach Hut is registered with the Care Quality Commission to provide accommodation for persons who require nursing or residential care and treatment of disease, disorder and injury. The service provides residential and nursing care to three young people who have complex learning and physical disabilities as well as associated health conditions. The Beach Hut is a bungalow located in a residential area in Clacton and is one of two services owned by the same provider. The other service is called Driftwood and provides respite care to children’s and young people.

The registered manager manages Beach Hut and Driftwood which is located nearby. 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 Beach Hut had 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, the promotion of independence and inclusion. People with learning disabilities using the service can live as ordinary life as any citizen.

Relatives and professionals spoke highly of the service and the quality of care provided. They told us that the values of kindness and compassion were embedded in the day to day life of the service. Staff went the extra mile for the young people to make things happen. We saw that care was person centred and young people were given opportunities to build their confidence and self-esteem.

Staffing levels were flexible and met the needs of the people using the service. Staff supported people to keep in touch with family and friends and access the community.

Staff worked hard to establish what was important to people and what they enjoyed. They communicated effectively with the young people and made things happen for them which improved their wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Checks were undertaken on the environment to ensure that it was a safe place for young people to use. Risks were identified and clear plans in place to manage people’s health needs and reduce the likelihood of harm.

Staff, including care and nursing staff received regular training to ensure that skills were updated, and they were competent to provide care.

Staff spoke with enthusiasm about their roles and the quality of care provided. The provider had a clear plan of continuous improvement and quality assurance’s processes were in place to identify shortfalls and any developing patterns.

Further information is in the detailed findings below.

The inspection took place on the 22 July 2016 and was unannounced. The last inspection of this service was carried out in November 2013 and the requirements of the regulations we inspected had been met.

The Beach Hut is registered with the Care Quality Commission to provide accommodation for persons who require nursing or residential care and treatment of disease, disorder and injury.

The service provides residential care to three individuals who have complex physical disabilities and associated health conditions.

The registered manager manages Beach Hut and another of the providers services which is located nearby. 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.

Relatives, visiting professionals and the young people living in the service were all positive about the care provided and told us that this was a good, well managed service. Individuals were protected from harm because openness was encouraged and staff encouraged to report any concern. Risks were identified and steps put into place to minimise the likelihood of an incident occurring. Checks were also undertaken on equipment to make sure that it was working effectively.

Staffing levels were adequate and there were sufficient staff numbers to keep the young people safe and promote the wellbeing of the individuals who used the service. Medicines were administered as prescribed and there were clear arrangements in place for the oversight and storage. Staff were trained and knowledgeable. They received regular updates to ensure that their practice was kept up to date and in line with current professional practice. Observations were undertaken to ensure that staff were putting into practice what they learnt at training.

Individuals were supported to maintain good nutrition and intake was monitored to ensure that plans were effective. Staff worked closely with a range of health professionals to promote individuals health and wellbeing.

We observed staff to be kind, caring and patient. They demonstrated that they knew people well and had meaningful relationships. Staff knew how each young person preferred to communicate and ensured that they retained control of their care. Independence was promoted and the focus what on what individuals could do.

Care was underpinned by detailed and informative care plans which enabled staff to work with young people in a consistent way.

Good systems of communication were in operation between staff and ensured that changes were identified and key information passed over to other team members. There were good community links and young people were able to access a range of social and leisure opportunities which promoted their wellbeing.

Staff were clear about what they were working towards and aiming to achieve. Morale was good and staff were well supported by a proactive management team. Young people and their relatives knew how to raise concerns although had not had occasion to do so. There was an effective quality assurance system which identified shortfalls, reflected on practice and looked at ways to drive improvement.

The Beach Hut was registered with the Care Quality Commission in August 2012 and first admitted young people to the home in October 2012. This was our first inspection of the service. The home provided treatment and support for young people with complex medical and care needs and was also registered as a children’s home with Ofsted. The Beach Hut had a sister home, which was also located in Clacton. Staff covered both homes and the management systems were linked.

The manager had a commitment to continuous quality improvement and in the protection and promotion of the rights of young people with a learning disability and complex care needs. The home provided long term care. They also provided ‘step down’ care to assist with the, sometimes extremely complex, transition from hospital to home. They also offered respite care as this provided carers with a break from their caring role. The high level of care provided by the home and the excellent multidisciplinary communication also helped to prevent unnecessary readmissions to hospital.

We spoke with two carers who were visiting a young person at the time of our inspection. We also observed the support provided to two young people who lived in the home. The carers were both extremely complimentary about the care and support provided by the home. They described the home as, “…absolutely excellent”.

As part of this inspection we spoke with one parent, two registered managers and four staff about the service. We also used observation to help us understand the experiences of the young people who used the service, because of their communication needs they were not able to tell us verbally about their experiences.

We found that people’s needs were fully assessed and care plans were put in place to ensure their needs were fully met. We found that the provider maintained contact with other professionals involved in the children's and young person's care and that people were protected from the risks of abuse.

We were told by a parent and other stakeholders that they considered the managers and staff were professional and competent in the care and support they provided to the children and young people they cared for.

We saw there were effective systems in place to review and monitor the service provided and that people who used the service, parents, carers and stakeholders were all consulted about their views and opinions on a regular basis.

We found that staff were trained and supported appropriately to carry out their role effectively and safely.