This inspection took place on 10 May 2018 and was announced. At the last inspection on 23 May 2017, the service was rated as requires improvement. We asked the provider to take action to make improvements regarding the environment, medicine management and risk of people, visitors and staff consuming contaminated water. This action has been completed.

The Beeches (The Drive) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides accommodation and support to eight people with a learning disability. At the time of our visit, there were eight people using the service.

There was a registered manager in place. 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 were safeguarded from the risk of abuse as the provider had systems to identify the possibility of abuse and stop it occurring, and staff had appropriate information to report any concerns. Staff understood their responsibilities to protect people from the risk of abuse.

The risks associated with people’s support were assessed, and measures put in place to ensure staff supported people safely.

Staffing levels were managed and planned to ensure consistency and staff who were familiar to people at the service. The provider had effective recruitment procedures in place. Staff had the knowledge and skills to care for people effectively and responded promptly to their needs.

People received their medicines as prescribed and they were supported to maintain their nutrition. Referrals were made to health care professionals for additional support or guidance if people’s health changed.

Staff demonstrated a good understanding of the requirements of the Mental Capacity Act 2005. The consent of people was sought appropriately and where limitations on people’s freedom were necessary these were properly discussed and authorised.

People undertook a wide range of activities, both individually and in groups. They were encouraged to do as much for themselves as possible. Staff were knowledgeable about their needs and how to meet them. People’s privacy and dignity were respected.

There were assessments undertaken and care plans developed to identify people’s health and support needs.

The registered manager worked in partnership with other health professionals to ensure people received effective care and support. People were involved in the planning and reviewing of their care.

There were effective management systems to monitor and improve the quality of service provided. The views of people, relatives, professionals and staff had been sought and acted upon. There was a complaints policy and procedure in place.

This inspection took place on 23 May 2017 and was unannounced. At our last inspection in April 2015, we found the provider was meeting the regulations we inspected.

The Beeches (The Drive) provides accommodation and support to eight people with a learning disability.

There was a registered manager in place. 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 quality assurance and governance systems in place to drive continuous improvement; however, the systems were not always working effectively because the provider had not identified some health and safety issues. Improvement was also needed in the management of medicines to ensure people remained safe.

The registered manager had not always informed us of any notifiable incidents in the service.

The provider had a complaints procedure. People and their relatives felt able to raise concerns with the management of the service if they needed to.

The provider had a safe system for the recruitment of staff. There were sufficient numbers of staff on duty to meet the needs of people who used the service.

People were supported to maintain good health and access healthcare services. Advice from other professionals was sought when needed.

The provider had systems in place to protect people from avoidable harm. People told us they felt safe and staff had received training in safeguarding people and knew how to recognise and report it. Risks to people were appropriately assessed and managed.

Staff had a good understanding of the principles of the Mental Capacity Act, and the importance of gaining consent before providing care to people. The registered manager had made applications in relation to Deprivation of Liberty Safeguards to the supervisory body.

Staff received appropriate training and support to help them in their roles. They received regular supervision and appraisal.

People's needs were assessed and detailed care plans were in place to enable staff to provide personalised care. Care plans were reviewed regularly.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing. They were given choices of food at meal times.

People were treated with dignity and respect by the staff. Their independence was promoted. We saw staff interacting with people in a caring manner. People were supported to make lifestyle choices.

Staff felt supported by the registered manager and relatives commented positively on the way the service was run. The registered manager welcomed comments to improve the service.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

A single inspector carried out this inspection. The focus of the inspection was to check if the service was safe. During an inspection on 05/06/14 we found that people who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises as doors were being held open by different objects and this could compromise the safety of people in the event of a fire.

During this visit we found the provider had taken appropriate action to ensure that they adhered to fire regulations. We saw that fire doors were either closed or held by a device that would release and the door would close by itself in the event of a fire.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

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

This is a summary of what we found:

Is the service safe?

People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening. However, during our visit we noted that fire doors were being held open by different objects and this could compromise the safety of people, staff and visitors.

Is the service effective?

We looked at the records and care plans of three people using the service. We saw assessments had been carried out with people to identify their specific personal care and support needs. People using the service had been able to express their views and preferences about how personal care and support was delivered. These assessments had been used to develop people’s individual care plans.

Is the service caring?

Staff understood the need to respect people's privacy and dignity and staff interactions with people using the service were sensitive and respectful. People who used the service told us they were satisfied with the care and support they received. Peoples’ needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Is the service responsive?

The provider carried out regular checks to assess and monitor the quality of the service provided. In this way the provider could ensure that the quality of the service was maintained. The home had allowed people to express their views and concerns in a safe and understanding environment. We spoke to people who used the service and they told us they would make complaints to the manager or a member of staff if they had a concern.

Is the service well-led?

People were complimentary about the staff that supported them. People we spoke with said the manager and staff were friendly and helpful. People were given opportunities to express their choices and to make decisions in their daily lives. Staff completed training in a number of key areas to ensure they were competent to do their job.

The service was providing care to seven people with learning disabilities. We spoke with three people during the inspection and met two other people using the service who were unable to communicate verbally. Two people were away on holiday. People using the service said they were happy at the home. One person said, "I'm happy. It's a nice home. Everything is good." People told us they liked the staff and enjoyed the activities on offer at the home. The provider assessed people's individual needs and preferences to ensure their care was safe and people's rights were protected. The staff communicated with people's health and social services professionals when appropriate.

The provider had replaced the carpets and completed the retiling of the bathrooms since the last inspection. The home was generally clean and well maintained. However, we saw that the office was left open and unattended for a short time during our visit which put people using the service at risk of harm.

Staff members told us they were well trained and supported for their roles and we saw staff training certificates and evidence of regular supervision meetings. The home kept accurate and up-to-date records about people's needs and the care they received.

There were seven people living at The Beeches when we carried out this inspection. We spoke to two people using the service, to staff and the manager. Some people had limited verbal communication ability but we were able to observe how they interacted with staff, what their mood seemed to be and their behaviour.

We found that people were well cared for by staff who were aware of their needs and how to meet them. People were supported to have valued and fulfilling lives in ways that maximised their independence and enabled them to make informed choices while keeping them safe from harm. We found that people were involved in making decisions about how to spend their time, what to eat and drink, and how their personal care needs should be met. One person we spoke to said that the staff did their jobs well and he liked being at The Beeches compared to other places he had previously lived.

The manager told us that the building had undergone some refurbishment since he came into post two years ago. However, we saw that the building was not well maintained or decorated. Work that had been carried out was of a poor standard and deteriorating.

People said they felt supported by the staff team and that they were included in decisions about their care as far as possible.

They told us that staff were kind and respected their privacy.

They told us that staff listened to them and involved them in aspects of their care and the general activities in the home.

People gave us examples of how they were given choices about their care and what they like to do. They confirmed that the management and staff included them in some decisions about the running of the home. They also told us that they had good contact with the local community.

“I like drama and going out with my friends.”

“We had a good holiday.”

People told us that staff talk to them about their care needs and let them know how and why they are supporting them. One person commented, “Staff help me when I need it.”

People told us they were happy with the food at the home and that they were given a choice of menu. They told us they get enough to eat and that they can have snacks outside of meal times.

People told us that they were satisfied with the way the service communicates with the doctor and other health care professionals.

People who use the service told us they felt safe at the home and that they would talk to the manager or staff if they were concerned about anything.

A person commented, “I would tell the staff if I didn’t like something.”

They told us they were happy with the general environment of the home and their rooms. One person told us, “I like my bedroom”.

People told us they felt safe with the staff working at the home.

They told us that they had confidence in the staff team and that staff responded to their needs appropriately. One person commented, “The staff are brilliant.”

“I am feeling settled here.”

People told us they had no complaints about the service. Everyone we spoke with said they knew how to make a complaint and who they would talk to if they needed to. One person said, “I know how to complain.”

This inspection took place on 28 April 2015 and was unannounced. At our last inspection in August 2014 we found the provider was meeting the regulations we inspected.

The Beeches (The Drive) provides accommodation and support to eight people with a learning disability.

There was a registered manager in place. 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 and their relatives expressed their satisfaction with the care and support provided by the service and said they felt safe. Safeguarding procedures were robust and staff understood how to safeguard people they supported. Systems were in place to make sure that staff learnt from events such as accidents and incidents.

Staff knew people’s support needs and we observed positive interactions between people and staff. We saw staff being kind and involving people in conversations and also treating them with dignity and respect.

Staff continually monitored people’s condition and where necessary sought the assistance of other health and social care professionals. We saw people were supported to eat and drink sufficient amounts of nutritionally well-balanced food and drink that met their needs. People were supported in promoting their independence and community involvement. People were also given opportunities to express their choices and to make decisions in their daily lives. Records confirmed people’s preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with their wishes.

The management team welcomed suggestions on how they can develop the services and make improvements. Where shortfalls or concerns were raised these were addressed. Everyone we spoke with said they were happy with the care they received in the service.

Systems were in place to monitor the quality of the service and to encourage people to express any concerns, so these could be addressed.