The inspection visit took place on the 15th January 2015 and this was unannounced.
We last inspected the service on 12th January 2014 and found the service was not in breach of any regulations at that time.
Beaufort house provides residential care for up to five adults on the autistic spectrum condition with associated learning disabilities. Beaufort house is a large terraced house in a residential area of Redcar which is close to local amenities.
At the time of our inspection there was no registered manager in place. The area manager and senior carer were overseeing the service. The previous registered manager left in December 2014 and they were in the process of recruiting a new 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 living at the service received good, kind, attentive care and support that was tailored to meet their individual needs. Staff ensured they were kept safe from abuse and avoidable harm. People we spoke with were positive about the care they received and said that they felt safe.
There were procedures in place to keep people safe. The service had processes in place to minimise risks to people whilst ensuring their independence was promoted. Staff were trained and understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Staff said they would be confident to whistle blow (raise concerns about the home, staff practices or provider) if the need ever arose.
Accidents and incidents were monitored each month to identify trends. The area manager explained that if trends were to be found remedial action would be taken. At the time of our inspection there were no significant accidents and incidents to alert to trends.
We found people were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers and we saw evidence that a Disclosure and Barring Service (DBS) check had been completed before they started work in the home. The Disclosure and Barring Service carry out a criminal record and barring check on individuals who intend to work with children and vulnerable adults, to help employers make safer recruiting decisions and also to prevent unsuitable people from working with children and vulnerable adults.
We saw medicines were being managed and stored appropriately. Daily room temperatures had been missed seven times so far in January 2015. Room temperatures need to be recorded to make sure medicines were stored within the recommended temperature ranges.
The service was very clean and tidy. We observed the cleaning rota that highlighted how cleaning should be carried out. We saw there was plenty of personal protection equipment (PPE) such as gloves and aprons. Staff we spoke to confirmed they always had enough PPE. One member of staff was the infection control lead.
Staff received training to enable them to perform their roles and the service looked at ways to increase knowledge to ensure people’s individual needs were met. Staff had regular supervisions and appraisals to monitor their performance and told us they felt supported by the area manager and senior carer.
The area manager and staff had been trained and had a good knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). They understood when an application should be made, and how to submit one. At the time of our inspection the service had three DoLs authorisations in place for people who lived there.
We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met.
We saw people had access to advocacy services. Advocacy seeks to ensure that people, particularly those who are most vulnerable in society, are able to have their voice heard on issues that are important to them).
People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. Information was person centred with information that included how I like to communicate and what I enjoy doing. Person-centred care sees people who use the service as equal partners in planning, developing and assessing care to make sure it is most appropriate for their needs. It involves putting people at the heart of all decisions. The care plans included risk assessments which were sufficiently detailed for each individual.
We saw people being given choices and encouraged to take part in all aspects of day to day life at the service, from going to the shops to helping make dinner.
Although three people needed one to one support with outings, the service encouraged people to maintain their independence and people were supported to be involved in the local community as much as possible using public transport and accessing regular facilities such as the cinema or local leisure centre.
We were shown an excellent transition plan for one person who started using the service in November 2014. This was due to a step by step transition programme being implemented.
The service had a system in place for the management of complaints.
There were effective systems in place to monitor and improve the quality of the service provided.
We saw safety checks and certificates that were all within the last twelve months for items that had been serviced such as fire equipment and water temperature checks.