The inspection took place on 24 August 2015 and was an unannounced inspection. On the date of the inspection there were 16 people living in the home. Beacon House provides accommodation for up to 16 people with learning disabilities who require varying levels of care and support. Beacon House is split into two distinct units, Beacon House Upper and Beacon House Lower. These are run separately with different staff and management within each unit.
A registered manager was 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.
Most people received their medicines in a timely way in line with the prescribers’ instructions and appropriate records were kept. However this was not consistently the case, as we noted one person did not receive all their medicines at the correct time. Medicines were correctly stored and arrangements were in place to order and dispose of medicines.
Most risks to people’s health, safety and welfare were appropriately managed. Robust risk assessments were in place detailing how staff should help keep people safe whilst delivering care and support. However we noted one instance where hazardous items were not appropriately locked away. Once we pointed this out to management; they took immediate action to address.
People and relatives told us that people felt safe in the service and staff had a good understanding of how to recognise and act on allegations of abuse.
We concluded, overall staffing levels were sufficient and matched with the agreed contracted hours for each person living in the service. However whilst staff on Beacon House Lower told us staffing levels were sufficient, staff on Beacon House Upper all told us they felt at times staffing levels were not sufficient within certain areas of the unit. We asked the management to investigate this and address the concerns raised by staff.
Robust recruitment procedures were in place to ensure people were cared for by staff of suitable character.
The service was acting within the legal framework of the Mental Capacity Act, including meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). A number of DoLS applications had been made where the service judged it was depriving people of their liberty. This helped to ensure people’s rights were protected.
People and relatives told us the food was good. We saw people had individual menus to ensure the food provided met their preferences. Some people were appropriately supported to cook for themselves to increase their independence.
People’s healthcare needs were assessed by the service. Specific plans were in place to support and maintain the health of the people who used the service.
Staff received a range of training tailored to their role working in learning disabilities. We saw this had been effective, for example staff had received training in autism and had used that knowledge to develop specialist care plans for people with autism.
People and their relatives all said staff were kind and caring. We saw this was the case in the interactions with observed. People appeared comfortable and relaxed in the company of staff. Staff demonstrated a good knowledge of the people they cared for, for example able to confidently describe their likes, dislikes and preferences. A range of communication techniques were used by staff to ensure people were listened to and their views and choices heard.
People had a range of highly personalised care and support plans in place which provided detailed information on how staff should meet their needs. Staff we spoke with were familiar with people’s plans of care and how to help them maximise their independence and develop life skills.
Staff supported people to undertake a range of activities and opportunities, including providing employment, trips into the community and holidays.
An appropriate system was in place to manage complaints and bring it to the attention of people who used the service.
The service was committed to continuous improvement of the service and a number of initiatives had been put in place to help deliver high quality care. For example the service was working towards recognised autism accreditation and we found this had resulted in a good level of expertise in this area.
A range of audits and checks were undertaken by the service for example medication audits and regular monthly audits by the clinical services manager. Where action was required robust plans of action were put in place to address.
People were involved in the running of the service through regular meetings and the service user forum where people were encouraged to get involved in the creation and review of policies including fire and safeguarding.