Archived: Beehive

At our last inspection on the 29 October 2015 we rated the service 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 on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service carried out an assessment of people’s needs before they commenced using the service. However, this did not cover needs related to ethnicity, culture or sexuality and we have made a recommendation about this.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Medicines were managed safely and steps had been taken to reduce the risk of the spread of infection.

Staff received on-going training and supervision to support them in their role. The service operated within the principles of the Mental Capacity Act 2005. People were able to choose what they ate and drank. People were supported to access relevant health care professionals.

We observed people were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place.

Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place which included seeking the views of people who used the service.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with relatives of people who used the service, staff supporting them and from looking at records.

Is the service safe?

We met with people who used the service but due to the degree of their learning and physical disabilities they were unable to give us any feedback about the quality of the service. We spent time with them and observed how they were supported by the staff. We saw that people were treated with respect and dignity by the staff. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. The manager organised the staff rotas and took people's care and support needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met. Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents and concerns. This reduced the risks to people and helped the service to continually improve. Staff had received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards training. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. The manager told us that one application for deprivation of liberty had needed to be submitted and this is continually monitored.

Is the service effective?

People were supported by caring and attentive staff. Staff we spoke with knew about people's care and support needs and their individual preferences. Their health and well-being were monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with other health care professionals to make sure people received prompt, co-ordinated and effective care. Staff worked to a key worker system to oversee people's care and had been trained to deal with specific conditions that they had.

Is the service caring?

We saw that staff showed patience and gave encouragement when supporting people. They were able to interpret what people indicated and responded accordingly. People's preferences and interests had been recorded and care and support had been provided in accordance with people's wishes. Staff offered people choices and talked to them about what was happening or what they needed to do. A relative had commented in a survey "very hard working (staff), very good at what they do and provide a lot of care and support."

Is the service responsive?

Staff we spoke to were knowledgeable about the needs of people they supported and how to meet them. Care plans included information about people's preferred routines and healthcare needs as well as their likes and dislikes. This ensured that they received an individualised service. Care plans were reviewed and updated monthly or when people's needs had changed. Senior staff referred people to appropriate professionals for assessment and advice. Any actions advised by them were implemented by staff. People were supported to access a range of healthcare professionals to promote their wellbeing.

Is the service well-led?

The service had a quality assurance process in place. Annual customer satisfaction questionnaires were completed by people and their representatives to seek their views and opinions about the service in order to find out where improvements were needed. Staff told us they were clear about their roles and responsibilities. They were supported by the management team to provide good, quality care and were encouraged to complete relevant training. Relatives and service users' views were also sought at meetings which were held regularly. We found a number of audits were undertaken by staff, the manager and by the registered provider to ensure that people received safe, quality care.

We found that people were supported to eat sufficient amounts of food, and that they were not at risk of malnutrition or dehydration. However, we found that people were not able to have choice about what food they ate.

We found that the service had robust staff recruitment procedures in place. This included staff providing written employment references and undertaking a Disclosure and Baring Service check. This is a check to see if the person has any criminal convictions or are on any list that bars them from working with children or vulnerable adults. Staff told us they had regular access to training, and we found certificates in place for various training courses including safeguarding vulnerable adults and medication administration. Records were stored securely, and staff were able to access records as required.

We observed people being supported to engage in activities in the community. One person went out with a member of staff during our visit to go for lunch and another person was supported by staff to go to the shops to buy some magazines. We observed staff responding to people's needs in a respectful and sensitive manner. For example, staff were observed explaining what was going to happen next and offering people choices.

People's needs were assessed and care plans developed that ensured people's needs were met effectively. Any identified risks to people's welfare were assessed and plans put in place to minimise these while enabling people to maintain their independence. People's healthcare needs were monitored and met with the support of healthcare professionals.

The home was well maintained, clean and warm at the time of our visit and health and safety checks were taking place at the required intervals to ensure the environment was safe.

There were adequate numbers of staff to meet people's needs effectively and staff told us that there were always enough staff on duty.

There was an effective complaints management system in place.