Ashdale House

Updated 4 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Ashdale House 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed the information, we held about the service and the service provider. We sought feedback from the local authority. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We met with all the people who used the service. Not everybody was able to verbally communicate their experiences of living at the home therefore we spent time observing people in areas throughout the home and could see the interaction between people and staff. We watched how people were being supported by staff in communal areas.

We spoke with one visitor about their experience of the care provided. We spoke with seven members of staff including the registered manager and the area manager.

We reviewed a range of records. This included three people’s care records, medicine records, two staff files in relation to recruitment and training records. A variety of records relating to the management of the service, including fire safety and maintenance of the home.

After the inspection

We contacted the relatives of three people and four health and social care professionals to gather feedback about the service. We continued to seek clarification from the provider to validate evidence found in relation to notifications received.

Updated 4 March 2020

About the service

Ashdale House is a residential care home providing personal care to eight people with a learning disability. The service can support up to 11 people.

The care service had been designed, developed and registered before 'Registering the Right Support' and other best practice guidance was published. However, the registered manager was working to ensure that developments were designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The provider, registered manager and staff team had worked hard to address the areas for improvement following the last inspection. Staff training had continued to be developed and become embedded. New opportunities for learning had been identified and staff learning continued. Mental capacity assessments were individual and decision specific. People’s care plans were person centred and records related to decisions made, were well completed. Changes had been made to the quality assurance system and this now identified areas that needed development. There was a positive culture at the home.

People were supported by staff who treated them with kindness and care. Staff were patient, they understood people’s needs, choices and knew what was important to each person. People were enabled to make their own decisions and choices about the care and support they received. Care and support was person centred.

People were enabled to maintain their own interests and friendships. Staff supported them to take part in activities of their choice to meet their individual needs and wishes and were meaningful to them. People had an activity planner so they knew what they were doing each day. These had been developed with staff.

Risk assessments provided guidance about individual and environmental risks. Staff understood the risks associated with the people they supported. They were able to tell us how they supported people to keep them safe and help to retain their independence. People were supported to receive their medicines when they needed them.

People were protected from the risks of harm, abuse or discrimination because staff knew what actions they should take if they identified concerns. There were enough staff, who had been safely recruited, working to provide the support people needed.

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

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff received training and support that enabled them to deliver the specific support that people needed. People's health and well-being needs were met. They were supported to see their GP and access healthcare services when they were unwell and to maintain their ongoing health needs. Peoples nutritional needs were met. They were supported to eat and drink a variety of food that they enjoyed and had chosen.

Quality assurance systems had been developed and identified all areas for improvement. People’s records were person centred and provided guidance for staff. There was a positive culture at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 18 February 2019) and there was a breach of regulation. This was the third time the service had been rated requires improvement, with breaches of regulations, since an inspection report published 23 November 2015. Following the last inspection, we met with the provider to discuss the ongoing concerns. They told us what actions they were going to take and when they would be improved.

At this inspection we found significant improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.