We carried out a review of the data available to us about Ash House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ash House, you can give feedback on this service.
About the service
Ash House is a residential care home providing accommodation and personal care for up to six people with a learning disability and autism. At the time of the inspection six people were living at the home.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, and right culture.
Right Support
Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People were supported by staff to pursue their interests. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. Relatives told us they felt their loved one were safe at the home. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.
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.
Right Care:
Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. People were supported by kind and caring staff. Staff protected and respected people’s privacy and dignity and understood and responded to their individual needs. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.
Right Culture:
Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People and those important to them, including advocates, were involved in planning their care. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update. The last rating for this service was requires improvement (Published 17 March 2020) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We received concerns in relation to the providers recruitment practices. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Ash House is registered to provide personal care and accommodation to a maximum of six people. People who live there may have a learning disability and/or autism. At the time of the inspection six people lived at the home.
The service applied the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people who used the service live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives. People using the service received planned and coordinated person-centred support that was appropriate and inclusive for them. They lived in a domestic size house that had no external visible features of it being a care home.
People’s experience of using this service and what we found
Risks relating to the premises had not always been identified and/or managed promptly which potentially placed people at risk of accidents and injury. Quality monitoring had not identified all issues that had potential to place people at risk of injury. People received their medicines as they had been prescribed, however, medicines were not stored in accordance with the manufacturers required temperature guidance. Infection prevention processes required some improvement. People were safeguarded from the risk of abuse and safe recruitment processes were in place. Overall, relatives and staff felt enough staff were provided.
Relatives told us that the support provided within the service was good. The registered manager was visible within the service and people were aware of who they were. The registered manager understood that they were required to provide us (CQC) with notifications about important events and incidents that occurred whilst the service was delivering care.
People were supported to have maximum choice and control of their lives. Staff supported people 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 achieve the best possible outcomes, including 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.
Newly recruited staff received induction training to introduce them to their role and the people they were to support. Training had been received by staff and was generally refreshed in line with the provider's timeframes. People were supported by staff who knew them and their needs well. People were encouraged, where possible, to make decisions about their care. People were supported by staff who understood the principles of the Mental Capacity Act 2005. People's nutritional needs had been assessed and guidance was provided for staff about how to encourage people to maintain a healthy diet. Referrals were made to healthcare professionals where required to ensure people's health needs were met.
Relatives felt staff were caring and treated people with dignity and respect. People were encouraged to develop and maintain their independence skills. Visitors were made to feel welcome. People were supported by staff to maintain contact with their families.
Assessment and reviews of people’s care and support needs were undertaken regularly or as required. People and their relatives were included in these processes to ensure all needs were determined and addressed. Relatives felt confident and comfortable to raise any complaints they had with the staff or registered manager. Relatives confirmed they were kept up to date with important information relating to their family member.
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 good (published 08 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to regulation 12 safe care and treatment and regulation 17 good governance. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any If we receive any concerning information we may return sooner.
Ash House is a residential home which provides support to people who have learning disabilities, autistic spectrum disorders and mental health issues. The service offers support for up to six young adults who are in transition from children’s services. At the time of our inspection, there were six male young adults living at the home.
There was a registered manager in place who was present throughout our inspection. 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 showed that they were at ease around staff and one another, and relatives we spoke with told us they felt that people were safe living at the home. Staff we spoke with were aware of how to recognise and report safeguarding concerns. People were supported by staff who had access to clear guidance about how to manage their risks.
People were supported by enough staff. Recruitment processes had been followed appropriately to help ensure that people were supported by staff who were suitable. People’s medicines were stored safely and records relating to this support were clear.
We saw that staff understood people’s needs, relatives we spoke with confirmed this. Staff received support and guidance to aid their development in the role. Staff understood the principles of the Mental Capacity Act (2005), however the processes at the home had not been developed in line with these principles.
People enjoyed their meals at the home and staff were aware of the need to promote a healthy, balanced diet. People were supported to access further healthcare support when needed.
People were treated with respect and dignity by staff who were kind and caring. Our discussions with staff and relatives confirmed this. People and their relatives were involved in care planning. People’s care records provided guidance about how to meet and respect people’s needs.
People were supported to participate in activities of interest to them at home and in the community. Relatives told us that they felt able to raise concerns, although the registered manager had not always provided clarity to ensure that people and staff understood how to raise concerns, and how their concerns would be addressed.
Relatives and staff spoke positively about the home. Staff were engaged and motivated in their roles. Records were not always robust and did not always demonstrate the quality and safety of the service. The registered manager had not always fully addressed feedback to provide confidence in the leadership and to ensure that people and relatives were involved in the running of the home as far as possible. Areas of improvements that had been identified through ongoing quality assurance processes were being addressed.
Ash House is a residential home which provides support to people who have learning disabilities, autism spectrum disorders and mental health issues. They offer support to young people who are in transition from children’s services. The home is registered with the Commission to provide care for up to six people. At the time of our inspection there were six people living at the home.
There was a registered manager in post who was not available on the day of the inspection. 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 and associated Regulations about how the service is run. During the inspection we spoke with the deputy manager.
We saw that people were comfortable around staff and with the support they were receiving. People had opportunities to participate in a range of activities staff knew they enjoyed. People were supported to maintain relationships which were important to them.
Relatives told us that they were happy with the care provided at Ash House, one relative said, “It is wonderful to see such progress and to know [my relative] is in a safe and loving environment.” Staff were aware of the need to keep people safe and the provider conducted checks to ensure people were supported by staff who were suitable. The storage, administration and recording of medication was good and there were systems for checking that medication had been administered in the correct way. The process for making sure people received their ‘as required’ or PRN medication was not robust.
People were supported to express their preferences. When the support people received risked restricting their freedom, the registered manager had supported people in line with the appropriate legislation. Some people were subject to restraint that was carried out in an appropriate manner but not well documented. Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills.
People were supported to have their healthcare needs met and were encouraged to maintain a healthy lifestyle. The registered manager sought and took advice from relevant health professionals when needed.
People were provided with a good choice of food in sufficient quantities and were supported to eat meals which met their nutritional needs as well as their personal or cultural preferences.
Staff understood the needs of the people they supported and the importance of providing care which was person centred. We saw that they were kind and considerate with people. We noted that staff communicated well with each other about the care and support needs of people. The provider had not checked how effective their monitoring process had been in maintaining or driving up standards of care.