Archived: Ashpoint House

Updated 10 September 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 9 August 2016 and was announced. The provider was given 24 hours’ notice because the service was a small care home for adults with learning disabilities. People are often out during the day and we needed to be sure that someone would be in.

The provider had not had the opportunity to complete a Provider Information Return (PIR) as they had not received this document prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

We spoke with the registered manager and the deputy manager. We spoke with two additional members of staff. We looked at two people’s care plans and the associated risk assessments and guidance. We looked at a range of other records including four staff recruitment files, the staff induction records, training and supervision schedules, staff rotas, medicines records and quality assurance surveys and audits. We observed how people were supported and the activities they were engaged in. People were unable to tell us about their experience of care at the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us

After the inspection we spoke with one relative about the service.

We last inspected Ashpoint House on 27 August 2013 when no concerns were identified.

Updated 10 September 2016

This inspection was carried out on the 9 August 2016 and was announced.

Ashpoint House is registered to provide accommodation and personal care for up to three people. People living at the service had a range of learning disabilities and autism. They all required support with behaviours which may challenge others.

Downstairs there was a kitchen, dining room, lounge, games room and the staff office. There were three bedrooms upstairs, one of which had an ensuite bathroom, a shower room and a bathroom. At the time of the inspection there were three people living at the service.

The service had a registered manager in post. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

Staff had not received formal one to one meetings with the registered manager to discuss their progress and any issues which may have arisen. This was an area for improvement. Staff received the induction and training they needed to give people appropriate support. Staff had training in autism and how to support people with behaviours that challenge.

People received one to one support from staff throughout the day. Staff covered for each other in the event of sickness or other absence to ensure that people were always supported by staff they knew. People required additional support when they went out in the community and they were able to access the activities they wanted and any appointments as necessary.

Staff knew how to recognise and respond to abuse. The registered manager was aware of their responsibilities regarding safeguarding and staff were confident the registered manager would act if any concerns were reported to them.

Staff completed incident forms when any accident or incident occurred. The registered manager analysed these for any trends to see if any adjustment needed to be made to people’s support.

Risks relating to people’s health, their behaviour and other aspects of their lives had been assessed and minimised where possible. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

Medicines were stored appropriately. People received their medicines when they needed it and there were guidelines in place for if people needed medicines on an as and when basis for pain relief.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. People had DoLS in place and staff had up to date knowledge on the Mental Capacity Act 2005 (MCA) and DoLS. They supported people to make their own choices where possible and best interest meetings had been held when people needed support to decide about required medical interventions.

People were supported to eat healthily. People were given a choice at each meal about what they would like to eat. People were seen and assessed by a speech and language therapist when they needed support to eat and drink safely. Staff had sought advice and guidance from a variety of healthcare professionals to ensure people received the best care possible. Staff followed guidance and advice given by health care professionals.

People and their relatives said that staff were kind and caring. People were unable to communicate verbally but staff anticipated their needs and understood their non-verbal methods of communication. People were treated with dignity and respect.

Staff were responsive to people’s needs. People’s care plans were updated monthly by staff to ensure they reflected the care and support people needed. There were behavioural support plans in place outlining potential triggers for behaviour that may challenge others and different strategies to deal with them. We observed these being followed by staff.

People accessed a variety of activities both inside and outside of the service. People had annual tickets to Dreamland (an historic amusement park) and regularly went swimming and to local places of interest.

There was a complaints policy in place and people’s relatives said they knew how to complain if they needed.

Staff and relatives told us they thought the service was well led. The registered manager was experienced in working with people with learning disabilities and providing person centred care. The CQC had been informed of any important events that occurred at the service, in line with current legislation.

The registered manager told us the ethos of the service was, “To ensure people are treated as individuals.” There was a culture of openness and honesty and staff responded to the needs of people as they changed.

The registered manager and the provider’s quality department regularly carried out audits to identify any shortfalls and ensure consistent, high quality, personalised care. People’s relatives, staff and other stakeholders were regularly surveyed to gain their thoughts on the service. There was no summary or publication to people, staff and stakeholders of the results, to show continuous improvement and the action the registered manager was taking. This was an area for improvement.