Archived: Ashleigh House

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found:

Is the service safe?

We found the service to be safe because they had a range of policies and procedures in place to protect the people who lived in the home. The staff we spoke with had a good understanding about how to report any concerns.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

The care and support plans we looked at contained clear information about identified risks and how risks should be managed. Examples included supporting people to access the community and maintaining independent living skills. We saw that a plan of care had been developed to manage any identified risks in the least restrictive way. This meant that people could be supported with activities with reduced risks to themselves or to the people who supported them.

We observed that staff supported people to access the community in accordance with their plan of care. We saw that people were supported by appropriate numbers of staff.

Staff were able to provide safe, appropriate and personalised care to the people who lived at the home. Each person had a plan which described the care and support they required and how staff should provide it. These plans also included who the important people in their life were, how people communicated, daily routines, preferences and how they made decisions.

Each person was allocated a keyworker who they would meet with on a regular basis. We saw the keyworker was involved in the review of people's care needs and preferences with other professionals.

There were sufficient numbers of suitably qualified, skilled and experienced staff on duty to meet the needs of the people who lived at the home. When we visited eight people lived at the home. The staff we spoke with confirmed there were sufficient numbers of staff on duty to meet the needs of the people they supported. The manager told us staffing levels were increased where needed to meet the social needs of the people at the home.

Is the service effective?

We found the service to be effective because people's care treatment and support achieved good outcomes. We also found that people's rights and choices were respected by staff.

Staff told us they attended a handover meeting at the start of every shift. They said that this provided them with current information about the people they supported. We saw staff recorded information about each person on a daily basis. Information included how people had spent their day and how they had responded to activities of daily living. This meant the effectiveness of people's care plans could be fully reviewed.

We observed that staff were competent and professional in their interactions with people who lived at the home. There was a stable staff team which meant people were supported by staff who knew them well. The atmosphere in the home was relaxed and staff interacted with people in a kind and respectful manner.

Staff used a range of methods to assist people to make choices about their day to day lives. Examples included objects of reference and photographs. We observed staff offering people choices in accordance with their needs and preferences. An example included using objects of reference which enabled one person to make a choice about what they wanted for lunch.

The service was effective in promoting people's independence and community involvement. People were supported to engage in the local community in a variety of ways. Examples included trips out, home visits, shopping trips and activities.

Is the service caring?

Staff interactions were kind, patient and professional and people appeared very comfortable with the staff who supported them.

We observed staff were skilled in recognising and responding to changes in people's behaviour. The staff we spoke with had a very good understanding about the needs and preferences of the people they supported. They understood and responded to people's needs and requests where individuals were unable to make their wishes known verbally. This demonstrated that staff knew people well.

People were unable to express themselves through verbal communication. We observed people responded positively to staff interactions. An example included people expressing happiness when they were informed about the afternoon visit out.

Is the service responsive?

The service was responsive to people's needs. Staff had up to date guidance on how to support each individual. We read the care plans of two people who lived at the home. These contained assessments of need and outlined how needs would be met. The assessments were regularly reviewed to ensure they reflected people's up to date needs and preferences.

People's health care needs were monitored and responded to appropriately. Information about people's health needs and contact with health and social care professionals had been recorded. We were informed that the service received good support from health and social care professionals and there were no problems obtaining their input for people when required.

Is the service well led?

The service was well led because there were systems in place which monitored the quality of the service provided. The service was proactive in seeking the views of the people who lived at the home and their representatives. We saw that the service responded to any comments or suggestions made.

The service was managed by a person who had been registered by the Commission. The registered manager regularly provided 'hands-on' care. This meant they remained up to date with the needs and preferences of the people who lived at the home. The staff we spoke with told us they received the training and support they needed.

We spoke to the manager, deputy manager and three support staff. All were positive about the support they received and they confirmed that they received regular supervision sessions. Staff files contained detailed records of supervision sessions. These showed that staff received regular supervisions where their on-going performance and competencies were discussed.

We saw that staff had the opportunity to attend regular staff meetings. We looked at the minutes from a recent meeting. These showed that a range of topics had been discussed which included policies and procedures, staffing and information about the people they supported.

We found procedures were in place to minimise any risks to the people who lived at the home. Regular internal audits had been carried out which monitored the on-going health and safety of people. Internal audits included checks on the home's fire systems, environment, care planning and the management of people's medicines.

Staff had a very good understanding of the needs and preferences of the people who lived at the home. The care plans we looked at promoted a very person centred approach to care. We found that people’s heath needs had been appropriately monitored and that people had access to a range of health care professionals.

We saw that appropriate procedures were followed for people who were unable to consent to their care or treatment. We saw that decisions had been thoroughly considered and agreed to be in the individuals’ best interests.

People who lived at the home were supported to take part in a wide range of activities and social events and the home enabled people to maintain contact with their families and friends.

The home followed appropriate procedures for the management and administration of medication. This meant that people received their prescribed medicines when they needed them.

The home had a complaints procedure which provided people who used the service and their representatives with clear information about how to raise any concerns and of how their concerns would be managed.

People appeared very comfortable in the presence of staff and it was evident staff knew people well. Staff were observed being kind, caring and patient when they assisted people with care and support.

We saw that staff offered people choices in line with their assessed needs, abilities and preferences. An example of this included the use of pictures to assist people to choose food and beverages. Staff responded promptly to people when they used objects of reference to express their needs or wishes. This demonstrated that staff knew people well.

We observed that staff were competent and professional in their interactions with people who lived at the home. Staff morale was good and there was a happy and relaxed atmosphere within the home.

People felt safe and staff knew how to recognise and report any suspicions of abuse. The home had procedures in place which ensured that people were protected from the risk of harm or abuse and that their rights are protected.