Livability Ashley Place

Updated 26 January 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Livability Ashley Place is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Livability Ashley Place is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. In addition, the provider is also registered to provide care at home for people living in their own home away from Ashley place. The registered manager is responsible for the management of both sites. Not everyone who used the care at home service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke/ communicated with 8 people who used the service and 5 relatives about their experience of the care provided. Some people who used the service who were unable to talk with us using speech so we used different ways of communicating including using Makaton and their body language. We spoke with 6 members of staff including the registered manager, deputy manager, senior support workers and support workers and chief.

We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 26 January 2023

About the service

Livability Ashley Place is a residential care home providing personal care and accommodation for people with physical disabilities and/or learning disabilities and autistic people. The layout of the service has been designed to support people who have physical support needs and are reliant on wheelchairs to get about. The equipment and adaptations support people to move around the building as independently as possible. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 21 people. 18 people were using the service at the time of the inspection. The service is also registered to provide personal care to people who live separately in their own homes; at the time of the inspection there were 2 people in receipt of personal care.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support

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. People had some opportunities to build skills and participate in individual activities. Staff tried to focus on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People told us they appreciated the building layout and the adaptions that helped with independence, such as push door openers, high low tables and overhead tracking hoists. Each person had their own room and en suite, which were personalised to meet their needs and preferences. People valued these things and they did go some way to mitigate people feeling like they were living in a large group in house.

Staff enabled people to access health social support the community. Staff supported people to make decisions following best practice in decision-making.

Right care

People experienced a generally positive quality of care. People and their families told us staff were kind and supportive but there had been times when communication with some agency staff had been difficult. We observed staff respecting people’s dignity and ensured people had the right to have their say on their care and support. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing. Staff and people worked together to assess risks people might face. Staff encouraged people to take positive risks. For example, the service has a catering kitchen and catering staff. People who expressed a wish to cook meals are supported to use the kitchen to do so. We were told by the registered manager there were plans to develop the service to improve access to cooking facilities.

Right culture

People did generally lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the provider, management and staff. There was mixed understanding or opportunities to apply active support approaches and the registered manager agreed the layout of the building did hinder people’s ability to do more daily tasks for themselves. Internal audits had picked up the need for further active support training for staff. Managers and staff clearly tried to deliver person centred support. People told us they were pleased with the support generally but would be happier if the use of agency staff were reduced because sometimes communication could be difficult with some agency staff. People had communication passports and permanent staff knew people well.

There had been a recent change of manager, with the new registered manager in post since September 2022. Some relatives and professionals told us, they had difficulties in communication with managers, some thought the deputy manager was the registered manager. Communication between staff and people and managers and people they work in partnership with is an area for improvement.

People received good quality health care, support and treatment because trained staff and specialists could meet their needs. Most staff knew and understood people well but there was a reliance on agency staff who did not always know people well.

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 12 March 2020).

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.

Why we inspected

This focused inspection was prompted by a review of the information we held about this service. We only inspected the key questions, safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Livability Ashley Place on our website at www.cqc.org.uk.