Archived: Ashlea Mews

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' 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?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. These safeguards ensure that the care people receive does not deprive them of their liberty? While no applications had needed to be submitted, proper policies and procedures were in place.

People received assessments when they went into the home; which were adjusted when necessary when their needs changed. Observations and records showed that staff within the home met those needs.

The provider had routines to keep the chance of infections low, and monitored people's weight to ensure they were receiving nourishing food. The staff were trained to do the tasks they needed to do. The staff team was stable. This was important because it meant that people knew the staff and the staff knew the people, so they could respond when they saw significant changes in someone's needs.

Is the service effective?

The home had systems in place to ensure that people needs were met. Staff made sure that people were assessed properly when admitted and that these assessments were reviewed regularly.

Records showed that the needs people had were met, with good recording of the way staff within the home were meant to meet and did meet those needs. This was confirmed during observations of staff interactions with people living there and their relatives.

A visiting social worker told us, "I have been visiting here for over 10 years and I have never had a problem with the home meeting people's needs dealing with some very complex issues and keeping us informed"

Is the service caring?

We spoke to a lot of people who said the staff were very caring, one person said, "When I get up in the morning and ask for a cuppa I get one straight away, if I press my buzzer they are there for you quickly, I get on well with everyone it's all laid on for you". We observed staff throughout the day. Staff interactions were often warm and personal. Not only were they professional in their dealings with people, they would show tenderness with the right use of touch or tone of voice.

Sometimes the interactions were loud and playful, but in a nice way that cheered people up. All of this was important because it showed that people got individual treatment, and staff understood that people needed to be treated differently.

One relative said, "I know that when I am not here staff will look after mum's health, everyone cares even down to little things like putting a picture up in mum's room quickly."

Is the service responsive?

Observations showed and people told us that the service responded to their needs quickly. One relative told us, "They respect my knowledge of mum's condition and respond to my requests."

Records demonstrated situations where people's needs changed quickly and staff responded to that promptly. For example, one person became ill very quickly with an infection, staff immediately sought medical attention and the person went to hospital where they received prompt medication and attention. Equally important for that person was the fact that she returned to the home relatively quickly. This was important for her as she said, "I love it here I get treated like the queen"

We saw increased staff numbers in the morning, which meant there was more people around at a busy part of the day.

Is the service well-led

The manager had been in place for a long time. The staff team was stable and expressed the opinion they were well managed.

The visiting social workers told us that the manager was very capable, and communicated well with them. Staff, people who used the service and visitors all said that the manager was approachable; would listen to people's needs and acted upon them where possible.

The manager had systems in place to monitor what was going on in the home and importantly spent time with the staff and the people who used the service and their relatives. People expressed appreciation for that personal contact.

We observed an example of how the manager was attuned to people's needs. We noticed the buzzer system seemed to be sounding constantly. We discussed this with the manager and she told us (and confirmed by our observations that it was usually the doorbell sounding) that the system between all of the floors and areas and the front door bell was linked together. She said that it might have been a good system twelve years ago when the home was built but she had asked for the system to be changed so it doesn't sound everywhere so often.

On the ground floor four of the five residents in the lounge were sitting in wheelchairs. We heard a number of call bells frequently activated by people needing care or support. We observed care interventions being carried out for those people who were more dependent and heard how staff spoke to people in a pleasant and respectful manner. We saw on the morning of our visit there were insufficient staff numbers to safeguard the health, safety, and welfare of people.

We saw evidence that people's needs were assessed and care was planned in line with their needs. Relatives told us they felt included in the care arrangements and decisions.

When we visited there were 37 people living in the home. We saw there were sufficient numbers of staff on duty to meet people's needs.

We found that the people who were using the service were protected from abuse as the provider had procedures in place for the staff to follow if they suspected anyone was at risk of abuse.

We saw the provider monitored the quality of the service, and asked people, their relatives and staff for their views.