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Inspection carried out on 6 March 2020

During a routine inspection

About the service

Ashdale - Sunderland is a residential care home providing personal care to four people aged 18 and over at the time of the inspection. The service can support up to four people in one large adapted house.

Services for people with learning disabilities and or autism are supported

The service had been designed and was following the principles and values underpinning Registering the Right Support. The premises were large and homely. People had access to their own space to live as independently as they wished and had the choice to access communal parts of the service to socialise with other people living at the service.

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

People living at Ashdale - Sunderland were very happy with the care and support they received from staff. People had unique bonds with staff and one person commented, “I really love all of the staff they have been with me a long time and I feel they are always there if I need anything or someone to talk to. They are helpful, kind and caring.”

Relatives were positive about the service and were actively involved by staff to help plan support for their family members. Care plans were bespoke and reflected the specific outcomes people wanted to achieve and their choices. Relatives described the positive influence staff at the service had on people. A relative commented, “The best thing about the service is knowing my family member is happy and safe. It is the nearest they will ever get to friends and the staff are like family. It helps them to keep their independence as much as possible at the same time being supported. Literally you could not find a better kinder caring place.”

Risks people may face were fully identified and mitigated. The premises were safe, and the service had a homely environment. Medicines were safely managed, and the service worked in partnership with other health care professionals to make sure people received a continuous level of support. There was enough staff to safely support people.

There was an established staff team who completed regular training and attended team meetings. Staff were supported with regular supervisions. Staff had a positive relationship with the registered manager and felt able to provide feedback regularly. The quality and assurance systems in place allowed for effective monitoring of the service by the registered manager.

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.

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 can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, 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.

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 7 October 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 9 August 2017

During a routine inspection

This inspection took place on 9 and 14 August 2017. The provider was given 24 hours’ notice because the location is a small care home for younger adults who are often out during the day; we needed to be sure that someone would be in.

Ashdale provides care and support for up to four people who have autism spectrum condition. The home is a large detached house in a residential area within walking distance of the City Centre.

The home had a registered manager in place. A registered manager is a person who has 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.

At the last inspection, the home was rated Good. At this inspection we found the home remained Good.

The provider had systems in place to ensure people were protected from abuse and harm. Staff had completed safeguarding training and were confident in what action to take if they witnessed abuse. Risk assessments were specific to the person and identified the risk and the actions needed to be taken to keep the person safe. Medicines were managed safely. Sufficient staff were available to ensure people’s needs were met.

The registered manager ensured experienced and appropriate skilled staff were deployed to support people. The home had a warm homely atmosphere and people’s rooms were personalised. People were promoted to have a balanced diet. People were supported to maintain good health and had access to healthcare professionals. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People said they were cared for by kind and caring staff, who treated them with respect and dignity. Staff were knowledgeable about the people they supported. They were aware of their preferences, interests and family structure. People were involved in all aspects of decision making about their care and treatment. People’s independence was encouraged and staff supported people to achieve their goals.

Care plans were comprehensive and included clear information for staff to make sure each person’s specific needs were met. Staff were proud to work for the provider and told us they were fully supported by the registered manager. The provider had an effective quality assurance process to monitor the quality and safety of the service and to ensure that people received appropriate care and support.

Further information is in the detailed findings below.

Inspection carried out on 15 April 2015

During a routine inspection

This inspection took place on 15 April 2015. The last inspection of this home was carried out on 13 June 2013. The service met the regulations we inspected against at that time.

Ashdale provides care and support for up to four people who have autism spectrum condition. The care home is a detached family house in a quiet residential area near the city centre. At the time of this visit there were four people living there. The service is situated beside another small care home and they are both managed by the same registered manager.

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 told us they “liked” living at this care home. They said they felt comfortable at the home and with the staff who supported them. One person commented, “I’ve always felt very safe at Ashdale.” There were enough staff to meet people’s needs. The home had a stable staff team and many staff had worked there for years. This meant they were familiar with people’s individual needs. The provider made sure only suitable staff were employed. Staff helped people to manage their medicines and did this in a safe way.

People and relatives had confidence in the skills of staff. One person said, “The staff are very good. They know how to help people.” A relative commented, “Staff seem very capable.” Staff received relevant training to assist each person in the right way. Staff understood the Mental Capacity Act 2005 for those people who lacked capacity to make a decision and Deprivation of Liberty Safeguards to make sure people were not restricted unnecessarily.

People were supported to be as involved and as independent as possible in choosing menus, grocery shopping and preparing meals. One person told us, “I like all the meals because we shop and make them ourselves.” Staff helped people to lead a healthy lifestyle, and supported them to go to any health care appointments.

People and relatives made positive comments about the caring and friendly attitude of staff. One person told us, “The staff are really lovely. They are all nice and caring.” There was a relaxed and sociable atmosphere in the home. One person told us, “It’s a very happy home and it’s got a good atmosphere.”

People were encouraged to make their own decisions and choices, for example about activities, menus and clothes. Staff were friendly and supportive when talking with people.

Staff were very knowledgeable about people’s individual needs, preferences, likes and dislikes. There were up to date care records that were personalised to each person and included guidance for staff about people’s specific needs.

Each person had a range of meaningful social, leisure and vocational activities they could take part in. One person said, “We do lots of different things.” People and relatives were asked to comment on the service and they felt able to give their views about the home at any time. People and relatives had information about how to make a complaint

People, relatives and staff felt the organisation was well run and the home was well managed. There was an open, approachable and positive culture within the home. Staff commented positively on working for the organisation, but felt their views were not always directly asked for by the provider. The provider had a quality assurance programme to check the quality of the service.

Inspection carried out on 13 June 2013

During a routine inspection

We haven�t been able to speak to all of the people using the service because they had complex needs, which meant they were not able to tell us their experiences. However, we gathered some evidence of people�s experiences of the service by observing care practice.

We also undertook a short observational framework for inspection (SOFI) exercise to observe the interactions between them and the staff. SOFI is designed to be used when inspecting services for people who had some difficulty in communicating their opinions on the services they receive.

During the SOFI, we observed people being offered choices; for example, people were offered a choice of drinks and a choice of meals. Staff were attentive and gave people the information about the drink and meal options in a way that was appropriate to their needs. One person was being supported to make their own meal and others were involved in setting the dining table and selecting condiments that they liked. In addition, we observed staff trying to engage people in discussions about the activities they had taken part in that day and what they wanted to do that evening.

We found that people who were using the service were receiving the care and support they needed. For example, the staff we spoke with could describe how they met the assessed needs of the people they were providing with care.

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 found that records, which the provider is required to keep, to protect the peoples' safety and wellbeing, were stored securely and could be located promptly when needed. For example, the care records were kept in secure cabinets.

During the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. We also observed that the people were clean and well groomed

Inspection carried out on 11 October 2012

During an inspection looking at part of the service

We found that people who used the service were protected from the risks of unsafe or inappropriate care and treatment. Records were kept securely and could be located promptly when needed.We spoke to people using the services but their feedback did not relate to this standard.

Inspection carried out on 28 June 2012

During a routine inspection

We spoke to the people who were living at the home. One person commented �We have meetings to talk about holidays�, �I have travelled by myself now� and �I go out with my friend�.They also told us that they like the staff and they felt safe at the home. However due to the complex needs and different communication styles of people who were using the service the information we received verbally from some people was limited.

Inspection carried out on 17 January 2012

During a routine inspection

We spoke to the people who were living at the home. One person commented �We have meetings to talk about holidays� and �I have travelled by myself now�. However due to the complex needs and different communication styles of people who were using the service the information we received verbally from some people was limited.

Reports under our old system of regulation (including those from before CQC was created)