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Inspection carried out on 20 May 2018

During a routine inspection

The inspection took place on 20 May 2018 and was unannounced.

Ash View House accommodates 17 people in three adapted buildings. Ash View House is a care home. People in the care home receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

There was a registered manager for the service. 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.

There was a culture of dynamic risk taking at Ash View House. This was supported by very well trained staff and really up to date systems and procedures in place, to keep people and others safe. This meant people thrived in an environment where they could develop and live a really fulfilling life but still be supported to stay safe.

People, relatives, professionals and staff gave exceptionally positive feedback about Ash view House; Comments included “The care is excellent, the staff are amazing.” “The staff strive to improve all the time, the owner is also lovely”, and “I would recommend this place to anyone, you are here with people who try to look after you and do the very best they can.”

The whole team were led by the management who were exceptionally committed to providing people with a highly responsive and very flexible service. Care was goal and aspirations led and this meant people thrived and planned to achieve long-term goals and outcomes. One person told us “It’s brilliant here they let me decide what I want to do and help me do it”. Another person told us “It’s the best home I have ever been in I can do so many things here, I went greyhound racing which I enjoyed a lot.”

Care was creatively planned to respond to people’s individual needs or goals. Activities were highly personalised to people’s specific interests. Care plans were personalised with information co-written with people at the home. This supported staff to provide high quality care and support.

People, relatives and staff were at the centre of Ash View House’s quality checking programme. The management team followed a wide range of systems to gain their feedback and views. Systems included regular meetings and a range of satisfaction surveys.

People, relatives and staff, told us the home was very well run and well-led by the management team. One person told us “I see the owner all the time I can talk to him about anything”. Another person said, “They are always asking what you think; it makes you feel you matter and are involved.”

The whole team's total commitment to delivering a truly person centred service has been embedded even further into all aspects of the service. Staff who have shown specific interests in particular areas, such as safe responses to behaviours that challenge were designated 'Leads'. These leads continued to play a key role in developing and improving practice as well as sharing learning and acting as role models.

The management team and staff they led had a good understanding and appreciation of people's needs. The team were creative in the ways they provide person centred care .This put people at the centre and ‘heart’ of how the home was run. The management continued to find new and creative ways to support people to have an exceptionally fulfilled quality of life.

Inspection carried out on 7 January 2016

During a routine inspection

This inspection took place on the 7 and 8 January 2016 and was unannounced.

Ash View House is a service that provides accommodation and personal care for up to 17 people with mental health needs, learning disability and autistic spectrum disorder. The service consisted of three separate detached houses next door to each other and a separate annexe.

At the time of our inspection 15 people were using the service. Five people lived at 30d Cock Road, five people at 30c, four people at 30e and one person in the annexe.

There was a registered manager at the service at the time of our inspection. 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 were safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. People were supported to take risks, promote their independence and follow their interests. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed.

The service was effective. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see their GP and other healthcare professionals when required. The physical environment was personalised and met people’s needs.

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand. People were supported to maintain relationships with family and friends.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

People benefitted from a service that was well led. The management team demonstrated good leadership and management, particularly with respect to developing the vision and values of the service. The vision and culture of the service was clearly communicated to and, understood by staff. The registered manager and senior staff had an open, honest and transparent management style. The quality of service people received was monitored on a regular basis and where shortfalls were identified they were acted upon.

Inspection carried out on 13 February 2014

During a routine inspection

We were given a tour of the home and found it to be well maintained, clean and homely. We saw that people were involved in external planned activities, while others were seen to be walking freely about or relaxing in the lounge areas. Staff interacted with people in a caring way and we saw that people were happy with the support offered. We spoke with two people during a midday meal. One person confirmed that they were respected and listened to by staff and that they felt safe. They said “This is the best place I have ever been in”.

People's needs had been assessed and their care had been planned and developed with their involvement. We spoke with three staff on duty who demonstrated their confidence and knowledge about people’s individual needs. They had been supported to deliver care and treatment safely and to an appropriate standard through planned training and supervision.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

After our visit we spoke with two family members and a professional involved in people’s care. We were given positive comments that included “Appointments are always kept and people are managed on an individual basis. They go the extra mile”. It was evident that the provider worked in co-operation with others.

Inspection carried out on 15 March 2013

During a routine inspection

As part of our inspection we spoke with five people who used the service, three relatives and three social care professionals. We also spoke with the registered manager, the home manager and one support staff.

On the day of our inspection there were ten people living at Ash View House including on person on trial admission. We saw people who lived in the house were being supported by six members of staff. We spoke with five people who lived at the home. They told us they were happy at Ash View House. Comments made included, "I like living here, I feel at home it is like a family “and “I feel at home, I am quite content, I have no complaints”.

We spoke with three relatives who all spoke positively about the support their relatives received. Comments included, "in general we feel very lucky that our relative is receiving the quality of care they are getting in Ash View House the staff are really good”,

We found systems were in place to ensure people were safeguarded from abuse.

We found staff were trained and supported to deliver care to an appropriate standard.

We found the provider had an effective system in place to monitor the quality of the service to ensure people received safe care.

Inspection carried out on 27 March 2012

During a routine inspection

We spoke with three people who use the service. They told us they enjoyed living in the home. One person said "the house is not a boundary, it is flexible to your needs". All of the people we spoke with told us they were able to do what they wanted to do. They told us about the numerous activities which they are able to take part in, for example: trips to Weston-Super-Mare and shopping trips. We were also told about more individualised trips which were tailored to peoples needs, for example a trip to Old Trafford for one of the people we spoke with.

The people we spoke with told us they had a choice in activities and also in their food. One person told us that the menus change regularly and that once a week there is a roast dinner for the whole house. We were also told that people are encouraged and supported to be independent in cooking their own meals. We saw people cooking and preparing their meals during our visit.

The people we spoke with told us staff were kind and they were able to ask for support when they needed it. They told us they enjoyed living in the home. We saw that people were able to develop within the home through the care and support they were provided by staff and associated professionals and that this was clearly planned.

We saw that staff provided support to people in a manner which promoted their independence.

The people that we spoke with told us they felt safe living in the home.

We found that staff were provided with training and support to fulfill their role and also to develop their skills and knowledge.

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