This was an unannounced inspection that took place on the 7 and 9 November 2018. Ashton Lane is a residential care home for six people with learning disabilities and complex health needs. Ashton Lane is a two-story building with a communal lounge, sensory area, adapted bathroom and kitchen on the ground floor. Bedrooms are accessed by a lift to the first floor.
Ashton Lane is a 'care home'. People in care homes 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.
At our last inspection in February 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
Why the service is rated good.
The service had two registered managers. At the time of our inspection one of the registered managers who is the assistant chief executive was in the process of deregistering to focus more on other projects at Stockdales. 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.
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. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
The service was remarkable. Since out last inspection the service had continued to make further improvements that had a positive impact on people's lives. Staff, relatives, and people living at the service all felt the care at the service was exceptional and people were enabled to have a good quality life. Staff cared for people in a very kind and compassionate way, they knew them well and people were happy and relaxed at all times. Relatives were very positive about the care provided at the service and complimentary about staff and management.
There were elements of outstanding practice in relation to managing behaviour that challenged. People who had a history of behaviour that challenged had a personalised positive behaviour support plan. This supported them to have as much control as possible over their lives, so they did not feel the need to behave in a challenging way. Staff noticed when people were showing signs of being upset and swiftly provided care and support.
Staff worked hard to establish people's preferences and went the extra mile to help them find more hobbies and interests. Arrangements for activities were varied and adapted according to people's individual needs. People had over the past year had become busier and more content.
There were flexible staffing levels to meet the daily needs of people living at the service. Staff supported people in line with their personalised care records to manage individual risks and care needs. The management team had a robust overview of the staff teams training, supervision and appraisal needs.
Social contact and companionship was encouraged, which helped to protect people from social isolation. Staff supported people to keep in touch with their families and friends, and to maintain community links. People regularly visited community facilities.
We reviewed three staff files and saw that satisfactory recruitment and selection procedures were in place.
Medicines management and administration processes were reviewed during the inspection and found to be safe.
Checks were made to ensure that the environment was a safe place for people to live. These included electric, gas, Legionella compliance and fire safety.
Staff were aware of the importance of respecting people's choices. They constantly consulted people and supported them to make choices. They worked within the requirements of the Mental Capacity Act 2005 (MCA). Where appropriate, applications had been made to the relevant authorising body to deprive people of their liberty.
Accidents and incidents were routinely recorded and analysed. There was an accident and incident reporting policy in place and staff routinely completed accident and incident documentation. The registered manager analysed monthly accident and incidents reports and established trends that were emerging as a measure of mitigating risk.
Staff spoke with enthusiasm about their roles and were clear about their responsibilities. There was an open and transparent culture. The registered manager was clear about their plans to continually improve the service.
Quality assurance processes were in place to drive continuous improvement. Significant events, such as accidents, incidents, safeguarding and complaints, were monitored by the registered manager and by the provider for developing trends.