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Inspection carried out on 23 August 2017

During a routine inspection

This inspection took place on 23 August 2017 and was unannounced. Ashley Court is registered to provide accommodation for people who require nursing or personal care. At the time of our inspection there were 26 people living at the service.

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

At our last inspection we found medicines were not always stored safely, at this inspection we found the provider had made the required improvements. People had support from staff to safely administer medicines as prescribed and medicines were stored safely. People were protected from the risk of harm. Staff understand how to safeguard people and manage risks effectively. People were supported by sufficient staff that had been recruited safely.

People were supported by staff that understood their needs. Staff were knowledgeable and had regular updates to their training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were given a choice of food and drinks and had access to health professionals to support and maintain their health and wellbeing.

People said staff were caring and they felt involved in all aspects of their care; Staff ensured people had a choice and were supported to maintain their independence. People’s privacy and dignity was maintained by staff.

People received support from staff that understood their needs and preferences. People were supported by staff to take part in activities and could spend time doing things they enjoyed. People understood how to make a complaint and complaints were used to improve the quality of the service people received.

People felt able to engage with the management team. Staff told us they could access support from the management team. We saw the provider had systems in place to ensure people received a good quality service.

Inspection carried out on 31 March 2015

During a routine inspection

We undertook an unannounced inspection of Ashley Court Care Limited on 31 March 2015. At the last inspection in July 2013 the service was meeting the regulations with all of the areas that we looked at.

Ashley Court Care Limited provides personal care in a residential setting for up to 28 older people. The provider had recently increased its provision from 21 to 28 service user places. At the time of our inspection there were 21 people living at the service.

There was a registered manager in post 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, visitors and external professionals were positive about the care provided by the service. Our own observations confirmed that care was attentive and compassionate.

People felt safe using the service. Risks to people were assessed so that staff knew how best to support people safely. Staff knew how to recognise and report abuse.

We found there were enough staff to support people during our inspection. Staff were recruited in a safe way.

We found some topical creams were incorrectly stored. We also found that staff did not have access to guidance for all people who required medicines on occasions; such as those who required pain relief.

People’s care was regularly reviewed. People and their representatives were involved in decisions about care.

Staff were supported to be effective in their roles and to deliver good care. Staff were aware of how to support people’s choices and promote their rights.

People received adequate levels of food and drink to keep them healthy. Staff were aware of how to support different people with special food and drink needs. People’s health was supported by access to appropriate external healthcare professionals.

Staff delivered care that was compassionate and supported people as individuals. Staff knew what conditions people had and how to support these. Staff respected people’s dignity, privacy and independence.

Staff were able to pick up on people’s changing care needs. They implemented advice form appropriate healthcare professionals in order to assist people with their well-being. People’s needs were assessed using appropriate assessment tools. However, we found that, while staff knew how to support people, people did not always have specialist care plans in their records to reflect this.

People knew how to raise matters of complaint with staff and were comfortable in doing so. No one we spoke with told us they had any reason to complain.

The management promoted a positive culture at the service. Staff felt supported by the provider. The provider carried out a number of audits to identify and address issues with the quality of the service.

Inspection carried out on 5 July 2013

During a routine inspection

On the day of our inspection 19 people were in residence. We spoke with three people who used the service, two visiting relatives, two care staff, the cook and the registered manager.

We found that people’s consent for care and treatment was obtained before this was provided.

Care plans provided staff with relevant information to promote their understanding of people’s care needs and how to meet them.

People had access to a varied menu and could be confident that their nutritional needs would be met.

The design and layout of the premises was suitable to meet people’s needs. One person who used the service said, "I've got my own bedroom and it's very comfortable."

The home had an effective quality assurance system in place to ensure people were not placed at risk of inappropriate care or treatment. One person who used the service said, "We have meetings to discuss social activities and the menus."

Inspection carried out on 22 May 2012

During an inspection to make sure that the improvements required had been made

An unannounced site visit was carried out on 7 December 2011 and 14 December 2011. This means the service provider did not know we were visiting. During this visit we found that although care plans provided relevant information about people’s care needs and how to meet them, we observed that people’s personal care needs were not being met appropriately.

We also found that the management of people’s prescribed medicines were unsafe and could have placed people at risk.

A further unannounced follow up visit was carried out on 23 May 2012, to find out what action the service provider had taken to improve standards and to ensure people receive an effective and safe service.

We used a number of methods to find out people’s experience of using the service. We looked at care records, systems in place for the safe management of medicines. We spoke with three people who use the service and three care staff. We observed care practices and how care staff interacted with people who live there.

We found that care plans provided sufficient information to support staff’s understanding of people’s care needs and where people had capacity; they were involved in their care planning.

One person who uses the service said, “I’m happy here, they do look after me.”

Another person said, “Its aright here, the food is good.”

We saw that action had been taken to ensure the management of people’s prescribed medicines was more robust and that people received the appropriate support to take their medicines safely.

We spoke with three care staff who demonstrated a good understanding of how to safeguard people from potential abuse.

We saw that people had access to the service’s complaints procedure, so they know how the share any concerns they may have.

We found that the service’s quality assurance system had been improved to ensure people receive good outcomes.

Inspection carried out on 23 June 2011

During an inspection in response to concerns

One person who uses the service said, “I have no complaints, they wash me and wash my clothes.”

Another person said, “It’s OK living here.” “The staff are fine, on the whole they are very good.”

We observed that not everyone was dressed appropriately to maintain their dignity.

We saw staff engaging in pastimes with people and talking to them in a caring manner.

We discovered that not all staff have a clear understanding of safeguarding and this could place vulnerable people at risk.

We observed that the management of people’s medicines were unsafe.

One person said, “The staff are fine.”

Another person told us they were happy with the service provided.

We observed that there were insufficient monitoring systems in place to ensure everyone receives a service that is specific to meet their needs safely.

One person who uses the service said, “I have no complaints.”

Another person who lives there said they were unaware of the home’s complaint procedure but would share any concerns with the staff.

Inspection carried out on 7 December 2011

During an inspection to make sure that the improvements required had been made

Care plans supports staff’s understanding about people’s care needs and how to meet them.

One person who lives there said, “I can’t complain they do look after me.”

Another person who uses the service said, “Its alright here, the food is good.”

Although efforts had been made to improve the information contained in care plans, the management of medicines was unsafe and this could compromise people’s care and treatment.

People who use the service have access to the home's complaint procedure which is published in various formats to promote people's understanding.

The home’s quality assurance auditing tools were not entirely robust to ensure people receive safe effective services at all times.

Inspection carried out on 27 January 2011

During an inspection in response to concerns

People who use the service told us they were happy living in the home and that staff are nice. However, we do have concerns that people’s needs might not be met due to shortfalls in care plans, risk assessments and care records.

Some people told us they are able to share their concerns but the absence of a complaints procedure in a format they can understand does not ensure everyone will know how to share their concerns or be confident they will be listened to.

People who live there are complimentary about the staff. However, there is insufficient evidence to show that staff have the necessary training and skills to meet people’s needs.

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