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Archived: Aster House Good

Reports


Inspection carried out on 11 May 2017

During a routine inspection

Aster House is a care home that provides services to people with mental health needs. The home can accommodate up to eight women. At the time of the inspection there were eight women using the service.

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

People continued to be protected against the risk of harm and abuse. Staff were aware of the different types of abuse and how people may present when being subjected to abuse. Staff received on-going safeguarding training that gave them the skills and understanding on how to respond and report suspected abuse. The service developed comprehensive risk assessments that identified risks and gave staff clear guidance on how to support people safely.

People continued to receive their medicines in line with good practice. The service had systems in place that ensured people received their medicines as prescribed. The storage, administration and recording of medicines were effective.

People were supported by sufficient numbers of suitable staff who met their needs safely. The service maintained robust employment processes that ensured only suitably vetted staff were employed. Staff received on-going supervisions and appraisal where they reflected on their working practices.

People’s care was delivered in line with the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff sought people’s consent to care and treatment and respected their decisions. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People continued to have their dietary and nutritional needs met by the service. People had access to sufficient amounts of food and drink that met their preferences in line with their health care needs. People had their health needs monitored in line with guidance from healthcare professionals.

People were encouraged to make decisions about their care. Staff supported people to develop their life skills to enhance their independence. People were supported to maintain their dignity and were treated with respect. People continued to be encouraged to participate in activities of their choice both in the service and in the local community. Where appropriate people were supported to seek employment.

People continued to receive care and support that was person centred and tailored to their needs. People had access to their care plans which were reviewed regularly to reflect their changing needs. People were aware of how to raise a concern or complaint and felt their complaints would be addressed in a timely manner.

People told us the registered manager was approachable and accessible throughout the day. The registered manager had embedded a culture of transparency, empowerment and inclusion for all within the service.

The service continued to carry out audits of the service to drive improvements. Records confirmed daily, weekly and monthly audits relating to the maintenance, fire, medicines and care plans were undertaken regularly with issues identified acted on in a timely manner.

Inspection carried out on 7 April 2015

During a routine inspection

Aster House provides accommodation and support for up to eight women who have mental health needs. Aster House provides a large, airy and bright home. Each person has their own bedroom and they share communal areas. People benefit from a large communal garden. The building had recently been decorated and provided a clean and welcoming environment.

We undertook an unannounced inspection of this service on 7 April 2015. On the day of our inspection eight people were using the service. At our previous inspection on 21 September 2013 the service met the regulations inspected.

Both the manager and the deputy manager were registered as managers with us, as they shared responsibility for the delivery of 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.

People were supported to maintain their safety. Staff were aware of the risks to people’s safety and supported them appropriately to manage those risks. This included supporting people who were at risk of self-neglect, self-harm and displaying risky behaviour. Each person had a tailored plan to manage the risks identified and provide a safe environment for them.

The service was tailored to meet people’s individual needs. We saw that tools and equipment were available to support people as they needed, for example with mobility and communication needs. Staff were knowledgeable of people’s support needs, and supported them as required with any mental health needs, including fluctuations in mood. Staff took the time to meet with people and listen to any concerns they had.

People had clear and detailed care plans. They focussed on people’s strengths and identified goals that they wanted to achieve whilst at the service. The care plans identified how people could support themselves and what support they needed from staff.

There was joint working with the community mental health team and the service’s commissioners. Staff liaised with the healthcare professionals involved in people’s care to ensure people received the support they required, and that staff were up to date with any changes in people’s care needs and progress they were making.

People were supported to become independent. Staff encouraged and supported people to build their own support structures so they had the support they required once they left the service. Staff assisted them to learn the skills they needed to move to independent living, including self-administration of medicines and budgeting skills.

The registered managers had introduced a suggestion scheme for both people and staff to use. This scheme was used to request any changes or additions they wished to see at the service. We saw that, where possible, the suggestions had been accommodated. This including changes to the delivery of training for staff, and the activities on offer for people.

Staff were supported to develop their knowledge and skills. The registered managers ensured all staff attended the training they needed to support people. The registered managers ensured they had the latest guidance on supporting people so care could be delivered in line with good practice guidance. Staff support systems were in place including supervision, team meetings and reflective practice. The management team encouraged staff to express their views and opinions, and there was open communication within the team.

There were processes in place to review the quality of the service. Audits were undertaken to ensure systems and processes were working efficiently and that good quality care was provided. The service ensured action was taken to address any concerns raised. The management team learnt from incidents that occurred to further improve the support provided to people.

Inspection carried out on 23 September 2013

During a routine inspection

Aster House had six permanent residents and one person on a trial period at the time of our inspection. Three people we spoke with made positive comments such as this was “The best place I’ve been in” and that the “Staff are nice”. All of them said that they were satisfied with the care and support they received.

We spoke with a person’s care coordinator who complimented the service and said that “I’m overall pleased with the placement”. Staff told us that “We’re doing our best for the residents” and that “I do enjoy coming to work every day”.

We observed during our inspection that people were treated with respect and saw that people had detailed care plans which were developed with the involvement of the people using the service and their care coordinators. We found that people’s needs were identified and their care was planned in a way to meet their assessed needs. The care plans were available and were reviewed on a regular basis. People’s health was monitored and they received medical attention when it was needed. We also found that the people were supported to receive safe and coordinated care.

There were procedures in place to protect people from abuse. The provider operated an effective recruitment process to ensure that only suitably qualified, skilled and experienced were employed at the service. We also found that there was a system in place to monitor the service to ensure people’s well-being and that the quality of the service was adequate.

Inspection carried out on 21 March 2013

During a routine inspection

People told us that they were happy living at Aster House and they felt that the staff and the manager listened to them.

We saw that care plans were updated regularly and there was evidence that care was planned with the individual. Each person had an individual risk assessment with clear actions of what their triggers were and how staff can support the person as well as what action to take if the person was experiencing a crisis.

We found that people were given various menu options that suited individual tastes and preferences. One person said “they are very flexible with food here. They cater for our various needs.”

Medication was administered by trained and competent staff who were aware of the side effects and how to monitor those who were self medicating. We checked medicine administration records and found no discrepancies.

There were enough staff to meet people’s needs. Staff had completed relevant training and there was a plan in place for those whose refresher training was due. Appraisals and supervision were done regularly.

People told us that they knew how to make complaints if the need arose. We reviewed the complaints log and found that complaints were investigated and resolved amicably.

Inspection carried out on 1 March 2012

During a routine inspection

Throughout our visit we observed staff interacting with people living in the home in a friendly, personal, kind and respectful manner. Overall, the home was comfortable, clean and well- maintained.

At the time of our visit, there were seven people living at Aster House, with a wide range of mental health support needs. The people we spoke to understood the recovery and rehabilitation ethos of the home, and felt involved in decisions about their care. They spoke positively about the therapeutic activities available to them.

People said that all the staff members were kind and listened to and took account of them. They told us that, “the staff are great”, the manager was described as “brilliant” and that staff “just want the best for me”.

They said they were supported and encouraged to make decisions and to be as independent as possible, and, within some boundaries, came and went as they liked, accessing activities in the community and visiting friends and family.

People got on well with other residents and staff and said that they had made good friends at the home. Staff respected their privacy and everyone said they felt safe and knew who to speak to if they had any concerns or complaints.

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