SENSE - 1 Ashley Green

SENSE- 1 Ashley Green is a residential care home for people under 65 years old with learning disabilities or autistic spectrum disorder, physical disability and sensory impairment. The service was providing personal care and support to five people at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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

People’s relatives told us their family members were safe and well looked after by staff. Staff assessed and managed risks to keep people as safe as possible. They were aware of their responsibilities in relation to keeping people safe from the risk of abuse. Staff were recruited safely and there were enough staff to meet people's needs. The service was clean and well maintained and staff practised good infection control and prevention. People were supported with their medicines safely.

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. Staff assessed people's capacity to make decisions. People’s consent to their care and support was sought and their choices respected. The design and layout of the service met people's needs. Staff supported people to maintain a balanced diet and monitor their nutrition and health. Staff were suitably trained and supported and had the skills, knowledge and experience to provide the support people needed.

Staff had assessed people's specific communication needs and were familiar with the ways people communicated. Staff were friendly and kind, and people's privacy and dignity were respected. Staff showed they valued people as individuals and had formed positive relationships with them. People’s relatives were involved in planning their family member’s care.

People had up to date support plans, which gave good guidance on how their care and support needs should be met by staff. Care was delivered in line with people's choices. People were involved in a variety of activities at the service and in their local community. People’s relatives knew how to complain and felt confident any concerns would be listened to and responded to well.

The service was well led by a management team who led by example to ensure an open and honest culture. The management team monitored the service to check on quality and make sure staff were providing good care and support. The registered manager and staff team worked in partnership with other services and organisations to make sure they followed good practice.

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 20 June 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.

The home was previously inspected on 16 March 2015 and was rated as Good in all domains except Safe which required improvement. This inspection took place on 24 May 2017 and was unannounced. The inspection was completed by one adult social care inspector and an expert-by-experience. At the time of our inspection five people lived at the home.

During our previous inspection in March 2015, we found that systems and processes in place to ensure people’s medicines were managed and administered safely were not always effective and audits failed to highlight any areas that required improvement. During this inspection in May 2017 we found the registered provider had implemented improvements, which meant people received their medicines safely and these were managed according to the latest best practice guidance. Effective internal and external medicine audits had been completed that maintained the level of medicines management.

During our previous inspection in March 2015 we saw good evidence that risk was well managed. However, where records were required to evaluate any support provided for its effectiveness in providing people with improvements to their health, these records were not always robustly completed. During this inspection in May 2017, we found care plans included detailed risk assessments. Where people were at risk with their health for example, from malnutrition, detailed records included charts that recorded people’s weight and these were reviewed to ensure they were effective and recorded the person’s progress.

At the time of our inspection there was a registered manager in post. 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.

Procedures were in place which helped to ensure people were supported by care workers who understood the importance of protecting them from avoidable harm and abuse. Care workers had received training on how to identify abuse and report any concerns to the appropriate authorities.

There were sufficient care workers with appropriate skills and knowledge to meet people's individual needs and the registered provider had a robust recruitment process that ensured only care workers deemed suitable to work with vulnerable people had been employed.

People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Care workers clearly understood and had developed a variety of resources that helped people to communicate their preferences and choices and we saw these were upheld and responded to throughout our inspection.

People and their relatives or advocates had involvement in their care planning. Records included how consent to care and support had been agreed and who was involved. This information was reviewed annually or as people’s needs changed.

People were provided with a wholesome and nutritionally balanced diet which was of their choosing and care workers were proactive in supporting people to assist them with preparation and choosing their drinks and foods.

People were supported to access other healthcare professionals where this was required.

Care workers had a good understanding of people's needs and were kind and caring. They understood the importance of respecting people's dignity and upholding their right to privacy.

People were supported to undertake activities of their choice and these included holidays, and involvement with the local and wider community.

Systems and processes were in place to encourage, manage and investigate any complaints.

People who used the service, and those who had an interest in their welfare and wellbeing, were asked for their views about how the service was run.

Regular audits and quality assurance checks were carried out to ensure the service was safe and well run.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We observed staff carrying out care tasks and we saw that they were doing so in accordance with each person's care plan.

We saw that staff treated people with dignity and kindness. We observed that a friendly and positive approach was used, to ensure that the wishes and needs of people using the service were respected.

We found medication was administered safely to people. People were given appropriate support, to ensure they had taken their medication as prescribed.

We found people were cared for, and supported by, sufficient, suitably qualified, skilled and experienced staff. Staff demonstrated different methods of communicating with people to ensure their wishes and beliefs were respected.

Relatives were aware of how to raise concerns or complaints. The provider had a complaints policy in place which was available throughout the service. Advocacy services were available if needed to support people with complex needs.

We were unable to talk to the staff who worked at the home because they had taken the people who used the service out to activities in the community.

The manager told us that they felt 'working with people who are deafblind was rewarding.' They told us that they felt that 'care is good.'

We saw that staff had received training in safeguarding and from the safeguarding questionnaires in the staff files we looked at, they were able to identify the signs of abuse.

The people who lived in the home were kept safe because the provider had taken steps to maintain the building and we saw that regular health and safety checks had been carried out.

We saw that the care plans were detailed and tailored to meet the needs of the individual.

We saw the interaction between staff and the people who used the service, we felt it was warm and respectful.