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Inspection carried out on 5 April 2019

During a routine inspection

About the service: Ashcombe Court is a residential home. It provides accommodation and personal care for up to eight people with a learning disability, autism or mental health needs. At the time of the inspection there were eight people living at the service.

People’s experience of using this service: People felt safe and happy living at the service. People were supported by staff who knew people’s care and support needs well.

The service was person centred and supported people in their individual goals and wishes. Individual risks were identified, and guidance was in place to support people safely whilst maximising independence.

People enjoyed the food at the service. The environment was clean and homely. People were encouraged to personalise their living space. People chose how they wished to spend their time. For example, to access the community, take part in activities and go on trips and outings.

Feedback was gained from people through meetings and surveys. Systems were in place to monitor and improve the quality of the service.

For more details, please see the full report which is on CQC website at www.cqc.org.uk

Rating at last inspection: Good (January 2017)

Why we inspected: This was a planned inspection based on the previous rating. However, the inspection was brought forward due to information of concern we had received from external sources. We reviewed the information we had received as part of our inspection process and found that it was not substantiated.

Follow up: We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.

Inspection carried out on 16 November 2016

During a routine inspection

We inspected this service on the 16 November 2016. This was an unannounced inspection. At our last inspection in September 2015 we found breaches of legal requirements in relation to poor and inaccurate records and lack of effective audits. The service was also not ensuring the principles of the Mental Capacity Act 2005 (MCA) were being followed. After the inspection the registered manager sent us an action plan saying how they would meet these legal requirements and by when. At this inspection we found the provider had made the improvements required.

Ashcombe court provides accommodation and personal care for up to seven people who do not have nursing needs but who could have a learning disability or mental health needs. At the time of the inspection there were seven people living at the home. Ashcombe court is set over two floors. The ground floor has two bedrooms, one communal lounge, the laundry room, a dining area, kitchen, manager’s office, medication room and access to the outside patio area. The first floor has five rooms and a staff sleeping area. All bedrooms are en-suite.

The service had 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.

People had detailed care plans that were personalised to them. They had risk assessments and support plans that gave staff guidelines to follow. Staff knew people well and were able to demonstrate a sensitive and caring approach when people required staff support. People’s personal evacuation plans had details of what support the person might require in an emergency.

People were supported by staff who had checks completed prior to commencing their employment. People felt safe and staff were able to demonstrate what action they would take should they have concerns to people’s safety. People were supported by staff who received regular supervision and training to ensure they were competent and skilled to meet their individual care needs.

People received their medicines safely and when required by staff who had received training. People were supported by adequate staffing levels and staff supported people in a kind and caring manner. Staff demonstrated they knew people well and felt supported and able to raise any concerns with the management of the home.

Most people were able to make decisions about their care. Were people were unable to make decisions the registered manager had followed the principles of the Mental Capacity Act. People were encouraged and supported to be to be independent. Changes to people’s care needs were identified monthly through review meetings. Any changes were planned with them and their care plans were amended to reflect those changing needs. People and visitors’ views were sought so improvements could be made. People were happy with the care and felt able to raise a complaint if they had one. People were supported to access the community when they wanted and maintain relationships with friends and family.

The provider had a quality assurance system to monitor the quality and safety of the service.

Inspection carried out on 7 & 11 September 2015

During a routine inspection

This inspection was unannounced and took place on 7 and 11 September 2015. At our last inspection in August 2013 no concerns were identified.

Ashcombe Court provides accommodations for up to seven people who have a learning disability or mental health needs who require support and personal care.

At the time of the inspection there were seven people living at the home. Ashcombe court has seven bedrooms, two on the ground floor and five on the first floor all have en-suites. There is a communal dining room, lounge, kitchen for people to make their own drinks in, medication room, office, laundry room, outside front garden and rear patio and seating area. The first floor also has a staff sleeping room and bathroom.

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. The registered manager was present on both days of the inspection.

People could be at risk due to incomplete and out of date records. People felt safe and were supported by staff who knew about abuse and who had attended training. There was a safe system in place for the recruitment of new staff. People had their medication administered safely by staff who were trained and competent in their role. The home had safety checks completed to ensure the building and appliances were safe.

People’s rights were not fully protected because they were not supported to access training to enable them to make their own decisions. Applications were not being made when people were having restrictions on their daily routines. Menus were based on people’s know likes and meals were flexible to when people wanted them. People who at risk of poor nutrition did not have accurate records completed that confirmed meals and the daily totals.

Staffing levels at the home were good. Staff knew people’s individual communication needs and used body language and gestures for people who required additional support with their communication. Staff felt happy and well supported by the management team, they were happy with the training and the improvements made to the staff induction. People were supported by enough staff and this was provided to ensure people had their support and one to one activities. People had their medication administered by staff who were trained and competent.

People did not always have their needs identified when they changed. Although people were supported by staff who were kind and caring. Staff were able to demonstrate how they gave people dignity and respect whilst supporting them. People received support from people who knew them well and were supported to maintain contact with friends and family. Care plans were person centred and people were able to develop weekly planners that included activities important to them. Reviews were undertaken and involved people and their relatives when required.

Audits in place were failing to monitor the quality of the service relating to accurate records and lack of mental capacity assessments. Not all notifications were being made when required to The Care Quality Commission. There was a complaints and easy read policy in place. Annual surveys were sent to people, relatives and professionals about the quality of the service and all people responded positively to the care they received.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 20 August 2013

During a routine inspection

When we visited seven people were using the service. We met with three people who were happy to talk to us. We were able to observe how staff interacted with people and we spoke with staff about the experiences of the people they supported.

Staff interactions were kind and professional and people appeared comfortable with the staff who supported them. People told us “the staff are like my family. They are all so kind” and “I am very happy here. They have helped me so much.” The staff we spoke with had a very good understanding about the needs and preferences of the people they supported.

The staff we spoke with demonstrated a good understanding of how to support people to make decisions and of the procedures to follow where an individual lacked the capacity to consent to their care and treatment.

Each person had a plan which described the care and support they required and how staff should provide it. These plans also included who the important people in their life were, how people communicated, daily routines, preferences and how they made decisions. This meant the staff who supported people could provide personalised care to each individual.

The home followed appropriate procedures for the management and administration of medicines. Where appropriate, people were supported to manage their own medicines in a safe way.

Systems were in place to monitor and improve the quality of the service people received.

Inspection carried out on 21 June 2012

During a routine inspection

People told us they were able to make choices about all aspects of their daily lives. During our visit we observed that people moved freely around the home and they were able to access their bedrooms, communal areas and kitchen when ever they wished. One person said “there are no strict rules here” and “If I wake up in the middle of the night I can come and get a drink or snack.”

We were informed that three of the six people who lived at the home required minimal staff support and were able to access the community independently. One person told us “It’s very good here as I have my freedom, a key to the door and can come and go as I please.” We were informed that staff support people to maintain contact with friends, families and enable people to utilise the community. This was observed during our inspection.

People told us that staff at the home were “kind and respectful” and that their right to privacy was upheld. Comments included “If I want privacy I go to my room and if the staff want me they always knock on my door”.

People appeared very comfortable in the presence of staff and it was evident staff knew people well. Staff interactions were noted to be kind and respectful and the atmosphere in the home was relaxed and inclusive.

One person explained how they had been involved in the development and review of their plan of care. They told us that they had regular meetings with their key-worker to make sure they were happy with the level of support offered. We were able to speak with a relative who confirmed that they were kept “very well informed” about their relative and that they had been “fully involved” in the care planning and review process.

People told us that they had regular house meetings where their views were encouraged. Comments included “we all get together and can talk about anything. The main suggestions that are made are usually about the menu and trips out.”

People spoken with told us that they got the support they needed when they needed it. One person told us “my goal is to have my own place and they are helping me with all the skills I need.” They said “I do my budgeting, shopping and they support me with cooking. I also manage my own medicines and appointments” and “I think it is a very good home”.

A visitor told us that the care and support their relative received was “excellent” and “you just can’t fault anything.” They told us that their relative had “improved so much since moving to the home” and that they were “much more settled and happy.”

People who lived at the home were provided with opportunities to be involved in various leisure activities, support groups and outings. On the day of our visit two people were visiting a nearby city and one person had been supported by staff to go shopping. One person told us that they were involved in a number of local groups and that they accessed community facilities independently.

People spoken with told us that the home supported them to maintain contact with family and friends. A visitor told us that they visited their relative on a regular basis and that they were always made to feel welcome. Care records for another person who lived at the home showed that they were supported to telephone and email their family and friends.

During our visit, in addition to the manager, we spoke with four care staff. All described the home as a happy place to work. We noted that staff morale was very good. This promoted a relaxed and pleasant atmosphere for the people who lived at the home.

Inspection carried out on 7 August 2012

During a routine inspection

People told us how they are well supported with their mental health needs by staff. Examples of the comments people made included, “it’s friendly and relaxed here”, “it is unique here in its structure, from the interaction between the residents and staff”, “there’s support when I need it , there is always someone to talk to”, and “it’s one of the best places I’ve ever lived, this is the happiest I’ve been in a long time”.

People are supported to develop independence in their daily lives. The staff team work hard supporting people in building up their daily living skills. Each person at the home is given a spending allowance to buy their own food to cook. Giving people their own money to buy food is a good example of people being supported to develop independence in their lives.

People are actively involved in planning the care and support they need. Peoples care plan records explain clearly what support they need and are helpful and informative.

People are cared for by staff who have a good understanding of mental health needs. This means people receive care from staff who understand how to support them.

There are effective systems used to involve people in monitoring and reviewing the quality of service and the care they receive.

The home is run in an open and inclusive way, with the best interests of people who use the service at the centre of how it is run.