Ashring House

Ashring House is a residential care home providing personal care to six people living with a learning disability.

Ashring House accommodates six people in one adapted bungalow.

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 that 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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People lived in a service which was personalised to them and their needs. People were treated with respect, kindness and compassion. Staff knew people well, including their likes, dislikes and aspirations. People were encouraged to be as independent as possible and develop their skills.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s needs were assessed before they moved into the home. Risks to people health and well-being were assessed and mitigated. Care plans supported staff to provide personalised care to people.

There were enough staff available to support people. Staff were supported with training, supervision and regular meetings to ensure they had the right skills and knowledge to support people. Staff told us they felt well supported by the manager.

People were protected from abuse. Staff understood how to recognise and report any concerns they had about people’s safety and well-being. When things went wrong, lessons were learnt. Quality assurance systems supported staff and the registered manager to identify areas for improvement. These were then acted upon.

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

People’s privacy and dignity was protected. People’s medicines were managed safely. When people had specific needs about eating and drinking, these were met.

Staff worked in partnership with other social care and health care professionals to ensure people received the support they needed. People’s health needs were considered and planned for. Health professionals told us staff knew people well, worked with them and followed guidance.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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 4 November 2016).

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.

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 previous inspection of the service took place in December 2013. The service met all the regulations we checked at that time.

People, their relatives and healthcare professionals were happy about the quality of care and support provided to people at the service.

The registered manager assessed and reviewed risks to the health and safety of people using the service. Staff followed guidance in place to manage the risks safely. Staff knew how to protect people from possible abuse and harm. They understood the provider’s safeguarding adults policies and procedures to follow if they had any concerns of abuse to keep people safe. Staff managed, administered and stored people’s medicines safely.

The provider ensured premises were safe and maintenance work carried out and completed. Staff knew the provider’s arrangements in place to deal with an emergency at the service. Staff maintained records of accidents and incidents involving people and the action taken to minimise the risk of a recurrence.

The provider used robust recruitment practices and deployed suitably vetted staff to work at the service. There were sufficient and appropriate numbers of staff working to meet people’s needs.

New staff were appropriately inducted into the service and their role. Staff had the skills and knowledge to meet people’s needs. The registered manager supported staff in their roles through regular supervisions and ensured they received training that enabled them to fulfil their roles.

Staff sought and received people’s consent to care and treatment. Staff understood and supported people in line with the requirements of the Mental Capacity Act 2005. The service met the legal requirements of the Deprivation of Liberty Safeguards.

People received sufficient food which met their dietary needs and preferences. People received appropriate support to access specialist advice and treatment in relation to their health needs.

Staff treated people with respect and upheld their privacy and dignity. Staff provided people’s care and support in a caring and compassionate manner.

People had their support and care needs assessed and care plans had information about the support they required and how it staff should provide the care. People and their relatives were involved in the planning of people’s care. People and their relatives contributed to reviewing the support people needed and received input from staff and healthcare professionals involved in their care. People received support as planned and which met their individual needs.

People were supported to maintain relationships with relatives and friends. People took part in activities they enjoyed. Staff encouraged them to try new things based on their individual interests, hobbies, preferences and abilities.

The service sought people’s views about their care and support and acted on their feedback. People knew how to make a complaint.

People, their relatives and staff said the registered manager was approachable. The registered manager used the audit systems in place to effectively monitor and evaluate the care and support people received.

When we spoke with visitors in the home, we were told: "the staff are lovely" and "my relative has thrived since they have lived in here".

We found people's nutritional needs were being met and supported.

We noted warm and respectful interaction between people who lived at the care home and staff who supported them. We observed that the environment was clean, bright and well decorated using art work of people who lived there and photographs documenting enjoyable shared activities and holidays. This meant that people were well supported and the environment was safe, suitable and homely.

One person told us about their active life in the community including independent shopping trips "to buy things for myself". We examined care planning and health and safety records which showed that care being delivered was effective and that the environment was safe and well maintained.

Staff were only employed following a structured recruitment and interview process and relevant checks were carried out prior to them starting work.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults.

Staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of the people they were supporting.

The Provider had effective systems in place to monitor and assess the quality of the service.