Ashcroft House - Bexhill-on-Sea

Ashcroft House is a residential care home providing personal care for up to eight people. At the time of inspection, three people were living at the service. People were living with learning disabilities, autism and/or a physical disability.

The building was situated over two floors. Bedrooms were spacious and there were communal areas for people to relax in. There was an accessible garden that we saw people using throughout 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 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

The outcomes for people 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 to gain new skills and become more independent.

People received safe care and support by staff who had been appropriately recruited, trained to recognise signs of abuse or risk and understood what to do to safely support people. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible. We observed medicines being given safely to people by trained and knowledgeable staff, who had been assessed as competent.

Staff were committed to delivering care in a person-centred way based on people's preferences and wishes.

There was a stable staff team who were knowledgeable about the people they supported and had built

trusting and meaningful relationships with them.

Staff had all received training to meet people’s specific needs. During induction, they got to know people and their needs well. One staff member said, “It’s really lovely here, the people are so special and very individual.” People’s nutritional and health needs were consistently met with involvement from a variety of health and social care professionals.

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.

Everyone we spoke to was consistent in their views that staff were kind, caring and supportive. One health professional described the service as, “Like a big family, the atmosphere is so positive, you hear lots of laughter.” People were relaxed, comfortable and happy in the company of staff and engaged in a positive way. People’s independence was considered important by all staff and their privacy and dignity was also promoted.

Activities were tailor-made to people’s preferences and interests. People were encouraged to go out and form relationships with members of the community. Staff knew people’s communication needs well and we observed them using a variety of tools, such as sign language, pictures and objects of reference, to gain their views.

People were involved in their care planning. End of life care planning and documentation guided staff in providing care at this important stage of people’s lives. End of life care was delivered professionally and with compassion.

People, their relatives and health care professionals had the opportunity to share their views about the service. Complaints made by people or their relatives were taken seriously and thoroughly investigated.

The provider used a range of quality assurance systems to check people and their relatives were satisfied and confident in the standard of care provided within the home. The service had systems to continuously monitor, assess and improve the service provided.

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 December 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.

The service was last inspected on 15 January 2014. At that time we found the service was meeting the requirements of the regulations we inspected.

This inspection took place on 2 and 3 November 2016. There were 5 people using the service at the time of this inspection. There had been no admissions to the service since the last inspection.

There was a manager at the service who was registered with CQC. 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 said they felt safe living at Ashcroft House. People were relaxed and happy and they freely

approached staff in conversation and interactions with them were positive. People said they enjoyed life at the service. One person said, “It is absolutely lovely here. I like the staff…I feel happy and safe here.” A health professional said they felt the service was safe and staff had a good understanding of the person’s needs.

People were protected from potential abuse because staff had a good knowledge of how to keep people safe from harm. Staff took steps to minimise risks to people's wellbeing without taking away people's rights to make decisions. People’s medicines were managed safely. There were enough staff to meet people's needs and ensure they enjoyed a range of activities. Staff had been employed following appropriate recruitment and selection processes.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They were happy in their work, motivated and confident in the way the service was managed.

Positive interactions were observed between staff and the people they cared for. People's privacy and dignity was respected and staff supported people to be independent and to make their own choices.

Staff understood the needs of the people they were supporting. Care plans were comprehensive although they contained some duplicated information, some of which had not been up-dated. There were systems in place to share information about people's changing needs.

People were supported to participate in a range of meaningful activities both in and outside of the service, according to their interests and choice. A complaints policy was in place and people knew how to raise any worries or concerns they may have.

The registered manager had created an open and inclusive ethos with people and staff feeling valued. People had regular opportunities to voice their feedback and become involved in the development of the service.

A quality assurance system was in place that consisted of audits and checks. When shortfalls were identified action was taken to address some issues although timescales for other actions were not always clear. For example, aspects of the environment needed attention to ensure the service was homely and maintained to a high standard.

People's needs were assessed by the manager in conjunction with other professionals involved in their care. This process included an assessment of risk and forming a management plan to keep the person safe. Reviews included the person and their relatives and others involved in their care.

We observed medication being administered and noted that the policy was followed correctly. The member of staff was polite and explained the medication to the person. We looked at the medication record and saw that it had been completed accurately.

The staff were fully trained and the provider had systems in place for supervision and appraisals designed to maintain the standards of care. We saw records of these in staff files.

We viewed the complaints policy and found it was accurate and set out actions to take in making and receiving complaints. It set out the timescales for responding to complaints and the process for investigation. It showed the contacts for escalating the concern if required within the company as well as details of the Care Quality Commission and the local government ombudsman service

There were five people living at the home at the time of the inspection. During our visit we spoke with two people who were using the service and three members of staff. People living at the home told us they liked the home and felt safe.

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat and the activities they wished to participate in. People were supported to personalise their own rooms and to be as independent as possible.

We saw people being addressed in a respectful manner. We looked at people's individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded.

Regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service.