18 September 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
This inspection was undertaken by one inspector.
Service and service type
195 Ashby Road is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service had a manager registered with the Care Quality Commission. This means they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced. However, we gave the service notice of the inspection on our arrival. This was because we had to gather information on the home’s current COVID-19 status and the providers procedures for visiting professionals. Day two of the inspection was announced and included phone calls to health professionals and relatives.
What we did before inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We asked the local authority and Healthwatch for any information they had which would aid our inspection. Local authorities together with other agencies may have responsibility for funding people who used the service and monitoring its quality. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with four people who used the service, four relatives, two social workers and an advocate. We spent time in the communal areas with people to help us better understand their experience of care. We spoke with six staff members including four support workers, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at the care and support plans for four people and looked at several documents relating to the monitoring of the location including training, medicines, health and safety checks. We confirmed the safe recruitment of two staff members.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We further looked at quality assurance records, various meeting minutes and communications with healthcare professionals.
18 September 2021
About the service:
195 Ashby Road is a residential care home for 10 young people with autism, learning disabilities and mental health issues. At the time of our inspection there were 10 people living there. One of the provider’s aims, is to help people learn practical life skills and take part in a range of community and home-based activities to enable a transition towards a more independent life.
Peoples experience of using this service:
People were assisted by a committed, well supported staff team to plan and achieve individual goals with the ambition to move towards independent living. People were supported to lead truly fulfilling and meaningful lives which championed diversity and personal achievement.
Staff knew each person exceptionally well and they supported, and responded to, people's preferences in a very individual way. People's sense of achievement was promoted with goals and future ambitions formed an integral part of their support. Staff supported people to express their individuality and to live the life they wanted. People's privacy and dignity was supported at all times. People had information made available to them in ways which were innovative and adapted to match their individual learning styles.
The registered manager had embedded and promoted an open and honest staff team culture to help ensure people and staff were listened to. The staff team promoted an embedded equality and diversity culture that treated people exceptionally well.
Audits and governance systems were highly effective in identifying and implementing improvements. People were fully involved in how the service was run and their voice was listened to and acted on. The provider had systems to encourage and respond to feedback from people or those close to them. The provider, and management team, had excellent links with healthcare professionals and the local communities within which people lived. This transformed people's lives for the better.
Complaints and compliments were used to help drive improvements and people benefited from changes that were made. Staff showed people true compassion and took account of the finer points of people's lives and cultures as they developed their skills of independence and personal achievement. .
People were protected from the risks of ill-treatment and abuse as the staff team had been trained to recognise potential signs of abuse and understood what to do if they suspected wrongdoing. The provider had assessed the risks to people associated with their care and support. Staff members were knowledgeable about these risks and knew what to do to minimise the potential for harm to people.
People received safe support with their medicines by staff members who had been trained and assessed as competent. The provider had systems in place to complete an investigation, should a medicine error occur, to ensure the person was safe and lessons were learnt to minimise the risk of reoccurrence. Staff members followed effective infection prevention and control procedures when supporting people.
The provider supported staff in providing effective care for people through person-centred care planning, training and one-to-one supervision.
• Model of care and setting maximises people’s choice, control and independence
• Care is person-centred and promotes people’s dignity, privacy and human rights
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
This service was able to demonstrate they were meeting the underpinning principles of Right support, right care, right culture. People were supported in a small home based in a residential area with access to community facilities. 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 received help and support from a kind and compassionate staff team with whom they had developed positive and professional relationships. People were supported by staff members who were aware of their individual protected characteristics like age, gender and disability.
People's assessed needs were effectively met by trained staff. People were supported to eat and drink healthily. People had access to healthcare services and were referred promptly if required. People made decisions about how they wished their home to be decorated and personalised their own living accommodation.
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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Why we inspected:
The inspection was prompted in part due to potentially restrictive practices within the home. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see all five relevant key questions sections of this full report.
Rating at last inspection
The last rating for this service was Outstanding (published 18 July 2018). At our focused inspection in October 2020 we looked at infection prevention and control procedures only, but we did not provide a rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.