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Eight Ash Court Limited Requires improvement

Reports


Inspection carried out on 12 July 2019

During a routine inspection

About the service

Eight Ash Court Limited is a residential care home providing personal care for 12 people who have a learning disability. Some people also had a physical disability.

The service consists of two bungalows, each providing domestic style accommodation for up to six people. There was no identifying signage outside the premises or on the service’s mini buses to identify it as a care home. This was in keeping with the design 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 as part of the community and achieve the best possible outcomes.

The principles of Registering the Right Support also reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. This required further development. People had been living in the service for a long time and staff knew them and their families very well. However, the positive feedback the service received from relatives had led to the provider not exploring new initiatives in learning disabilities and/or autism, and seeing how it could be used to consistently support good outcomes for people and promote a better quality of life.

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

The service didn’t always (consistently) apply 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 did not fully reflect the principles and values of Registering the Right Support for the following reasons, people were not always supported to participate in meaningful activities and decisions made in people’s best interests had not been fully assessed and documented.

The system to identify and mitigate potential risks were not robust enough to ensure people were always safe. We have made a recommendation for improvement in this area. Appropriate reports to safeguarding professionals had not been made by staff and staff were not able to tell us about how safeguarding concerns should be reported, without prompting. There is currently an investigation being undertaken relating to this and we have recommended the service improve in ensuring safeguarding processes are embedded into practice.

Relatives told us people were supported in a safe, clean environment. However, improvements were needed to ensure infection control processes were always sufficient to ensure people were safe. We have made a recommendation to improve in this area.

Improvements were needed to ensure all management and staff were receiving training to keep their knowledge and skills updated to support them in carrying out their role effectively.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; there were policies and systems in the service supported good practice but this had not always been followed.

People’s privacy and dignity was not always respected. We have made a recommendation that the service improve in this area.

People’s care needs were assessed and planned for. However, they were not always kept up to date to ensure people received a consistent service. We have made recommendations that the service improve in the systems to support people with their oral care and ensure people’s end of life decisions are sought and documented.

The provider’s systems for assessing and monitoring the service were not robust enough to promptly identify shortfalls and address them. We have recommended that the service use the provider’s resources effectively to improve in this area.

Despite the shortfalls we had identified in the service, people and t

Inspection carried out on 18 August 2016

During a routine inspection

Eight Ash Green Ltd is a small care provider providing intensive support for up to twelve people who have a learning disability. The service is split into two bungalows, each bungalow sleep up to six people. This inspection took place on the 18 of August 2016. At the time of our inspection there were twelve people using the service.

There is a Registered Manager at this location. 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.

In some people’s records, we found that accidents and incidents had not been consistently recorded. When accidents occurred, the provider did not use this as a learning point to develop practice. There were only a few minor incidents that had not been recorded. The manager confirmed they would address this to make sure people received the care and support they needed and were not harmed.

The registered manager told us that they would review this area of the service immediately and take action.

Staff were appropriately trained and skilled and provided care in a safe environment. A thorough induction was provided and staff understood their roles and responsibilities.

People lived in an environment that met their needs and people enjoyed the food provided. The premises were properly maintained with a clean, bright and inviting environment. Rooms were personalised and individually decorated.

Staff knew how to safeguard vulnerable adults and they were able to describe potential risks to people.

We saw that people had developed caring and positive relationships and they were sensitive to individual choices. Relatives told us that when they visited the home there was a calm and friendly atmosphere.

The registered provider was working within the principles of the Mental Capacity Act and was following the requirements of the Deprivation of Liberty Safeguards.

Staff treated people with dignity and respect and helped to maintain people's independence by encouraging people to care for themselves as much as possible.

People had their requests responded to promptly, and people told us there were enough staff to meet their care needs. Peoples medicines were managed safely and staff understood their responsibilities.

People who used the service, family members, and visitors were made aware of how to make a compliment, complaint, or comment and there was an effective complaints policy and procedure in place.

The service regularly used community services and facilities and had links with the local community. People, their family members, and staff were regularly consulted about the quality of the service they received.

The registered manager conducted regular audits and improvements were carried out when these had been identified. The manager explained that they were reviewing ways in which the service could review the quality of the service, by putting continuous improvement at the heart of this process.

Staff members understood the principles of the Mental Capacity Act 2005 (MCA) and were able to describe their responsibilities to seek the consent of the people they supported. When people were thought to lack mental capacity the provider had taken the appropriate action to make sure their care did not restrict their movement and rights under the MCA. Decisions about the care people received were made by the people who had the legal right to do so.

Health care professionals were involved in peoples care when necessary and encouraged to provide feedback about the service.

Families were encouraged to become more involved in the service by providing feedback on the service by completing an annual questionnaire.

People and their relatives told us that the service was well led and spoke positively about the registered

Inspection carried out on 28 October 2013

During a routine inspection

We looked at the care files for three people. People�s needs were assessed and there were care plans and monitoring charts in place which were reviewed monthly.

We saw that the provider had information to support people if they were admitted to hospital, for example communication passports. We spoke with another provider who told us, �They are on the ball. If there is a problem they seek advice.�

We reviewed the medication administration records for four people. There were clear and detailed guidelines available for staff. We spoke with three members of staff all of whom said that they felt supported. One member of staff told us, �I had one day of medication training and I had competency assessments done too.� This meant that staff were able to safely administer regular and as required medicines.

We saw evidence of completed induction forms. One member of staff said, �They showed me everything you need to do to support the people living here. It was really useful.� We looked at the staff files for three members of staff and saw evidence of a range of training certificates for both mandatory training and additional training.

There was a process in place for recording and learning from accidents and incidents. We saw that people who used the service and their relatives were asked for their views and these were acted upon. One relative told us, �They have information about complaints on display. I would just ring them and I am sure they would be responsive.�

Inspection carried out on 20 December 2012

During a routine inspection

People told us that they liked living at Eight Ash Court and that they were asked for their views about the service. We found that care was provided according to people's assessed needs. We saw that people were supported to live as independently as possible and maintain community involvement.

We saw there were good arrangements to protect people from abuse. People told us they felt safe. There were appropriate recruitment arrangements. Staff had training and supervision to be able to provide safe care.

There were suitable arrangements in place to monitor the quality of care being provided.