We carried out a review of the data available to us about Livability Ashley Place on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Livability Ashley Place, you can give feedback on this service.
Livability Ashley Place is a residential care home providing personal care and accommodation for people with physical disabilities and/or learning disabilities and autistic people. The layout of the service has been designed to support people who have physical support needs and are reliant on wheelchairs to get about. The equipment and adaptations support people to move around the building as independently as possible. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 21 people. 18 people were using the service at the time of the inspection. The service is also registered to provide personal care to people who live separately in their own homes; at the time of the inspection there were 2 people in receipt of personal care.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support
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 had some opportunities to build skills and participate in individual activities. Staff tried to focus on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. People told us they appreciated the building layout and the adaptions that helped with independence, such as push door openers, high low tables and overhead tracking hoists. Each person had their own room and en suite, which were personalised to meet their needs and preferences. People valued these things and they did go some way to mitigate people feeling like they were living in a large group in house.
Staff enabled people to access health social support the community. Staff supported people to make decisions following best practice in decision-making.
Right care
People experienced a generally positive quality of care. People and their families told us staff were kind and supportive but there had been times when communication with some agency staff had been difficult. We observed staff respecting people’s dignity and ensured people had the right to have their say on their care and support. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing. Staff and people worked together to assess risks people might face. Staff encouraged people to take positive risks. For example, the service has a catering kitchen and catering staff. People who expressed a wish to cook meals are supported to use the kitchen to do so. We were told by the registered manager there were plans to develop the service to improve access to cooking facilities.
Right culture
People did generally lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the provider, management and staff. There was mixed understanding or opportunities to apply active support approaches and the registered manager agreed the layout of the building did hinder people’s ability to do more daily tasks for themselves. Internal audits had picked up the need for further active support training for staff. Managers and staff clearly tried to deliver person centred support. People told us they were pleased with the support generally but would be happier if the use of agency staff were reduced because sometimes communication could be difficult with some agency staff. People had communication passports and permanent staff knew people well.
There had been a recent change of manager, with the new registered manager in post since September 2022. Some relatives and professionals told us, they had difficulties in communication with managers, some thought the deputy manager was the registered manager. Communication between staff and people and managers and people they work in partnership with is an area for improvement.
People received good quality health care, support and treatment because trained staff and specialists could meet their needs. Most staff knew and understood people well but there was a reliance on agency staff who did not always know people well.
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 12 March 2020).
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
This focused inspection was prompted by a review of the information we held about this service. We only inspected the key questions, safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Livability Ashley Place on our website at www.cqc.org.uk.
Livability Ashley Place is a residential care home providing personal care and accommodation for people with physical disabilities, learning disabilities and/or autism spectrum disorder. The service is also registered to provide personal care to people who live in the community in their own homes; at the time of the inspection there were four people in receipt of personal care.
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.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 21 people. Eighteen people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People told us they felt safe with staff. A person said, “The staff make me feel safe, the front door is secure, I can leave when I like but people can’t just walk in.” Relatives continued to have no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.
Risk assessments were carried out to make sure people received their care safely and had opportunities to take part in activities which interested them and promoted their independence.
Medicines were managed safely, and staff had a good knowledge of the medicine systems and procedures. There were adequate numbers of staff to meet people’s needs in both the residential and community setting.
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. A person said, “They (staff) encourage residents to be involved in their own care plan. I am involved in my one. I have been involved with it right from the start, I was asked right from the beginning how I wanted to be involved and I fully direct my own care.”
People were supported to maintain their health and wellbeing. People enjoyed the meals provided and were offered foods to encourage a varied diet. A person said, “The food and drink is really good. I choose what I eat each day. We can eat as and when we want and what we want and when we want.”
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.
We observed people and staff had developed positive relationships, and staff treated people with compassion, kindness and respect. A person said, “The staff are friendly, they are great. Very caring. I know I probably shouldn’t say this, but I don’t really see them as staff. They have become my friends. We have a banter.”
People were encouraged to engage in activities and some people accessed day services, occupational volunteer roles and clubs to promote their social networks. People's communication needs were fully considered, and people had access to information that was accessible and meaningful to them. People's care plans were person-centred and captured their likes, dislikes and preferences.
The registered manager monitored the quality of the service and used feedback from people and staff to identify improvements and act on them. The service worked in partnership with other agencies to ensure quality of care across all levels. People, relatives and staff were encouraged to provide feedback about the service. The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care 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 17 July 2017).
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.
People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.
Potential risks to people had been identified and assessed appropriately. There were sufficient numbers of staff to support people and safe recruitment practices were followed. Medicines were managed safely.
Staff had received all essential training and there were opportunities for them to study for additional qualifications. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.
The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Currently non one was subject to DoLS. We found the manager understood when an application should be made and how to submit one. We found the provider to be meeting the requirements of DoLS. People were able to make day to day decisions for themselves. The manager and staff were guided by the principles of the Mental Capacity Act 2005 (MCA) regarding best interests decisions should anyone be deemed to lack capacity.
People were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.
Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and people were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.
Care plans provided information about people in a person-centred way. People’s personal histories had been recorded and their preferences, likes and dislikes were documented so that staff knew how people wished to be supported. There was a variety of activities and outings on offer which people could choose to do. Complaints were dealt with in line with the provider’s complaints procedure.
Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.