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Inspection carried out on 20 August 2020

During an inspection looking at part of the service

134 Ashland Road is a ‘care home’. The service is a residential home with 10 bedrooms, a large kitchen diner, communal areas, a laundry room and garden with seating. On the day of our inspection 9 people were using the service.

We found the following examples of good practice.

Visitors had been kept informed of changes to visiting arrangements. Clear guidance had been displayed for people on entering the building and hand washing was encouraged by staff on entering the building. Hand sanitiser, antibacterial wipes and face masks were available for all visitors.

Staff had been supported to shield where necessary. Staff shift patterns were changed to reduce the number of people going in and out of the home. Staff well-being was monitored through supervision.

People received care in their bedrooms for the first three weeks. Staff explained the virus to people using fun activities to engage people and pictures to help people understand the risks to them and the importance of good handwashing and social distancing.

The Registered manager knew how to arrange testing and had been keeping up to date with government guidance.

Staff wore appropriate PPE. Staff carried photos of themselves to show people who they were in case people became anxious of staff wearing masks.

Staff had received Covid19 related training internally and from external health professionals. This included first aid, infection control and how to put on and take off PPE safely. Guidance on handwashing and safe use of PPE had been displayed around the home to remind people of best practice.

An external company was contracted to clean the service daily. The Registered manager told us staff also carried out additional cleaning of high touch points like handles and switches throughout the day. Night cleaning duties were recorded and checked by the registered manager. People used their own equipment which was named to prevent cross contamination.

Further information is in the detailed findings below.

Inspection carried out on 27 February 2020

During a routine inspection

About the service

134 Ashland Road provides accommodation and personal care for up to 10 people with learning disabilities and physical disabilities. At the time of our inspection seven people were living at the service. The service is one adapted ground floor building.

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. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

People felt safe living at the home. People followed safe procedures when greeting visitors. Risks were assessed, monitored and managed. Sufficient numbers of staff were employed with appropriate skills and competencies. Medicine protocols and best practice were followed. Systems were in place to ensure lessons were learned when things went wrong.

People’s diverse needs were assessed and included protected characteristics under the Equality Act 2010. Staff were supported to undertake relevant training to do their job. People were supported to have sufficient to eat and drink. The registered manager implemented change when required. The service worked alongside and also shared relevant information with other professionals to ensure people got the most effective care.

The premises were adapted to meet people’s needs. Where required new equipment was purchased to make sure people were responded to in a more effective way. People’s bedrooms were decorated to reflect their personality. The service was following the principles of the Mental Capacity Act.

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

The home was calm, relaxed and homely. People were supported to express and share their views. People were treated with respect and dignity and encouraged to make informed choices. Staff asked permission before they provided care and treatment.

People were supported to maintain relationships, avoid isolation and achieve their goals. With an excellent opportunity to participate in group and individual activities. Staff and the management team worked with passion and dedication to ensure people achieve good outcomes and including people’s individual needs that related to their protected equality characteristics. End of life wishes were arranged with contributions of people and their families.

People’s communication support plans had accessible information. End of life plans were comprehensive and accessible, with contributions from people and their families. This had been sustained since their last inspection. There was an open and transparent culture when dealing with complaints.

The service was well-led. Auditing and quality monitoring were robust and covered every aspect of the service. This ensured areas that required attention were acted upon. This provided a positive open and transparent culture. The manager and staff team were proactive, responsive and supported people to continually achieve and develop throughout their time at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (23 August 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.

Inspection carried out on 19 July 2017

During a routine inspection

134 Ashland Road provides accommodation and personal care for up to 10 people with learning disabilities and physical disabilities. At the time of our inspection eight people were living at the service.

At our last inspection in May 2015, the service was rated ‘Good’. At this inspection we found that the service remained ‘Good’ for being safe, effective, responsive and well-led, however ‘Outstanding’ was identified for caring.

People remained safe. Staff were aware of their role and responsibility in protecting people from avoidable harm. They had attended appropriate safeguarding training and had policies and procedures to support them. Risks associated to people’s needs including the premises and environment, were regularly reviewed and staff were aware of how to reduce known risks. Staffing levels were sufficient and regularly reviewed to ensure they were appropriate. Staff were appropriately recruited. The storage and management of medicines were found to be safe. Some minor concerns were identified that included one topical cream being out of date, and some records were not consistently completed as required, and immediate action was taken to address this.

People continued to receive an effective service. Staff received an appropriate induction, ongoing training, support and opportunities to review their work. Staff understood the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards that protected people’s human rights. People were supported to maintain good health and nutrition and received support to access primary and specialist healthcare services.

People received excellent care. Staff went above and beyond to support people at the end of their life. They ensured people experienced a dignified and peaceful end to their life where their wishes and religious needs were met. Staff supported people to fulfil their dreams and gave them opportunities to enrich their life. Good communication was used by staff that reflected people’s preferred communication methods and independence and involvement was promoted as fully as possible.

People continued to receive a responsive service. Assessments were completed and support plans developed to support staff to provide a personalised service based on people’s needs, routines and interests. Some information and records were not as detailed as others or consistently completed. People had access to the complaint policy and procedure. Where concerns had been raised they had been responded to appropriately.

The service continued to be well-led. The provider had arrangements in place for monitoring and assessing the quality of care people experienced. These included seeking and acting upon the views for people who used the service and others. The registered manager was aware that some improvements were required with record keeping.

Inspection carried out on 5 and 6 May 2015

During a routine inspection

134 Ashland Road provides accommodation and personal care for up to 10 people with learning disabilities. 10 people were living at the home at the time of our inspection. This was an unannounced inspection, carried out on 5 and 6 May 2015.

A registered manager was in post at the time of our inspection. 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 living at the home were safe. Systems were in place for the provider to make safeguarding referrals when needed so that they could be investigated. Staff supported people in a safe way. Risk assessments were completed regarding people’s care.

The building and equipment were safe. People received their medicines in a safe way. However, written protocols were not always in place for PRN ‘as required’ medicines when needed.

There were enough staff present during our inspection to provide safe care. Robust recruitment checks were completed. Staff felt supported and had received an induction, supervision, appraisals and training. Staff were due to attend some refresher training and arrangements were in place for this.

The provider applied the principles of the Mental Capacity Act 2005. The registered manager understood their responsibility in relation to the Deprivation of Liberty Safeguards.

People received enough to eat and drink. Care staff knew about people’s eating and drinking needs. People were supported to maintain good health and referrals were made to health care professionals for additional support when needed.

Staff treated people in a caring way and promoted people’s dignity and respected their privacy. People were involved in day to day decisions about their care. Staff knew people well and offered them choices and respected people’s decisions. People were supported to take part in social activities.

A complaints procedure was in place. Staff felt comfortable to speak with the registered manager if they had concerns. The registered manager was very approachable and knew people well who lived at the home.

There was a positive and open culture in the home. Effective systems were in place to monitor the service.