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Inspection carried out on 8 August 2019

During a routine inspection

About the service

Ash Tree provides care for up to five people who have a learning disability.

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 small domestic style property. It was registered for the support of up to five people. Five people were using the service. This is in line with current best practice guidance. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything suggesting they were care staff when coming and going with people.

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

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 were safe from abuse and avoidable harm. Safeguarding procedures were in place and staff followed these. There were enough staff to support people. Staff were recruited safely and, had the skills and experience to meet people’s needs. The environment was clean, well maintained and a safe place for people to live. Staff followed infection prevention and control procedures to reduce risk of infection and people received their medicines as required.

People’s needs, and choices were assessed before they used the service. Risks to people’s health and well-being were managed. Staff received training and updates on best practice guidelines that were appropriate to people they supported.

People were treated to kind and compassionate care. Staff protected people’s dignity and confidentiality. Staff were sensitive to people’s individual needs and they understood how best to support people. Relationships between people and staff were positive and staff knew people’s needs.

Changes to people’s health were reported and monitored, and staff supported people to their appointments.

Support was person centred and delivered the way people preferred and met their individual needs. Staff understood people’s needs with regards to the protected characteristics of the Equality Act 2010. Information was available to people in accessible formats and staff knew people’s communication needs and understood how best to engage people and support people.

People were occupied with activities, hobbies, and interests of their choosing. The atmosphere in the home was warm and friendly and people looked happy in their surroundings.

People knew how to make a complaint and would feel confident doing so. People had opportunity to meet with the manager to discuss any concerns and visitors were welcomed to the service anytime.

The service was managed well and there was an effective quality assurance processes in place. Action plans were developed following any shortfalls in the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes including control, choice and independence.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (report published 21 December 2016). Following this inspection the service remained good overall.

Why we inspected

This was a planned inspection based on the previous

Inspection carried out on 24 November 2016

During a routine inspection

We inspected the service on 24 November 2016. It was an unannounced inspection.

Ash Tree provides accommodation for people with learning difficulties and sensory impairments. There were five people using the service on the day of our inspection.

The service had a registered manager. 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 were protected from harm and staff were clear of their role to keep people safe and protect them from abuse. There were enough staff to keep people safe. There was a recruitment policy in place which the registered manager followed. We found that all the required pre-employment checks were carried out before staff commenced work at the service.

Staff received training and support to meet the needs of the people who used the service. People received their medicines as required and medicines were managed and administered safely.

People enjoyed the meals provided and where they had dietary requirements, these were met. People were offered adequate drinks to maintain their health and wellbeing. Systems were in place to monitor the health and wellbeing of people who used the service. People’s health needs were met and when necessary, outside health professionals were contacted for support.

Risks relating to the environment and people’s conditions had been assessed and action taken to reduce the likelihood of harm.

People were supported to make decisions about the care they received. The registered manager had considered the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) by making appropriate referrals to DoLS. However where people’s mental capacity to make decisions could not be presumed assessments of their mental capacity had not been taken and decisions were not taken in people’s best interest.

People’s independence was promoted and staff encouraged people to make choices. People were supported to follow their interests and engage in activities

The registered manager had assessed the care needs of people using the service. Staff had a clear understanding of their role and how to support people who used the service as individuals. Staff knew people well and treated them with kindness and compassion.

People’s relatives and staff felt that the service was well-led. People’s opinions were sought and respected. They knew how to complain should they have needed to and felt confident that the registered manager would respond to their concerns.

The registered manager had implemented range of audit systems in place to measure the quality and care delivered so that improvements could be made. We saw that action had been taken when identified as necessary. The provider demonstrated that there was drive for improvement.