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Inspection carried out on 25 September 2019

During a routine inspection

About the service

Ashford House is a supported living scheme within which the service was providing personal care to three people at the time of the inspection. Ashford House supports people with enduring mental health needs.

People using the service live in a single ‘house in multi-occupation’ which can be shared by up to six people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Risks associated with people’s health, medical and social care needs had been assessed and detailed guidance had been provided to staff on how to reduce known risks to keep people safe.

Medicines were managed safely and administered as prescribed.

Recruitment processes were followed robustly and help ensure that only those staff assessed as safe to work with vulnerable adults were recruited.

Support staff had been given the title of care practitioners by the provider. Care practitioners received appropriate levels of support and training to enable them to carry out their role effectively.

People received the appropriate levels of support, where required, with managing their health and medical needs. The service worked in partnership with a variety of health and medical professionals to ensure people received the right support.

People were supported to eat, drink and maintain a healthy lifestyle where this was an assessed need.

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 observed that people had established positive relationship with the care practitioners that supported them which were based on trust and mutual respect.

Care plans were person centred and very detailed, giving care practitioners the required information to support people appropriately and in response to their needs.

Complaints received were documented with details of the investigation and actions taken to resolve the complaints and where required make the necessary improvements.

People knew the management team well and we observed that people were able to approach them at any time.

The service had systems in place to monitor and oversee the quality of care and support that people received so that improvements could be implemented where required. Learning and development of the service was a key focus area for the management team.

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 (published 29 March 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 6 March 2017

During a routine inspection

We undertook an announced inspection on 6 March 2017 of Ashford House. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection. The inspection was carried out by one inspector. Ashford House is a supported living service and at the time of the inspection the service was providing care and support for four people with mental healthcare needs.

At the last inspection on 8 January 2015, the service was rated as Good.

At this inspection we found the service remained as Good.

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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.

Risks had been identified and assessed and provided information on how to mitigate known risks to keep people safe.

Medicines were being managed safely.

There was enough staff to support people. Pre-employment checks had been carried out when recruiting staff.

Staff had the knowledge, training and skills to care for people effectively. Staff received regular supervision and support to carry out their roles.

Staff sought people's consent to the care and support they provided. People's rights were protected under the Mental Capacity Act 2005.

People were encouraged to eat healthy. There was a weekly cooking class to help people cook meals.

Staff had positive, caring relationships with the people who lived at the service.

People were treated in a respectful and dignified manner by staff who understood the need to protect people's human rights.

People received care that was tailored to their individual needs, interests and preferences. Care plans promoted a person-centred approach.

Complaints were investigated and action taken to the satisfaction of complainants.

People found the management team approachable and had confidence in their ability to act on things. Staff felt well supported by the management team.

Quality assurance and monitoring systems were in place to make continuous improvements.

Inspection carried out on 8th January 2015

During a routine inspection

We undertook an announced inspection on 8 January 2015 of Ashford House. We told the provider two days before our visit that we would be coming. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection. The inspection was carried out by one inspector. Ashford House is a supported living service. At this inspection the service was providing care and support for 6 people with mental healthcare needs.

On the day of the inspection staff were welcoming and people in the supported living accommodation appeared relaxed and well cared for. We saw staff talking with people in a friendly and respectful manner. People we spoke with informed us that they were well cared for and staff were competent and capable.

Throughout the inspection we saw that staff were responsive towards people and available to talk with them when they wanted to. Staff respected people’s privacy and knocked on bedroom doors to ask for permission before they went in.

People had been carefully assessed and appropriate care plans were prepared with the involvement of people and their representatives. Their physical and mental healthcare needs were closely monitored. There were regular reviews of people’s health and the service responded promptly to changes in people’s needs. Staff were aware of signs to look for which may indicate that people were deteriorating mentally. People told us they attend appointments with health and social care professionals. This ensured they received treatment and support for their specific needs.

Staff had been carefully recruited and provided with induction and training they needed to enable them to care effectively for people. Staff we spoke with had a good understanding of the specific needs of people. People and professionals informed us that staff understood the care needs of people and provided people with the supervision and care they needed. Meetings and one to one sessions had been held to ensure that people could express their views and their suggestions were addressed. The registered manager was able to provide us with examples of how they were able to assist people achieve goals they set for themselves and work towards independent living.

The service had a safeguarding policy together with the London guidance document “Protecting Adults at Risk: London Multi-Agency Policy and Procedure to Safeguard Adults from Abuse”. Staff had received training and knew how to recognise and report any concerns or allegation of abuse.

The registered manager and the staff team worked well with other professionals to ensure people were well cared for and able to make progress towards independent living. Professionals informed us that staff kept them informed and maintained close liaison with them. The last satisfaction survey indicated that people were satisfied with the quality of care provided.

We found the premises had been well maintained and clean and tidy with the help of staff. People said they cleaned the premises with the help of staff. There was a record of essential inspections and maintenance carried out.

Inspection carried out on 20, 21 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

During the inspection the service was providing care to six people who lived in supported accommodation. All of them had mental health needs. We were able to speak with three people who used the service.

We observed the care provided and the interaction between staff and people who used the service. We spoke with three care staff, the managing director and the registered manager. We also spoke with two health and social care professionals who were visiting a person.

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People told us that they were well treated by staff. One of them stated, �I feel safe here. The staff are approachable.� The service had a safeguarding policy and procedure. Staff had been provided with safeguarding training. They were aware of action to take in response to safeguarding incidents or allegations. The supported accommodation had been kept clean with assistance from staff. Risk assessments of the premises had been carried out. Two health and social care professionals informed us that they had confidence that staff would take appropriate action if there were any risks to the safety or welfare of people

Is the service effective?

Feedback from people who used the service indicated that the service was effective and responsive to the needs of people. People�s care needs had been fully assessed. Care plans had been prepared and these were up to date and had been regularly reviewed with people and professionals involved. There was evidence that staff had ensured that people�s medical needs had been attended to by healthcare professionals such as their psychiatrists, community nurses and their GP. Staff were capable and knowledgeable regarding how to care for people with behavioural needs. This meant that potential problems and risks could be minimised or defused. We noted that people interacted and responded well towards staff. The two health and social care professionals informed us that staff were able to manage people�s care effectively.

Is the service caring?

People informed us that staff took an interest in their welfare. One person said, �Yes, they know what they are doing and behave in a professional way.� Staff were knowledgeable regarding the specific care needs of people. They informed us that they encouraged people to be as independent as possible by encouraging them to participate in activities, take care of their personal needs and manage their medication. We noted that when a person exhibited signs of deterioration in their mental condition, prompt action was taken to ensure that they received support from professional involved in their care. Staff had an understanding of people�s cultural and religious needs and where appropriate, arrangements had been made to meet their needs. This included celebrating special days and providing foods relevant to people�s culture.

Is the service responsive?

People told us that staff listened to them and when concerns were raised, they responded promptly. We observed that staff were attentive towards people and communicated well with them. One to one sessions had been organised where people could discuss their progress or concerns with staff. Weekly meetings had been held where people could express their views and provide suggestions regarding activities and meals provided. Staff gave us examples of what they did in response to suggestions made. These included arranging for people to go to the cinema and going biking. This was confirmed by one person we spoke with.

Is the service well-led?

The registered manager was knowledgeable regarding her role and responsibilities. There were arrangements for monitoring the quality of care provided. A satisfaction survey had been carried out. The results indicated that people who used the service were satisfied with the care provided. Monthly monitoring checks had been carried out by the managing director. Regular checks on medication arrangements and care documentation had been carried out.

Staff meetings took place monthly. The minutes of these meetings indicated that staff had been updated regarding the management of the home and the care of people. Staff we spoke with informed us that they had been provided with appropriate support to enable them to take good care of people. Staff had received essential training and were knowledgeable regarding their roles and responsibilities.

Inspection carried out on 11 June 2013

During a routine inspection

People�s diversity, values and human rights were respected. Staff knew how to communicate with people. We saw staff knock on people�s doors and announce themselves before entering. People told us that staff helped them find voluntary work and activities in the community.

People said they were happy about the care they received from staff at the service. For example one person told us �I�ve been happy here, good communication from staff who direct you in ways to improve your life, they prompt me when I have no motivation.� Another person said �the staff respect me and are never rude, when they have to tell me something they do it as a friend.�

We observed the cleaning of the service and talked to people who lived in the service. Comments included �very clean, I do my bit to help.� and �it�s kept clean, the staff clean up all the mess.�

The four people we talked with all felt there were enough staff on each shift to support them. One person told us �there are enough staff around all the time to support my needs, when I�m unwell they are trained to deal with my illness.�

People were happy with the service and were consulted about the running of the service. who use the service. One person told us �this is an amazing place.� Another person said �after coming from hospital this place is a breath of fresh air.�

Inspection carried out on 4 October 2012

During a routine inspection

The provider had two services located next door to each other called Ashford House and Ashford Lodge. The same staff team provided supported to people living in both houses and everyone entered and left the service via Ashford House. There were six people living in Ashford House on the day of our visit. We spoke with three people who used the service. They were all very positive about the care and support they received. One person told us that staff were �easy to talk to�. Another said of the service, �you get all that you need�. People felt safe and a person told us, �the manager and staff are all very nice�. They knew how to make a complaint and said they would approach the manager if they had any concerns about the service.

Staff received appropriate training and support to enable them to deliver the support to people that they needed. The provider had effective systems in place to monitor the quality of service provided.