We carried out a review of the data available to us about Ashfield House 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 Ashfield House, you can give feedback on this service.
Ashfield House is a residential care home providing personal care to eight people living with a learning disability, autism or mental health needs at the time of the inspection. The service can support up to eight people across two buildings, one main residence and a bungalow attached to this for people who wish to be supported more independently.
People’s experience of using this service and what we found
Quality assurance tools at the service had not consistently identified areas that required improvement and ensured these had been implemented effectively.
People were supported by trained staff who had been recruited safely. People were supported to receive their medicines as they were prescribed. People were supported in line with government guidance around COVID-19.
People were supported by sufficient staff to meet their needs in a timely and flexible way. People had access to their local community and could engage in activities of their choosing.
People were involved in their care planning to enable them to make choices in their care. People were encouraged to maximise their independence and living skills.
People were supported by staff who understood their communication needs and were meeting these. People knew who the management team were at the service and felt able to give feedback about their care.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, 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 providing support to people with a learning disability and autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture as the model of care and setting maximised people’s choice, control and independence.
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 requires improvement (published 24 December 2019).
Why we inspected
The inspection was prompted in part due to concerns received about safeguarding, the quality of care provided at the home and infection prevention and control. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
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 coronavirus and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We have found evidence that the provider had made significant improvements to the culture and quality of care within the home. However, improvements were ongoing in relation to quality monitoring and oversight. Please see the well led sections of this full report.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
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.
Ashfield House is a residential care home providing personal to eight people who may have a learning disability, autism, mental health or physical disability.
Ashfield House accommodates six people in one adapted building over two floors and two people in an annexe which has its own kitchen and communal area.
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 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 due to lack of choice and control. For example, people did not always have a choice about when they were able to go out in the community during the evenings and on weekends.
People’s experience of using this service and what we found
People were not consistently supported to maintain their hobbies and interests in the evenings or on weekends as people had to wait their turn for access to transport. Staff working patterns were not always flexible to support people with their social care needs.
The checks the registered manager and provider made had not fully considered people’s views and experiences of their social needs. The provider had not identified that people were, at times, restricted of their choice and freedom to access the community. Some staff felt that better leadership and direction was required for staff when the management team were not on duty, such as evenings and weekends.
People told us they continued to feel safe and well supported. Relatives confirmed they felt their family member was safe. Staff had a good understanding in how they protected people from harm and recognised different types of abuse and how to report it. Potential risks to people had been identified and staff had consistent knowledge in how to reduce the risk of harm. There were enough staff on duty to keep people safe. People’s medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.
People’s care continued to be assessed and reviewed with the person and their relative or advocate involved throughout. People were supported to have a healthy balanced diet, and where able, people were supported to prepare their own meals and drinks. Staff engaged and worked well with external healthcare professionals and followed their guidance and advice about how to support people following best practice.
People were treated with respect and their dignity and privacy was maintained.
People’s health care was delivered in a timely way, with any changes in care being communicated clearly to the staff team. People and relatives had access to information about how to raise a complaint.
People and their relatives were happy with the way the service was run. The registered manager was visible in the home, listened and responded to those who lived in the home and the staff who worked there. People and relatives were listened to and had the opportunity to raise their suggestions and ideas about how the service was run. Staff felt supported by the registered manager to carry out their roles and responsibilities effectively, through training and regular contact with the registered manager.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
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. The registered manager was absent on the day of inspection.
People continued to be supported in a safe way and where risks to people were identified they were managed effectively. Staff knew what abuse was and how to recognise and report it. Medicines were managed safely. There were enough staff available to offer individual support to people and recruitment processes ensured they were suitable to work within the home. Staff had received an induction and training to help them support people.
When needed capacity assessments had been completed and decisions made in people’s best interests. When people were being unlawfully restricted this had been considered.
People were treated in a kind and caring way. Their privacy and dignity was promoted by staff and they were encouraged to be independent. They were able to make choices around their day and were offered the opportunity to participate in activities they enjoyed. People were supported to access health care professionals and health care services when needed. They were offered a choice of foods they enjoyed.
Quality monitoring checks and feedback from people who used the service was obtained to bring about changes. Staff felt listened to and were provided with the opportunity to raise concerns. There was a complaints procedure in place and this was followed by the provider. The provider was displaying their previous rating in line with our requirements.
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
Ashfield House was last inspected in June 2013. At that time the provider met all the regulations we checked. This current inspection was unannounced which meant that staff did not know we were visiting.
Ashfield House provides care to six people of both genders with a learning disability. The home has a registered manager who has been at the home since it opened in 2012. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Our observations and discussions with family members showed that there were positive caring relationships between staff and the people that lived at Ashfield House. We saw that people were treated with respect and care was based on people’s preferences and aimed at supporting people to develop their skills and to be as independent as possible. We observed that people appeared to be relaxed and their expressions indicated they were settled and happy. This was the view of family members we spoke with, who told us their relatives were settled and happy. They said they were very pleased with the care their relative received.
Staff were aware of the provisions of the Mental Capacity Act (2005) and people were supported to make decisions about their life. Where people lacked the capacity to make decisions these were made in their best interest. Staff were following the Deprivation of Liberty Safeguards provisions and applications were made when people’s liberty was restricted.
We found that people were having their needs assessed and that plans of care were in place. These were personalised and took account of each person’s individual wishes and preferences. People were supported to access health care services including attending well person clinics and specialist services. People received effective care that was based around each person’s individual needs and preferences. Risks to people were identified and plans were in place to make sure people were kept safe whilst ensuring their rights were promoted.
People were supported to undertake activities of their choice. These took place both in the home and out in the community. Some people attended college and others went to a work placement. People took part in aspects of running the home including keeping their home clean and doing their laundry and helping to prepare and serve food.
There were robust recruitment procedures in place that involved the people that lived at Ashfield House. Staff were supported and trained to ensure they were able to provide care at the required standard to ensure people’s needs were met.
We saw that systems were in place to monitor and check the quality of care and to make sure the environment was safe and well maintained. There was evidence that learning from incidents and investigations took place and changes were put in place to improve the service. This meant that people were benefiting from a service that was continually looking how it could provide better care for people.
We saw that staff helped and supported people. We spoke with one person who lived there who said: 'It's nice here". We saw that people received care that met their individual needs.
People were being cared for by staff who had knowledge of keeping people safe from the risk of abuse.
We found that there were regular audits and quality checks. We also saw that the provider had learnt from incidents to improve the quality and effectiveness of the care they delivered.