We inspected this service on 21 February 2017. The inspection was unannounced. Ashness Two is a care home registered for a maximum of five adults who have mental health needs. At the time of our inspection there were four people living at the service. A fifth person was in the process of gradually moving into the service. The service is located in a large terraced house with access to a back garden.
The last inspection took place on 26 November 2015. At that inspection we found two legal requirements were not being met in relation to safe care and treatment, as medicines were not being safely managed and there was insufficient action taken to prevent fire in people’s bedrooms.
At the time of this inspection there was a registered manager in place. 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 staff were kind, caring and offered them support as they needed. There was a calm and relaxed atmosphere at the service on the day of the inspection. We saw staff talking and working with people in a calm and respectful manner.
People told us they felt safe and that the service was a good place to live in. We spoke with staff who were aware of the importance of safeguarding adults and knew what to do if they had any concerns.
The majority of people living at the service were independent and went out to meet friends and participate in hobbies and activities without support. But staff offered assistance with appointments when required, monitored and supported people with their mental health needs and ensured they had appropriate additional professional support if their needs changed.
Care and support plans were comprehensive and up to date. Risk assessments were in place for identified risks, but not all gave clear detailed advice to staff in how to manage these.
Medicines were stored safely and within the correct temperature range. We noted that records did not show tablets carried over from one month to the next so it was not possible to check stocks against records for all medicines, but this has been rectified since the inspection.
Supervision took place regularly and staff received training in key areas to ensure they were skilled to carry out their role.
The provider had ensured that recruitment checks, including Disclosure and Barring Service (DBS) certificates, were completed before staff started working with people. For some staff the provider had obtained verbal references but was still awaiting written references. However, these staff had worked as agency staff prior to becoming permanently employed so at that point the provider had received historical references. In this way they had satisfied themselves staff were considered safe to work with people who used the service.
We found the premises were tidy and whilst it was clear that daily cleaning took place there were areas where the service had built up grime. The registered manager undertook to carry out a deep clean of the service by the end of March 2017. A number of rooms had been decorated in the last six months and there were plans in place for other areas to be decorated by the end of March 2017.
We found that measures were in place for infection control through the use of specific mops for particular areas and chopping boards for specific food stuffs. However we found a fridge in the kitchen with a meat product that was cooked but not entirely sealed or labelled. It had been cooked just prior to our arrival. Also staff had stored their own food in the fridge that required freezing. These issues were resolved by the end of the day of the inspection.
One person had their money managed by the service and we saw the process was robust with records maintained and receipts retained.
Regular checks were completed for fire safety equipment and fire panels, electrical testing, lighting systems and gas safety.
The provider had quality assurance processes in place to monitor the quality of the service. Quality checks of the service took place by a member of the management team monthly, and management minutes showed the findings were discussed by the management group. The deputy manager also carried out checks of medicines and the management of people’s money.
Staff, people living at the service and relatives told us the management was a visible presence within the home, and the registered manager and deputy manager were well regarded.
We have made a recommendation in relation to risk assessments.