Ash Villa

The registered manager was not available on the day of the inspection; however, we spoke with the deputy manager.

The area used for staff don and doffing process was not suitably placed. We spoke with the deputy manager and they addressed this before we left and confirmed the new area to be used. The provider was also working with Public Health England to ensure they had appropriate safety measures in place.

We found the following examples of good practice.

There was a restriction on visiting the service at the time of the inspection. There were procedures in place for visitors to the service, including healthcare professionals and relatives to reduce and prevent the spread of infection.

The provider ensured people maintained contact with relatives by staff supporting them with telephone calls and letter writing. The deputy manager told us they had accommodated garden visits during the summer and was reviewing visits for the winter once they had reviewed current guidance about accepting visitors.

There was a clear regular programme for staff and people living in the home to be tested for COVID-19. This meant swift action could be taken if or when positive tests were received.

Staff followed procedures for don and doffing PPE and how to dispose of it safely, in line with GOV.uk guidelines. All staff wore appropriate PPE, which was in good supply.

A robust contingency plan was in place and used for when positive testing or isolation for staff or people arose. There were arrangements to deploy staff across the service to reduce the risk of cross infection. Agency staff were used to cover shortfalls in staffing, due to staff testing positive for COVID-19.

Handover meetings were completed in line with safe distancing guidelines.

A generic risk assessment was in place for people in high risk groups, but not individualised to identify personal risks. The deputy manager gave an example of vulnerability for people and the staff team. They assured us that adjustments if required to staff working practices would be put in place as and when required to keep them safe. Staff who were noted at risk were shielding at this time.

People using the service had tested positive and were self-isolating in their own rooms or communal areas when appropriate. Arrangements were in place to reduce the spread of infection. Peoples individual needs were considered to ensure everyone was kept safe.

Housekeeping staff told us they had increased the cleaning regime. The cleaning schedules had been consistently completed for the weekly and monthly tasks around the home environment. Staff told us they try to deep clean every other day and we were assured the cleaning was being completed. The deputy manager had identified that the new ways of working had not been filtered down to all cleaning staff and was addressing this.

Further information is in the detailed findings below.

Ash Villa is a residential care home for ten people with learning disabilities. There were ten people living at the home at the time of our inspection. The service was a larger property than current best practice guidance. However, it was a large property which allowed people a lot of space; for example, there was a large extension on the ground floor which allowed for additional living space.

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

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People using the service can live as ordinary a life as any citizen.

The risks to people’s health and wellbeing were assessed and action taken to reduce them. There were systems to learn from mistakes including the detailed analysis of accidents and incidents. People were supported by staff who understood how to protect them from avoidable harm. There were enough staff deployed to keep people safe in the home and when they chose to go out. People’s medicines were well managed and staff understood how to reduce the risk of the spread of infection.

Staff received training to enable them to do their jobs well. Assessment ensured people were supported to transition into the service well. They were supported to maintain a healthy diet. Their health and welfare were managed with referrals to other professionals made when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were kind and caring relationships between people and staff which were based on dignity and respect. People felt involved with decisions and that staff respected their wishes. People had care and support provided which met their preferences. Complaints were handled in line with the provider’s complaints policy. People did not currently receive end of life care but people had discussed their wishes with staff.

Staff enjoyed working at the service and felt respected and valued. The provider’s quality assurance processes were effective in identifying potential risks to people’s safety. There was a continued focus on learning, development and improvement.

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 good (published 7 July 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.

Ash Villa is a residential care home for 10 people with dementia, sensory impairment, learning disabilities or autistic spectrum disorder. At the time of this inspection, 10 people lived at the home.

At the last inspection, the service was rated Good. At this inspection we found the home remained Good.

People told us they felt safe living at the home. At our last inspection we found there were unsuitable lighting and loose ceiling tiles. We found this had been improved at this inspection. Staff understood what abuse was and knew what action to take if they had concerns. Staff were effective in identifying and managing risks to people’s health and well-being and knew how to keep people safe.

Staff were recruited safely and they received a comprehensive induction to the home which gave them the skills required to care for people who lived at Ash Villa.

People received their medicine from trained staff and medicines were given to people safely.

People were supported with their nutritional needs and had a balanced diet. Where possible, people were involved in preparing food and drinks.

People participated in activities they enjoyed. Activities were planned for each person and recorded on a calendar so people knew what they were going to do and when.

People knew how to complain or make their concerns known to staff and the registered manager. The provider sought the views of people, their relatives and staff through surveys.

There were processes to monitor the quality of the care provided. Audits and other checks were done on the environment, fire safety infection control and action was taken when problems were identified.

People using the service felt safe. Staff were aware of the processes to follow if they had concerns about people's safety and had received training in safeguarding vulnerable adults. Where people communicated through their behaviour, there were plans in place informing staff of what may trigger the behaviour and how they should respond.

The provider had taken steps to provide care in an environment that is suitably designed and adequately maintained. We had a tour of the building and did not find any concerns in relation to the maintenance of the areas we saw. All areas we saw, which included three bedrooms and all communal areas were well maintained, clean and free from odours.

There were effective recruitment and selection processes in place to ensure staff employed were suitable to work with vulnerable adults. Following recruitment, staff were supported to develop their skills and knowledge. Two people we spoke with told us they felt staff knew what they were doing in relation to their work. One person said, 'They know how to care for me here.'

People who use the services told us "They are happy to speak to staff about issues" and that they "Have told the manager about problems and they have helped me". People who use the services said that staff helped them to "Decide what I want to do every day and they help me plan my activities".

Relatives told us they found staff to be "Helpful and supportive" and that staff seemed to be "Appropriately trained to look after people living here". Relatives said that their opinions were requested by the care home in questionnaires they received regularly.

We saw that each person's room was arranged according to their individual wishes and they were able to choose how their rooms were changed when this was required. During our inspection we saw that all signs in the care home had pictures to help people understand the meaning of the notices.

We observed care and treatment being delivered to people during our visit, including an evening meal for people. We saw that staff were able to provide care for people on an individual basis and as part of the staff team on duty during the inspection.