Ashcott Bungalow

Aschott House is a residential care home providing personal care and support for up to 7 people who have a learning disability and/or who are autistic. There were 7 people living in the service on the day of our inspection visit.

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

Right Support:

The service supported people to have choices and promoted their independence. Staff had completed training to ensure they understood how to support people appropriately. A staff member said, "I have all the training and support I need to care for and support people safely, these are updated and done on a regular basis to keep my knowledge fresh and clear.” People were encouraged to have maximum choice and control of their lives and staff helped them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s medicines were managed by trained staff.

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.

Right Care:

People received kind and compassionate care from staff at the service. Staff and the management team protected and respected people’s privacy and dignity. They spoke about people with respect and were knowledgeable about people living at the service. Staff understood how to protect people from poor care and abuse. They had received training on how to recognise and report abuse. Training in this area was regularly updated. There were sufficient appropriately recruited and skilled staff to meet people’s needs and encourage them to develop their life skills. Risks to people were appropriately managed.

Right Culture:

The service promoted person-centred care involving people who used the service and their families. People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management team and staff. People and those important to them, including advocates, were involved in planning people’s care. Relatives told us they were comfortable visiting the service and that their relative thought of the service as their home. The management team had a range of systems and processes to monitor the quality of the service and drive improvements.

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 10 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection of 20 October 2015 the service was rated Good. At this inspection we found the service remained Good.

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 service continued to provide a safe service to people. This included systems in place intended to minimise the risks to people, including from abuse and with their medicines. Staff were available when people needed assistance and the recruitment of staff was done safely.

People were cared for by staff who were trained and supported to meet their needs. 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. Systems were in place to assess and meet people’s dietary and health needs.

Staff had good relationships with people who used the service. People were involved in making decisions about their care and support.

People received care and support which was planned and delivered to meet their specific needs. People were supported to participate in meaningful activities. A complaints procedure was in place.

The service had a quality assurance system and shortfalls were identified and addressed. As a result the quality of the service continued to improve.

Further information is in the detailed findings below.

We spoke with four people who used the service, the manager, the provider and two staff members. We looked at four people's care records and staff training and supervision records and records relating to the medication management in the service. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service a staff member looked at our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Relevant staff had been trained to understand when an application should be made, and how to submit one.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

People were provided with their medication in a safe manner and at the prescribed times. We saw that medication was stored safely.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs. One person said, "I am happy." Another person said, "I like living here, I am going out today."

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met.

Staff were provided with the training and support that they needed to meet people's needs in a safe and effective manner.

Is the service caring?

We saw that the staff interacted with people living in the service in a caring, respectful and professional manner. People told us that the staff treated them with kindness.

Is the service responsive?

People using the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.

Is the service well-led?

The service had taken action to address the shortfalls identified at our previous inspection. They had reviewed policies and procedures and advice provided to staff to reduce the risks of the shortfalls happening again. As a result the quality of the service had improved.

Since our last inspection a new manager had started working in the service. They told us that they were in the process of making a registered manager application with us.

We spoke with seven people who used the service. We also spoke with two staff members and the area manager. We looked at four people's care records. Other records viewed included staff training and supervision records, meeting minutes and medication administration records (MAR). We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service a staff member asked to see our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. One person said, "I would tell the staff if something was wrong."

There were enough staff on duty to meet the needs of the people living in the service.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications had been submitted, staff had been trained to understand when an application should be made, and how to submit one. We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and DoLS. This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

During our inspection we found that records did not show that medicines were always being given to people as intended by prescribers. We noted some good information available about people's medicines but some medicine profiles were inaccurate. There was inadequate risk assessment for a person self-administering some of their medicines and there was a lack of records about the administration of medicines given hidden in food to a person that assured us their medicines were always being given in their best interests and appropriately. We noted that all care staff authorised to handle and administer people's medicines had received training but not all had been more recently assessed as competent to undertake medicine-related tasks. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service effective?

People told us that they were happy living in the service. One person said, "It is very good." Another person said, "We have fun, I like it here."

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. However, there were shortfalls identified in the records. Even though the records were reviewed and updated, they were not done promptly when there had been a change in people's needs to ensure that staff were provided with up to date information about how people's needs were to be met. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Staff had been provided with the training that they needed to meet the needs of the people who used the service.

Is the service caring?

We saw that the staff interacted with people living in the service in a caring, respectful and professional manner. People told us that the staff treated them with kindness and respect. One person said, "They (staff) check that I am ok." Another person said, "I like them (staff)."

Our observations and discussions with staff showed that the staff were knowledgeable about people's individual needs and how they were met. Staff offered people choices throughout our inspection, including what they ate and drink and what they did during the day. We saw that the staff listened and acted on what people said.

Is the service responsive?

People completed a range of activities in and outside the service regularly. The home had its own adapted minibus, which helped to keep people involved with their local community. People were supported to maintain relationships with their friends and relatives.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health care professionals, including a doctor and district nurse.

Is the service well-led?

The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. There was no registered manager in the service. The most current manager had recently left the service. The area manager advised that they undertook the day to day management of the service and that they had recently recruited a new manager.

Staff had not been provided with the supervision and appraisal that was identified in the service's own staff handbook. This meant that staff were not provided with the opportunity to discuss the way that they worked and to receive feedback on their work practice. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Staff and the area manager told us about the proposed changes to the service, which was split into two, The Bungalow and The House. The plans were that The Bungalow would remain as a care home and The House would provide supported living by the provider's domiciliary care service.

People spoken with and the minutes of house meetings showed that they were consulted about the proposed changes in the service, asked for their views about the service they were provided with and that their comments were listened to and acted on.

We talked with five of the people who used the service, they told us that they liked living there. People also told us that they got on well with the staff that supported them to go out to do their personal shopping, to follow their favourite activities and to be part of the local community. One person told us that the staff were, ' good people, very friendly and kind.'

We observed that the staff were attentive to people's needs. Staff interacted with people in a friendly, respectful and professional manner. We saw that staff sought people's agreement before providing any support or assistance.

We spoke with three staff members, they told us they were supported through supervision and that they believed they were trained sufficiently to support people with learning disabilities in all aspects of their lives.

We also saw that the provider had systems in place to deal with complaints made about the service and that people who used the service were supported to make a complaint if they wanted to.