Background to this inspection
Updated
20 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector carried out this inspection.
Service and service type
Ashgate Cottage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people and staff at home to speak with us.
What we did before the inspection
We reviewed all the information we held about the service, including notifications of changes, events or incidents that the provider is legally obliged to send us within the required timescales. We contacted professionals in local authority commissioning teams and safeguarding teams. We reviewed the service’s previous inspection reports.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
People receiving personal care were unable to speak with us at length so we spoke with three relatives about their experience of the care provided. We spoke with five members of staff: the nominated individual, the registered manager, deputy manager, a support worker and senior support worker. We observed interactions between staff and people who used the service. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included two people’s care records and medication records. We looked at staff files in relation to recruitment. We reviewed a variety of records relating to the management of the service, including training, accidents, incidents, safeguarding, auditing, policies and procedures.
After the inspection
We contacted a further two health and social care professionals.
Updated
20 February 2020
About the service
Ashgate Cottage is a care home for up to three people who have autism spectrum conditions. It is a detached bungalow in a quiet residential area. At the time of this visit there were three people using the service. The service is situated beside another small care home and they are both managed by the same registered manager.
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 home was small and personalised, with no obvious signage indicating it was a care home. The feel of the service was homely and determined by people’s needs.
People’s experience of using this service and what we found
People felt safe and supported by staff who knew them extremely well. Risk assessments were in place. They had regard to people’s potential and aspirations rather than what may be difficult for them. Positive risk taking was part of the culture and helped people achieve greater independence.
All relatives were confident in staff and their ability to keep people safe. Staffing levels were regularly reviewed and appropriate to people’s needs.
All incidents and accidents were documented and analysed to help identify any developing patterns.
Staff worked well in conjunction with a range of external healthcare professionals. They also had access to an internal team of occupational health and other specialists.
Staff were well supported with a range of ongoing training, supervision and informal support.
People's needs were comprehensively assessed and continually reviewed. Staff had a comprehensive understanding of people’s communication needs.
Activities were geared towards people’s interests and there was a strong person-centred culture. People’s rooms were pleasantly decorated to their tastes and communal areas updated following consultation with people.
Relatives and staff told us the service was well-managed. The provider had in place clear quality assurance and auditing processes. The registered manager continually sought ways to improve the service with a view to helping people live full lives.
The service applied 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 using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 13 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.