We carried out a review of the data available to us about Ashgate Cottage 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 Ashgate Cottage, you can give feedback on this 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.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
People were unable to tell us about the service because of their complex needs. Their relatives told us the service was safe and provided good support for people. Staff said they were well trained in safeguarding adults and were confident that any concerns would be dealt with by the organisation. There had been no concerns in over three years.
There were enough staff to support the three people. Staffing arrangements were flexible to make sure there were staff rostered to accompany people to any leisure events or health care appointments. The organisation vetted potential new staff to make sure they were suitable to work with people. Staff were trained in medicines management and supported people with their medicines in a safe way.
Staff were well trained in care and in health and safety. They received specific training in supporting people with autism spectrum condition. Staff said they felt supported by their managers and by the organisation.
People were assisted in the least restrictive way possible; the policies and systems in the service supported this practice. Risks to people’s well-being were assessed and kept under regular review. Specialist equipment was provided to minimise risks without compromising people’s rights.
People were supported with their dietary needs. They were encouraged to be involved in shopping, choosing and preparing meals, where possible, with staff supervision.
Relatives said staff were caring and people were happy and relaxed at the home. The low staff turnover meant people were familiar with staff and felt comfortable with them. Relatives said they and their family members had good, trusting relationships with staff.
Staff understood each person and supported them in a way that met their specific needs. Relatives felt fully involved in reviews about people’s care. Each person had a range of social and vocational activities they could take part in. People’s choice about whether to engage in these activities was respected.
Staff and relatives felt there was an open, approachable and stable management team. The registered manager had worked at the home for several years. The provider continuously sought to make improvements to the service people received. The provider had effective quality assurance processes that included checks of the quality and safety of the service.
Further information is in the detailed findings below
This inspection took place over two days. The first visit on 20 November 2014 was unannounced which meant the provider and staff did not know we were coming. Another short visit was made on 27 November 2014.
The last inspection of this home was carried out on 1 August 2013. The service met the regulations we inspected against at that time.
Ashgate Cottage provides care and support for up to three people who have autism spectrum disorder. The care home is a detached bungalow in a quiet residential area near the city centre. 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.
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 were unable to tell us about the service because of their complex needs. Their relatives made many positive comments about the service. Relatives said people felt “safe” and “comfortable” at the home. Relatives felt included in decisions about their family member’s care.
Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident that any concerns would be listened to and investigated to make sure people were protected. There had been no concerns at the home over the past year.
There were enough staff to meet people’s needs. The home had a stable staff team and many staff had worked there for years. This meant they were familiar with people’s individual needs. Staff received relevant training to assist each person in the right way. The provider made sure only suitable staff were employed. Staff helped people manage their medicines and did this in a safe way.
Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and Deprivation of Liberty Safeguards to make sure they were not restricted unnecessarily. Relatives confirmed they had been involved in the agreements about keeping people safe and that people were able to take “reasonable risks” with support so they had as independent a lifestyle as possible.
People were supported to enjoy a healthy lifestyle that included healthy diets which met their individual dietary needs. People were supported to be involved in shopping, choosing and preparing meals. There was a calm, supportive atmosphere in the home and there were positive interactions between staff and the people who lived there.
People were encouraged to make their own choices and decisions about their day to day lives, wherever their capabilities allowed. Staff were respectful of people’s individual and diverse needs. Relatives said people were treated with dignity and respect.
Relatives told us they felt people were well cared for in the home. Each person had a range of social and vocational activities they could take part in. People’s choice about whether to engage in these activities was respected.
Relatives were frequently invited to comment on the service in an informal way and they felt able to give their views about the home at any time. However the results of formal annual satisfaction questionnaires were not collated, shared or used to improve the service. People and relatives had some information about how to make a complaint. Although this was out of date, relatives felt confident about raising any issues.
Relatives and staff felt the organisation was well run and the home was well managed. There was an open, approachable and positive culture within the home and in the organisation.
We found that the provider had some arrangements in place to obtain consent from people prior to them being given care and treatment.
We found that people who were using the service were receiving the care and support they needed. For example, the staff we spoke with could describe how they met the assessed needs of the people they were providing with care.
We found that the people who were using the service were protected from abuse as the provider had procedures in place for the staff to follow if they suspected anyone was at risk of abuse.
The complaints procedures had been made available to the people who used the service and their relatives. This was provided in a format that met their needs.
We found that some records, which the provider is required to keep, to protect the peoples' safety and wellbeing, were being stored securely and could be located promptly when needed. For example, the care records were kept in secure cabinets.
During the inspection, the staff members on duty were observed speaking to people in a kind and respectful way. The methods staff used to communicate with people was personalised and meaningful. We also observed that the people were clean and well groomed.
We also undertook a short observational framework for inspection (SOFI) exercise to observe the interactions between them and the staff. SOFI is designed to be used when inspecting services for people who had some difficulty in communicating their opinions on the services they receive.
During the SOFI, we observed people being offered choices; for example, both people were offered a choice of drinks and a choice of meal. Staff were seen to be attentive and gave people the information about the drink and meal options in a way that was appropriate to their needs. One person was supported discreetly by staff to manage a personal care issue. In addition, we observed staff trying to engage people in discussions about the activities they had taken part in that day and what they wanted to do that evening.