This announced inspection took place on 19 and 22 November 2018. Ardington House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC (Care Quality Commission) regulates both the premises and the care provided, and both were looked at during this inspection. Ardington House provides supported short breaks to people with learning disabilities; it is registered to provide accommodation and personal care for five people. At the time of the inspection there were eight people with personal care needs regularly accessing the service for short breaks.
The 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 with learning disabilities and complex needs using the service can live as ordinary a life as any citizen.
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.
At the last comprehensive inspection in September 2017, we found the service to be rated ‘Requires Improvement’. Systems were not implemented to ensure that people's capacity to consent to their care and support was formally recorded and staff training had not been updated as required by the provider’s policies and procedures. We also found that the systems and processes in place to monitor the quality and safety of the service required strengthening and the provider had not returned a Provider Information Return (PIR) prior to the inspection.
The leadership and governance of the service had improved since the last inspection. However, this needed to be further strengthened to ensure sufficient oversight of medicines procedures, and that all required improvements were made to staff training updates and mental capacity processes. A PIR was submitted prior to this inspection.
Staff were provided with a suitable induction during which they had the opportunity to shadow experienced staff and mandatory training was provided to staff when they started work at the service. Training records showed that staff were able to access a wide variety of both mandatory training and training specific to the needs of the people they were supporting. There were regular formal updates of some training, however regular updates were still not provided for all mandatory training.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, best interest decisions were not always completed where people were found to lack mental capacity. People were encouraged to make decisions about their care, daily routines and preferences and staff worked within the principles of the Mental Capacity Act.
Appropriate policies and procedures were in place for the safe handling of medicines. However, the provider needed to ensure that staff consistently followed best practice and we have made a recommendation about medicines management.
People told us that they felt comfortable and safe when staying at Ardington House. Relatives agreed their family members were supported in a safe way by staff. Staff understood their responsibilities to keep people safe from harm and to report potential risks to their safety.
People's needs were assessed prior to them receiving the service to ensure that staff were able to fully meet their needs.
People were supported to choose their meals and staff encouraged people to have a healthy balanced diet while staying at Ardington House.
The culture of the service was caring, person centred and inclusive. Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Staff encouraged people to follow their interests and many outings and activities took place while people were staying at the service.
People that used the service and their relatives had the opportunity to comment on the quality of the support and care that was provided. Any required improvements were undertaken in response to people’s suggestions.
Care planning and risk assessments were personalised and mentioned the specific care each person required, including their likes and dislikes. Staff were aware of people's preferences, and supported people in a person-centred manner.
People were involved in their own care planning as much as they could be, and were able to contribute to the way in which they were supported. People were listened to by staff.
Staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Staffing levels ensured that people's care and support needs were safely met.
Effective systems and checks were in place to ensure the premises were safe. Staff had the appropriate personal protective equipment to perform their roles safely. Staff supported people in a way which prevented the spread of infection. The service was clean and tidy, and had a maintenance staff member regularly carry out any works required.
There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.