3 June 2015
During a routine inspection
Ashtead cottage is a learning disability care home, and is registered to accommodate up to 10 people some of whom are living with dementia and mental health problems. The home is a large property with ten bedrooms arranged over three floors. There were a total of 12 members of staff employed plus the registered manager. On the day of our visit there were nine people living at the home.
The inspection was unannounced and took place on the 03 June 2015.
The home had a registered manager in place. 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 requirements in the Health and Social care Act 2008 and associated regulations about the service is run.
People told us they felt safe living at the home because of the good care staff provided. Their relatives told us that the staff were caring and met their needs. Our observations confirmed this, and we found that there were systems in place to protect people from the risk of harm.
The provider had a good recruitment system in place. We found evidence that all relevant recruitment checks had been undertaken prior to staff starting work. There were enough staff with appropriate skills and experience to keep people safe.
Systems were in place to ensure that medicines were stored, administered and managed safely. We found that staff had the required training, and there were enough experienced staff to manage medicines appropriately and to meet people’s needs safely.
Staff told us they were supported by the registered manager and had received the training and information they needed to do their jobs well, and to meet people’s care needs. Staff spoke positively about the support they received from the registered manager. Staff told us there was a good level of communication within the home which helped them to be aware of any changes in people’s care needs. People and their relatives told us they could speak with the staff to raise any concerns, and they knew how to raise concerns if they needed to. A relative told us any concerns were dealt with by the registered manager in a timely manner.
The registered manager and the staff understood their responsibilities under the mental Capacity Act 2005 and the deprivation of Liberty safeguards (DoLS). There were clear records in place to show who could represent people and act in their best interest if complex decisions were needed about their care.
People and their relatives spoke positively about the service and the care people received, and we saw that staff supported people with all their nutritional needs. People had their health needs monitored, and had access to health care professionals who supported staff to meet people’s needs.
Relatives told us the care people received was good and they spoke positively about the care people received. We found that people’s care records, reviews and risk assessments were up to date. Relatives told us they were included in reviews and were notified of any changes in people’s care needs. Staff understood the needs of people and we observed that care was provided in a kind and caring manner.
Staff told us they received on-going training and understood their responsibilities, as well as the values of the service. They told us they had received training to ensure the care provided to people was safe and met their needs. Staff told us they received regular supervision and support to assist them to deliver care that was relevant to meet people’s needs. We observed that people received support around their personal care and nutritional needs.
We observed that people were encouraged to be independent and supported to take part in their hobbies and interests, such as attending various clubs in the community.
We found that the service was well led and the staff were supported by the registered manager to do their jobs well. The staff and registered manager monitored and reviewed the quality of the service from questionnaires completed by people and their relatives. They asked people and their relative’s verbal questions relating to the quality of the service on a regular basis.
The registered manager had systems in place to gain people’s views about the service. These included residents meetings to identify, plan and make improvements to the service, such as what community activities people became involved in, and what internal refurbishment plans would be undertaken. The registered manager promoted an open culture at the home, and relatives told us they felt they could approach the registered manager at any time to discuss concerns.