Ashleigh House

Updated 8 July 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Ashleigh 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 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

This inspection was unannounced.

What we did before the inspection

We reviewed all information we had received about the service since the last inspection. This included the feedback received from our partner agencies, complaints and statutory notifications that had been submitted since the last inspection. Notifications are changes, events and incidents that the service must inform us about.

Since the new registered manager took over the running of Ashleigh House in January 2021, we have had regular online meetings with them as part of our ongoing monitoring of the service. We used the information shared in these meetings to help us to plan this inspection.

We also 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

We met with seven people who used the service and observed the care that was provided to them. We spoke with seven members of staff, including the registered manager. We reviewed a range of records. This included the care plans for three people and documents relating to medicines. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including incidents and accidents and audits were also viewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We also spoke on the telephone with five relatives of people living at Ashleigh House and received written feedback from other professionals who had regular involvement with the service. On 24 May 2021 we had a video call with the registered manager provide feedback and discuss our inspection findings.

Updated 8 July 2021

About the service

Ashleigh House provides accommodation and personal care for people with a learning disability and autistic people. The service is registered to support up to nine people, there were eight people living at Ashleigh House at the time of our inspection. The new management team were continuing to take steps to create a more domestic and homely feel.

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

Since the last inspection, staffing levels had significantly increased to enable people to be supported in a more person-centred way. People were better 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 now supported this practice. The provider needs to continue to take steps to embed and sustain these improvements. Please see the Effective, Responsive and Well-Led sections of this full report which identify how the service needs to continue to develop.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The new registered manager was continuing to develop and improve the quality of support against their own action plan since taking over the running of the service. The outcomes for people were continuing to better reflect the principles of this guidance of providing; right support, right care, and right culture. The registered manager demonstrated a good understanding about what further action was required to further improve people’s support. In order to embed and sustain improvements we have made a recommendation that the provider seeks support from a reputable source in respect of developing the strategic and independent monitoring of the service.

Right support:

• Model of care and setting maximises people’s choice, control and independence

The registered manager was continuing to coach and mentor staff to develop their understanding of people’s needs and support them in a more personalised way. Staffing levels had been significantly increased across both day and night and this had improved both the quality and safety of people’s lives.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights

Care was continuing to become more person-centred and better promoted people’s dignity, privacy and human rights. People’s individual needs were now recognised, and diversity celebrated. Staff had a better understanding about people’s emotional needs and the link between their anxiety and behaviours.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

The new registered manager had continued the creating a more open and transparent culture which promoted learning from incidents and accidents through the process of reflective practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last comprehensive inspection rated the service as Inadequate (reported published 7 May 2020) and there were multiple breaches of regulation. We carried out a focused inspection (report published 16 October 2020) where we found the management team had made improvements to the service in line with their action plan. A further targeted inspection (report published 21 January 2021) confirmed these improvements were ongoing.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since May 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as Inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on actions that the provider told us had been taken to improve the service.

The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.

Follow up

We will continue to work alongside the provider and local authority to monitor their progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.