The inspection was carried out by one Inspector over three hours. During this time we met and talked with all of the people living in the home, and with staff on duty. The manager was present throughout the inspection and assisted us with providing documentation for us to view. We found that the manager responsible for the Regulated Activity "Accommodation for persons who require nursing or personal care" was no longer working at this service. He was now employed by the company to provide day facilities for people using the company's services. This person is named as the manager in our report as he was still registered with the Commission (CQC) as the manager at the time of our inspection. A new manager, Clair Davies, had been appointed as manager and was in the process of completing formal registration processes with CQC. She was available throughout the inspection.
We looked at the answers to five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Is the service safe?
We looked at two people's support plans and saw that they had individual risk assessments in place to identify potential risks and to show how these could be avoided or minimised. We saw that the assessments were reviewed regularly, and provided clear directions for staff to follow. This meant that there were ongoing procedures in place to maintain people's safety.
We saw that people's views on their placement were taken into account, and one person had recently stated 'I do not want to live on my own, I know I am safe at Ashlea House'.
We found that staff understood safeguarding procedures, and how to safeguard the people they supported. There were systems in place to make sure that the staff learnt from events such as accidents and incidents, complaints, concerns, and investigations. Staff had been trained in regards to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) although it had not been necessary to submit any DoLS applications.
We inspected medication management and found that there were suitable procedures in place to ensure that people received the right medicines at the right time, with the support of appropriately trained staff.
Staff training records showed that all of the staff had completed mandatory training, which included subjects such as fire awareness, moving and handling, infection control and food safety. They had also completed training in relevant subjects such as managing challenging behaviour and autism awareness. This meant that people were supported by staff with sufficient training to enable them to provide safe and effective care.
Is the service effective?
One person told us that they had moved to the service from another home within the same company, and were more settled at Ashlea House as it was a quieter environment. We saw from looking at care plans and daily reports that people were developing their life skills and were able to try out new experiences. This showed that people were receiving effective care and support that met their needs.
Is the service caring?
We saw that staff interacted well with people and knew how to relate to them and how to communicate with them. People living in the home made positive comments about the staff, with remarks such as 'I like living here, the staff are very good', and 'The manager and staff are fantastic!'
We found that the staff were constantly looking out for opportunities for people to provide them with different choices, such as work experience, and different activities. They discussed everything with people in regards to their care planning, their rooms, their interpersonal relationships, their likes and dislikes, and their hopes and fears. This meant that staff were able to get to know people well, and recognised when they were feeling unwell or upset, and knew what action to take to help them.
Is the service responsive?
On the day of the inspection a person was being supported to attend their doctor's (GP) practice due to ill health. We found that staff were quickly aware when people needed support from health or social care professionals, and arranged visits as needed.
Some people had medicines to take 'as necessary' (PRN), and the staff had clear directions on when these medicines should be given. This showed that the service was responsive to people's health needs.
We found that the staff listened to people, and took appropriate action to deal with any concerns. There was a house meeting each week when people living in the home sat together with staff and planned for the following week. This included discussing menus and agreeing meals together. People were able to change their minds about meal choices, and were able to take part in meal preparation according to how they felt on the day, and according to their individual abilities. The staff allowed people to be flexible in their choice of activities each day, even though each person had a weekly planner to provide structure to their week. This showed that the service was responsive to people's feelings, moods and behaviours.
Is the service well-led?
The company and the manager had systems in place to provide ongoing monitoring of the home. This included care plan reviews, and checks for the environment, health and safety, fire safety, staff training needs and medication audits.
We saw that people living in the home related well to the manager and staff, and respected them. They said that the staff supported them with whatever they needed. People were invited to fill in satisfaction surveys to show how they felt about living in the home. The results of these were given when they next met together, and any agreed actions were followed through.
The staff confirmed that they had individual supervision and staff meetings. This enabled them to share ideas and concerns. Staff were provided with staff surveys so that they could share their views in a written format if they wished to do so.
This showed that there were reliable systems in place to provide oversight for the service, and effective leading by the management.