This inspection took place on 14 March 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.Ashleigh is a residential resource that is part of a specialist Further Education College for people with autism spectrum disorder and related conditions. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The majority of people who live at the service are students at the college run by the organisation. They live in the service during term time and return home in the college holidays. The service also offers 2 adult social care placements and respite for one person.
The care home previously accommodated 18 people in one adapted building and was registered in 2011. At the time of inspection six people were using the service. The provider had recently applied to the Care Quality Commission and had re-registered to reduce the number of people who could be accommodated to a maximum of 10 people..
The provider was making changes to ensure the building complied to the model of care proposed from 2015 and 2016 guidance that people with learning disabilities and/or autism spectrum disorder which proposed smaller community based housing. The provider had reduced the numbers of people who could be accommodated at the service to 10 people. Building work was also taking place to create flats and bedsits for people who used the service. The care service had been developed and designed in line with best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism spectrum disorder using the service can live as ordinary a life as any citizen.
Due to their health conditions and complex needs not all of the people who used the service were able to share their views about the support they received.
At our last inspection in November 2015 we rated the service good. At this inspection we found the evidence supported the rating of outstanding as the caring and well-led domain exceeded the fundamental standards.
A registered manager was 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 responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
A chief executive was responsible for the running of the organisation. They supported the management team and represented their views during board meetings. Managers and staff across the organisation were encouraged to continue their professional development in order to progress and provide the best outcomes for people to facilitate this.
The chief executive and registered manager had a clear vision for the organisation and service which put people at the heart of it.
People were extremely well-cared for, relaxed and comfortable. Staff knew the people they were supporting very well and we observed that care was provided with great patience and kindness. The service went to great lengths to ensure people’s privacy and dignity were always respected. Everyone we spoke with complimented and praised the staff team and gave examples of the outstanding care that was delivered. Relative’s comments included, “Ashleigh has been providing person-centred care long before it became a buzz word.” “The care is outstanding.” “Staff go the extra mile, the staff team is well-established and they are very professional and enthusiastic” and “Ashleigh is brilliant.”
Staff were very well supported by the registered manager and senior management team. The registered manager had a clear vision for the service and its development. Staff were extremely knowledgeable about people's needs. They were enthusiastic and believed passionately in the ethos of the organisation.
Staff were highly skilled and knowledgeable about each person they cared for and they were extremely committed to making a positive difference to each person. There was clear evidence of collaborative working and excellent communication with other professionals in order to help people progress and become more independent.
The service was very flexible and adapted to people's changing needs and desires, enabling positive outcomes for all people. Records were well-personalised, up-to-date and accurately reflected people's care and support needs. Care was completely centred and tailored to each individual. Systems were in place to identify what each person wanted to achieve, and how best to support them to do this. Risk assessments were in place and they identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Positive behaviour support plans were in place that were the least restrictive to the person.
People were encouraged and supported to lead as fulfilled a life as possible. They were supported to foster their dreams and aspirations and there were several examples where staff supported people in different aspects of their lives.
People were appropriately supported in maintaining their health and they received their medicines in a safe way. They were provided with many opportunities to follow their interests and hobbies and they were introduced to new activities. They were all supported to contribute and to be part of the local community.
People were supported to have maximum control over their lives and staff supported them in the least restrictive way possible; policies and procedures supported this practice. All people were kept involved and encouraged to make decisions, whatever the level of need about their current and future living arrangements. They were involved in regular meetings about their care and the running of the home. Menus were planned with input from people, based on their personal preferences and choices.
Robust auditing and governance systems were in place to check the quality of care and to keep people safe. People were encouraged and supported to give to give their views about the service.
There was regular consultation with people. People had access to an advocate if required. A complaints procedure was available. People and relatives told us they would feel confident to speak to staff about any concerns if they needed to.
People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. There were various opportunities for staff to receive training to meet people’s care needs. A system was in place for staff to receive supervision and appraisal and there were robust recruitment processes being used when staff were employed.