Archived: Ardington House

Ardington House is a care home which 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 15 people with personal care needs regularly accessing the service for short breaks at different times.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People had developed positive and trusting relationships with staff which kept them safe from harm or abuse. They had detailed personalised plans of care to enable staff to provide consistent care and support in line with their personal preferences. The risk management plans mitigated any risks identified to their care.

There were enough staff to support people in the way they wished, and the provider had undertaken recruitment checks which assured people were cared for by suitable staff. People were protected against the risk of infection and received their medicines on time.

People were supported to maintain good health and nutrition. Information was provided to them in an accessible format which enabled them to make decisions about their care and support. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive ways possible; the policies and systems in the service supported this practice.

People were well cared for and supported to live as full a life as possible within the community. They were enabled to pursue their interests and be involved with activities within the home and community. Staff encouraged and supported people to fulfil their aspirations and desires. They had the knowledge and skills to support people in the way they wished, respecting their individuality and encouraging them to be as independent as possible.

People and their relatives knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints received. The service had a positive ethos and an open culture. The registered manager was approachable, understood the needs of people, and listened to staff and relatives.

There were systems in place to monitor the quality of the service and drive improvements. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating for this service was Requires Improvement (published 5 February 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.

Ardington House is registered to provide accommodation and personal care support for up to five people that have learning disabilities and/or autism spectrum disorder. The service provides respite care for young people aged sixteen and above. At the time of inspection there were three people receiving respite care at the home.

The service is required to have a registered manager. There was a registered manager in post at the time of our inspection. 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.

Systems in place to monitor and improve the quality and safety of the service required strengthening. Arrangements in place to ensure that staff had sufficient skills and knowledge to provide people with appropriate support required improvement. Some staff had not been provided with timely refresher training in key areas such as safeguarding.

People’s capacity to consent to their care and support was not always assessed. People supported by the service were not able to consent to some aspects of their care. However, there was no evidence that capacity assessments had taken place and no records to demonstrate how best interest decisions had been made. Staff did demonstrate that they understood some aspects of the Mental Capacity Act 2005 and gained people’s consent when supporting them.

Recruitment practices protected people from being cared for by staff that were unsuitable to work at the service. Staff received an induction into the home and did not work with people on their own until they understood the care needs of each person.

People felt safe in the home and received safe care and support. Staff had a good understanding of their role in safeguarding people and they knew how to report concerns. Staffing levels ensured that people received the support they required at the times they needed it. People were supported to develop life and social skills and gain as much independence as possible. Their support was provided by a staff group, who shared a strong person centred ethos.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health as staff had the knowledge and skills to support them and there was access to healthcare services when needed.

Staff were committed to the work they did and had good relationships with the people who were provided with respite care in the home. People interacted in a relaxed way with staff, and people and their relatives spoke about the positive impact staying at the home made on their lives.

People and their representatives were involved in the planning of their care and felt included in discussions, being able to have their say about how their support was provided. Staff listened and respected people's views about the way they wanted their support to be delivered.

People participated in a range of activities within the service, the local community and further afield. The atmosphere was very positive and people were enthusiastic about the activities they took part in.

Staff were aware of the importance of managing complaints promptly in line with the provider’s policy. People staying at the home and staff were confident that any issues would be addressed and that if they had concerns they would be listened to. People their relatives and staff had confidence in the leadership of the provider and registered manager.