Care Service Description

Ardsley House is a care home which supports up to 13 younger adults with a learning disability. The care home is just located off the motorway and near to local shops and amenities. Ardsley House At the time of our inspection there was 13 people using the service.

Rating at last inspection

At the last inspection, the service was rated Good.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People received support which was individual to their needs, and risks were minimised wherever possible. Staff received training and support from the manager which helped them be effective in their roles. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible. The service provider’s policies and systems supported this practice. We observed a relaxed atmosphere in the service, and saw people were free to decide how and where they spent their time and with whom. The home provided a separate building in the grounds where people could access arts and crafts, and support with the vegetable gardens. The registered manager ensured the quality of the service was monitored, and improvements were made when required.

Further information is in the detailed findings below.

At our inspection we gathered evidence to help us answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on observing care, speaking with people who used the service and the staff supporting them and from looking at records.

Is the service safe?

People who used the service were not protected from the risk of abuse. Before we visited the service we noted from our records there had been an increase in the number of incidents where people who used the service were abused by another person they lived with. Four of the nine people we spoke with told us they were unhappy because the behaviours of others they lived with had upset them. One person said, “There’s lots of swearing and shouting and it upsets me.” We observed people getting angry with others during our visit. Staff told us there had been an increase in incidents and this was impacting on the lives of others.

It was evident from the care records and from what we were being told people were living in a tense and often unpleasant environment. There had been a number of incidents between the same two people. We looked at one person’s care plans but there was no behaviour management plan or guidance to help staff prevent incidents recurring.

The provider had introduced systems to help ensure they acted in accordance with legal requirements where people did not have the capacity to consent. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards.

Is the service effective?

The provider supported staff to deliver care to an appropriate standard. Staff we spoke with told us everyone worked well together and they felt well supported. Training records showed that appropriate training was being delivered. This included an introduction to learning disabilities, health and safety, crisis management, basic life support, infection control, confidentiality and data protection, food safety for food handlers and level two health and social care (adults).

Staff had received an annual appraisal but they had not received regular supervision sessions with their supervisor. The provider’s supervision policy stated that staff should receive supervision every eight weeks but this had not happened.

Is the service caring?

We observed staff assisting people who used the service and saw good care being provided. It was clear from our observations that staff knew the people they were supporting very well. People were involved in daily living tasks within the home and staff assisted when appropriate. We spoke with nine people who used the service and they told us they received good support from staff.

Everyone said they had lots of opportunities to do things within the home and accessed the local and wider community. One person said, “I like going shopping with my keyworker.” Another person said, “We do arts and crafts, gardening and Zumba.

Is the service responsive?

The service sometimes responded to people’s views but this did not always happen. One person talked to us about what they wanted to do but their care plan did not reflect their wishes. Another person had requested a change in their room because it was upsetting them but this had not been actioned and there was no record of how this was followed up.

We also found that a clear assessment of people’s needs was not always carried out. One person’s daily notes showed they often got distressed and had been very unsettled. There were clear signs that the person got more distressed at specific times and with specific people. There was no risk assessment or care plan around these triggers or guidance for care delivery.

People had health action plans but these were not up to date. These should identify the actions needed to maintain and improve the health of the person. People who used the service and staff told us they received support with healthcare but we could not establish from the records if people’s healthcare needs were being properly met. One person had required some recent healthcare treatment but there was no reference to this in their health action plan.

Is the service well led?

The provider had an effective system to regularly assess and monitor the quality of the service that people received. Staff told us senior managers visited and talked to them about the service.

The registered manager discussed the various systems they had in place to monitor quality and safety. The provider was carrying out an audit at the time of our visit. We looked at a selection of reports which showed the provider had assessed and monitored the quality of service provision. The provider carried out checks to make sure the premises were safe and adequately maintained.

We spoke with seven people who used the service. Six people said they were happy with the care and support they received. One person said, “I think it’s lovely here and the staff are nice.” Another person said, "I do lots of different things." Another person told us they enjoyed going out with the staff and talking to their keyworker. One person told us their care was not appropriate to meet their needs and they could not make some decisions about their care.

In the main, people could make day to day decisions such as choosing what to wear, when to get up and go to bed and where to spend their time. People said they met with their keyworker and talked about what they wanted to do. However, we found that it was unclear why or how some decisions were made and staff did not always act in accordance with the provider’s guidelines.

The provider had effective systems to monitor the quality and safety of the premises. We looked at service records and certificates which showed the premises had been checked.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider carried out annual satisfaction surveys, which were analysed and used to help improve the service. We looked at the last survey results which showed there was a high level of satisfaction. Everyone said they felt safe, were happy about the way the service was managed and had opportunities to try new things.

We spoke with five people who used the service and one relative. People said the staff were good. The relative we spoke with said; “The staff are fantastic and very friendly.” People told us they had things to do. One person said; “I go out to coffee mornings.” Another person told us; “I go out with my key worker. We chat about what activities I want to do.” The relative we spoke with commented when she visited the home she noticed there were always activities for people to do.

Two people we asked told us they met regularly with their key worker and could input into their care record.

People told us they had chosen how their rooms were decorated and could put their own belongings in their room. Two people commented that their rooms were going to be redecorated soon and that they had chosen the colours.

People we spoke with told us they had jobs to do around their home, such as cooking, cleaning and washing, which helped people to remain independent.

People told us they felt “safe” living at Ardsley House and Cottage. We asked four people what they would do if they didn’t like something that was happening at the home. All the people knew to speak to the registered manager, general manager or any member of staff.

At our last visit to the service in May 2009 we said people who use the service were encouraged to make decisions about their lives and were involved in planning their care and support. People who live at the home said they had regular meetings called 'Your Voice' meetings where they were encouraged to 'have their say'.

The provider gave us information that showed a compliment had been received from a person who uses the service. They said,

“Thank you for all your help and support you give me over the past year”

In the home’s brochure, a person who uses the service said, “It’s a fun place to live, I enjoy the activities; I’ve always got company and someone to talk to.”

In survey results provided by the manager of the service 75% of people said their care and support was ‘good’ and 25% said it was ‘ok’.

In April 2010 we received some surveys from seven people who use the service. The comments were positive and people said they received good care.

Minutes of meetings provided by the manager show that people were asked for their choices on their Christmas meal and celebrations. The minutes said that people gave a resounding yes to ‘a traditional Christmas lunch’.

In minutes of a meeting for people who use the service they said, “We discussed easy read Safe guarding Policy and most people had an understanding of the policy those who were not sure sat with a staff member after the meeting and discussed the policy with them.”

In survey results provided by the manager of the service 75% of people said it was ‘good’ and 25% said it was ‘ok’ where they lived. Also 75% of people said their staff were ‘good’ and 25% said they were ‘ok’.

Information provided by the manager showed us that the easy read complaints policy had been discussed with people who use the service.

The inspection was unannounced and took place over two days on 13 and 27 November 2014.

At the last inspection in May 2014 we found the provider was breaching Regulation 9 and 11. The breaches related to care and welfare of people who used the service and safeguarding people from abuse. At this inspection we found the provider had made improvements and was meeting the regulations.

Ardsley House is registered to provide accommodation and personal care for up to 13 people who have learning disabilities. The service had a registered manager. 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 this inspection people we spoke with told us they were happy living at Ardsley House. Their care and support was personalised. People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Health action plans and support plans contained information which explained how people’s needs should be met.

People decided how they wanted to spend their time and enjoyed activities within the home and the community. People were involved in household tasks such as cooking and cleaning. They attended meetings where they helped plan meals and future activities.

We found people were protected from abuse. The provider had introduced robust systems to make sure people were safe which included consulting healthcare specialists who provided guidance for supporting people with behaviours that challenge. People’s safety had been assessed and risks were managed and monitored. Appropriate arrangements were in place for the safe handling of medicines.

There were enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff were skilled and experienced to meet people’s needs because they received appropriate training, supervision and appraisal.

The service had good management and leadership. The provider had a system to monitor and assess the quality of service provision. Safety checks were carried out around the service and any safety issues were reported and dealt with promptly.