Ash Cottage provides accommodation and care and support for up to 24 older people, some of whom were living with dementia. The service does not provide nursing care. There were 20 people living in the home at the time of the inspection.

Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an extended converted farm cottage and provides accommodation on four floors accessed by a passenger lift.

People’s experience of using this service

People were happy about the way the home was managed and were complimentary about the registered manager and staff. The registered manager considered people’s views about the quality of care provided and used the feedback to make improvements to the service. The registered manager and the provider monitored all aspects of the service and took appropriate action to improve the service.

People told us they felt safe and staff were kind and caring. The provider had safeguarding adults' procedures and staff understood how to protect people from abuse. Recruitment processes ensured new staff were suitable to work in the home. There were sufficient numbers of staff to meet people's needs and ensure their safety. People received their medicines when they needed them from staff who had been trained and had their competency checked. The temperature and security of medicine storage areas were not appropriate. The registered manager addressed this immediately. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People were protected from the risks associated with the spread of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's care needs were assessed prior to them living in the home. Arrangements were in place to ensure new staff received induction training. Staff received ongoing training, supervision and support. The training records were not reflective of the training carried out. The registered manager provided an accurate record following the inspection. People enjoyed the meals and were supported to eat a nutritionally balanced diet. People had access to various healthcare professionals, when needed. People were happy with their bedrooms and the communal areas. We found areas of the home needed refurbishment and redecoration. Plans indicated extensive refurbishment work would be carried out from July 2019.

Staff treated people with dignity, respect care and kindness. They spoke with people in a friendly and patient manner. Staff knew people well. They knew about their backgrounds and about their routines and preferences. Whilst people received the care they needed and wanted, we found the care plans did not always fully reflect what staff knew about people's likes and dislikes; the registered manager agreed to review this in the new care planning system. People or their relatives, where appropriate, had been consulted about their care needs and had been involved in the care planning process. People’s access to a range of activities had improved recently. They told us they enjoyed the activities. People could raise any complaints or concerns if they needed to and had access to a complaints procedure.

Rating at last inspection

At the last inspection, the service was rated Requires Improvement (published 1 August 2018).

Why we inspected

This was a planned inspection based on the previous rating.

At our last inspection of July 2018, we found a breach of regulations as the quality assurance processes were not effective in identifying shortfalls. Following the inspection, the provider sent us an action plan advising how the service would be improved. During this inspection, we found sufficient improvements had been made. The registered manager was monitoring all aspects of the service and had taken appropriate action to add

We carried out an inspection of Ash Cottage on 4 and 5 July 2018. The first day was unannounced.

At our last inspection in June 2017 we found a breach of legal requirement in relation to medicines management. Following the inspection, we asked the provider to take action to make improvements and to send us an action plan. During this inspection, our findings demonstrated there had been an improvement in the management of people’s medicines.

During this inspection, our findings demonstrated there was a breach of the regulations in respect of the provider's quality monitoring systems. Following the inspection, we asked the provider to take action to make improvements and to send us an action plan.

This is the second consecutive time the service has been rated as 'Requires Improvement'.

Ash Cottage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Ash Cottage provides accommodation and care and support for up to 24 people, some of who were living with dementia. The service does not provide nursing care. There were 18 people living in the home at the time of the inspection.

Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an extended converted farm cottage first built in 1886 and has a listed status and provides accommodation on four floors accessed by a passenger lift. The gardens are well maintained with a small car park for visitors at the front of the house.

The service was managed by 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.

Whilst the quality assurance and auditing processes had identified some shortfalls that had been actioned by the registered manager, they had not been fully effective. We noted that a new system was being introduced and would help the provider and the registered manager to identify and respond to matters needing attention. We will review this at our next inspection.

There were systems to obtain people’s views of people. There was evidence that people were listened to.

People told us they felt safe in the home and they were happy with the service they received. People appeared comfortable in the company of staff. Safeguarding adults' procedures were in place however the reporting processes needed to be updated. Staff understood how to protect people from abuse. Staff treated people respectfully and their privacy was respected.

The systems in place to manage people’s medicines had improved. Staff administering medicines had been trained and supervised to do this safely.

Risks associated with the environment and with people’s health and welfare had been assessed. There was a system in place to record accidents and incidents. However, the registered manager was aware further action was needed to analyse any incidents and accidents to identify any patterns and trends and to prevent a re-occurrence.

New robust recruitment policies and procedure had been introduced to ensure new staff were suitable. Arrangements were in place to make sure staff were trained and competent. People considered there were enough staff to support them when they needed any help.

Appropriate Deprivation of Liberty Safeguard (DoLS) applications had been made to the local authority and people's mental capacity to make their own decisions had been assessed. However, additional information was needed to ensure people’s preferences were met.

People had access to activities inside the home and were supported to maintain relationships with friends and family. People told

We carried out an unannounced inspection of Ash Cottage on the 5 June 2017.

Ash Cottage provides accommodation and care and support for up to twenty people some of whom were living with dementia. The service does not provide nursing care. There were 19 people accommodated in the home at the time of the inspection. The service was registered with the Care Quality Commission (CQC) on 22 June 2016. This was the first ratings inspection since that date.

Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an extended converted farm cottage first built in 1886 and has a listed status and provides accommodation on four floors accessed by a passenger lift. The gardens are well maintained with a small car park for visitors at the front of the house.

The service was managed by 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.

During this inspection, we found one breach of the regulations in respect of medicines management. You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe and staff were caring and friendly. Safeguarding adults' procedures were in place and staff understood how to safeguard people from abuse. The registered manager and staff were observed to have positive relationships with people living in the home. People were relaxed in the company of staff and there were no restrictions placed on visiting times for friends and relatives.

We found staff were respectful to people, attentive to their needs and treated people with kindness, patience and respect. The atmosphere in the home was happy and relaxed. It was clear staff knew people well and were knowledgeable about their individual needs, preferences and personalities.

People considered there were sufficient staff to support them when they needed any help. We observed they received support in a timely and unhurried way. The recruitment process was being reviewed to ensure it was safe and fair. Arrangements were in place to make sure staff were trained and supervised.

Whilst there were some good processes in place to manage people's medicines safely we found some improvements were needed. Staff administering medicines had been trained and supervised to do this safely.

Appropriate Deprivation of Liberty Safeguard (DOLS) applications had been made to the local authority and people's mental capacity to make their own decisions had been assessed and recorded in line the requirements of the Mental Capacity Act 2005. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Each person had a care plan that was sufficiently detailed to ensure they were at the centre of their care. People’s care and support was kept under review and they were involved in decisions about their care. However, they had not been involved in formal reviews of the care plans. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs changed.

People lived in a comfortable, clean and well maintained environment. Appropriate aids and adaptations had been provided to help maintain people’s safety, independence and comfort. Some people had arranged their bedrooms as they wished and had brought personal possessions with them.

Activities were appropriate to individual needs. People told us they enjoyed the meals and were provided with a nutritionally balanced diet that catered for their dietary needs and preferences.

People were kept up to date