About the service:

• Ashfield Care Home limited (99 Ashley Road) is a care home for people with a learning and/or physical disability. The home is registered to provide accommodation and personal care for up to 10 people. At the time of our inspection there were six people living at the home.

People’s experience of using this service:

• People told us they felt safe living at Ashfield Care Home. Relatives told us they found Ashfield Care Home provided a safe place for their relative to live and had no concerns.

• People had individual risk assessments completed which ensured they were supported to live their lives as independently as possible while minimising any identified risks.

• People received care and support in an individualised way, which was planned and delivered to meet their needs.

• Ashfield Care Home was staffed with sufficient levels of trained staff who were themselves supported with a system of regular supervision and annual appraisals. Staff felt supported and commented positively on the training they received.

• People’s medicines were being managed safely, stored securely and administered by trained staff.

• We have made a recommendation regarding the upkeep of the premises to ensure infection control risks are minimised.

• People and their relatives were fully involved in assessing and planning the care and support they received. People were referred to health care professionals as required.

• People were supported to maintain and increase their independence. People were supported to access the community and trips to places of interest each day. People’s privacy was protected and they were treated with dignity and respect.

• People and relatives knew how to make a complaint and felt confident they would be listened to if they needed to raise any concerns.

• Relatives expressed confidence in the management team and felt the service was well led.

• More information in Detailed Findings below.

Rating at last inspection: Good (The date the last report was published was 8 September 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remains rated as Good overall.

Follow up: We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated as Good.

We inspected Ashfield Care Homes Limited (99 Ashley Road) on 26 July 2016. This was an unannounced inspection.

Ashfield Care Homes Limited (99 Ashley Road) is a care home for people with a learning and/or physical disability. The home is registered to provide accommodation and personal care for up to ten people. At the time of our inspection there were six people living there. The home is set in well maintained gardens and consists of a main house with a large lounge and dining room. The house and gardens are accessible for people who use a wheelchair.

The service had a registered manager 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. The registered manager also managed another small home which was a short distance away on Ashley Road.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005, which applies to care homes. The registered manager did not fully understand how to implement this legislation and had begun to address this during the inspection.

Staff supervision and appraisals had not taken place regularly although staff told us they felt supported with on-going training and were involved in the development of the home. The provider operated safe recruitment and retention processes. Relevant checks were carried out before staff were employed.

People were protected from possible harm. Staff understood the home’s safeguarding and whistle blowing procedures and who to contact if they had any concerns.

People told us they felt safe. There were sufficient staff deployed to provide person centred care and keep people safe.

There were systems in place to manage, record and administer medicines safely. Staff had a good knowledge of people’s medicines and received regular training to maintain their competency.

Risks relating to people and the environment were assessed and managed. There were systems in place to report repairs and maintain the premises.

People received personalised care, in line with their needs and preferences. People were supported to maintain their health. Specialist medical advice, treatment and support was sought promptly when required, including GPs, speech and language therapists and behavioural support specialists.

Staff interacted positively with people and were caring and kind and respected their dignity. Staff encouraged people to maintain their independence, to make decisions and to have as much control over their lives as possible.

People were offered a choice of drinks and meals, prepared in a way that met their specific needs. Important information, such as their likes and dislikes and allergies, was known by staff who assisted and encouraged people to eat if they needed help.

Staff seemed to know people well and had time to sit and chat about things that were important to them. Activities took place daily both within the home and in the community.

There was an open culture and a clear management structure within the home. People living at the home, their relatives and health care professionals were complimentary about the management of the home.

Quality assurance systems were in place to assess and monitor the quality of care and drive improvements. Incidents and accidents were recorded and trends identified for learning and minimising future incidents. Records were well maintained and regularly reviewed.

We last inspected the home in December 2013 when we found no concerns.

The registered manager was on annual leave on the day of our inspection and so we were assisted throughout this inspection by the home’s deputy manager. At the time of the inspection there were six people living at the home, most of whom had lived at the home for many years. We were introduced to everyone who lived at the home and spoke with three people about their experience of living at the home. We also spoke with three members of staff who were on duty at the home that day.

We found that people’s needs had been comprehensively assessed when they were admitted to the home. Care plans had been developed from these assessments to inform staff about how people should be supported.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Staff were appropriately supported to carry out their duties through regular one to one supervision sessions, annual appraisals and through day to day supervision of practice.

The home had systems in place to make sure that the quality of service was monitored.

The people who lived at the home seemed at ease with the staff and told us that they enjoyed living at the home. No one raised any concerns about the way they were cared for and supported.

People who use the service were given appropriate information and support regarding their care and treatment. We saw evidence of this in the people's care plans, meetings with people using the service and displayed around the home.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans included up to date risk assessments that addressed the individual needs of people using the service. People told us that they were supported in promoting their independence and community involvement and that they enjoyed a variety of activities inside their home and in the community.

People were provided with a choice of suitable and nutritious food and drink. We saw evidence of discussions with people about their likes and dislikes and food preferences.

There were enough qualified, skilled and experienced staff to meet people’s needs. Staff training records that we looked at showed us that staff had regular and up to date training.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. Quality assurance surveys that we looked at showed us that people who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

Discussions with staff showed us that people's privacy and dignity was maintained and respected.

People told us they were treated well by staff. People said they liked living at 99 Ashley Road and staff provided good support.