Ashfield House – Raunds is a residential care home for 40 older people who may have dementia. There are two floors and people with complex needs live on the upper floor. At the time of the inspection there were 33 people living at the home.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

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.

People felt safe living in the home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required to keep them safe and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job. People had risk assessments in place which identified and managed people’s known risks, and appropriate arrangements were in place to manage and store people’s medicines.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person. People were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People had their healthcare needs managed in a way that was appropriate for each person and people’s nutritional needs were well supported.

People received support from staff that treated them well and prioritised their needs. People were relaxed and comfortable around staff and staff understood the need to maintain people’s dignity. People were supported to maintain good relationships with people that were important to them and the home had good links with advocacy services to ensure people had the support they required.

Care plans described the support people required and explained people’s preferences and routines. People were given choices about how and where they spent their time and this was respected by staff. There was a complaints procedure in place and people were supported and empowered to make a complaint if they wished to. Complaints were investigated and appropriate actions were taken.

People at the home reacted positively to the manager and the culture within the home supported a warm and friendly atmosphere. Systems were in place for the home to receive and act on feedback and policies and procedures were available which reflected the care provided at the home.

This unannounced inspection took place on 15 October 2014.

Ashfield House provides accommodation for persons who require personal care (without nursing) for up to 40 older people including people living with dementia. On the day of our inspection visit 40 people were living at the home.

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 and has the legal responsibility for meeting the requirements of the law; as does the provider, 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 staff knew how to respond to behaviours that challenged the service. However risk assessments were not always in place to formally address the behaviours and the systems to review or evaluate people’s behaviour were not robust..

Systems were in place to continually assess and monitor the staffing levels and the staff recruitment systems were robust. The staff training ensured that the staff had the right skills to support people effectively.

The staff cared for people in a, respectful and professional manner. Their actions demonstrated that they knew and facilitated people’s individual care and support needs.

CQC monitors the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and reports on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that the manager had knowledge of the MCA 2005 and DoLS legislation. They knew how to make a referral for an authorisation so that people’s rights would be protected.

People were supported to be able to eat and drink sufficient amounts to meet their needs. People told us they liked the food and they were provided with a variety of meals.

People’s healthcare needs were monitored, and assistance was sought from other professionals so that they were supported to maintain their health and wellbeing.

Systems were in place to assess and monitor the quality of the service. People’s views were sought on a regular basis to identify improvements needed.

People who used the service told us that they liked living at the home. One relative told us, "The staff are fantastic they really care for the people who live here." A relative of another person who used the service told us, "I have written a letter to their head office and you can quote from that." We read the letter and it contained such quotes as “The staff, and I mean from the manager right down to the odd job man, all knew mum; they would talk, laugh and joke with her, although they did this with all the residents it always felt that it was only mum they did this with.” The letter also said “With all the bad press reports that have been hitting the media just lately I am truly grateful that my mum was in the care of such wonderful people and I feel that you at head office should recognise Ashfield House as the best in this country.”

A person who used the service we spoke with told us “I am really happy here, the staff always have time for me, I cannot praise them enough.”

We found the home to be compliant against the regulations we inspected against.

During our visit people told us that staff treated them with respect and encouraged them to make choices about their day to day life. People told us, and we heard, staff speak with them in a kind and respectful manner.

A visitor we spoke with explained how the manager had helped them come to terms with their relative entering the care home for the first time.

One relative said "I am absolutely delighted with the home, any concerns the staff sort it out everytime, it's clean and the staff are so caring."