Ashford House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, both were looked at during this inspection. Ashford House provides care and accommodation for up to 10 people living with mental illnesses such as schizophrenia and learning disabilities. At the time of this inspection, there were nine people living at the home.

At our last inspection, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

People said they felt safe the service, staff and the registered manager were aware of their responsibilities for ensuring that people were kept safe and that any concerns were reported. Checks such as identity and criminal records checks continued to be carried out on new staff as part of the recruitment process. Staffing levels were suitable to meet the needs of people who used the service and were adapted when needed depending on activities and if people’s needs changed. Medicines continued to be managed safely and staff were assessed to ensure they were competent to support people to take their medicines. People said they were supported to take their medicines how they were able to.

People continued to be 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 continued to have their needs assessed and care was planned using best practice guidance. People said they were involved in reviewing their care and relatives and healthcare professionals were invited to attend reviews. People were observed making choices throughout the inspection and were supported to maintain a healthy lifestyle. Staff received training and support which allowed them to provide care to people in a safe way and allowed them to develop within their roles.

Staff were observed being kind to people and respecting their privacy, dignity and independence. People were asked for their views about the service. Staff were aware of how people communicated and were sensitive people’s individual needs regarding understanding information and were patient with people who needed more time to communicate. People told us they liked the staff and got on well with them.

People’s preferences and choices were reflected in their care plans. The service took account of people’s individuality and supported them to maintain their individual interests and spiritual beliefs. Staff were supported to learn more about people’s beliefs and how they practiced them individually. People knew how to raise concerns and were provided with information in a way they understood.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. People told us they liked the registered manager and staff and were comfortable at the service. Staff felt they were able to approach the manager and felt listened to and supported to share their opinions. Governance structures had been put in place by the provider so that information could be shared and lessons learned in the service. People and their relatives were asked for their views and action plans were put in place to address any shortfalls in the quality of the service.

Further information is in the detailed findings below.

There were eight people living in the home at the time of the visit. One person was out at day care activities. Six people that spoke with us told us that they were happy living in the home.

Comments included. “The last place I lived in I didn’t have much freedom. Here I can go out and I have loads of friends. I have hobbies and can go on Face book, its good.”

People had their needs and wishes assessed and recorded in order to ensure that the home could meet their individual needs.

Each person living in the home had a detailed plan of care in place that included people’s individual needs and wishes and also recorded people's physical and emotional healthcare needs.

The home’s staff worked with a variety of healthcare professionals including mental health and the learning disability teams. We were shown that advocates and specialist consultants were used where appropriate.

We spoke with staff and reviewed records which showed us that people were protected from abuse and their care was planned and delivered in a safe manner.

There were sufficient numbers of staff with the skills and training needed in order to meet people’s individual needs and lifestyle choices.

A person who used the service told us. “It’s alright here, it’s a nice house, the staff are friendly and I like having my own things in my room”.

People told us that they liked the home and were supported to engage in a variety of activities.

People told us that they are supported to develop their independence and they felt respected as individuals.

Staff told us that they felt that they were supported and trained to carry out their roles and meet the needs of people who use the service.

Ashford House provides care and accommodation for up to 10 people living with mental illnesses and learning difficulties. At the time of this inspection, there were nine people living at the home.

A registered manager was in post when we visited. 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 we spoke with told us they felt safe. They knew what to do if they felt they had been badly treated or if they wished to complain. Staff confirmed they been trained how to identify and report any incidents of abuse they may witness.

Any potential risks to individual people had been identified and appropriately managed.

There were sufficient numbers of staff on duty with the necessary skills and experience to meet people’s needs.

People’s medicines had been administered and managed safely.

People who were able had given consent to the care and support they received. Where they were not able the registered manager had ensured best interest decisions had been made.

The registered manager and staff understood their role in relation to the Mental Capacity Act 2005 (MCA). However staff did not fully understand how the Deprivation of Liberty Safeguards (DoLS) should be put into practice. These safeguards protect the rights of people by ensuring, if there are any restrictions to their freedom and liberty, these have been authorised by the local authority as being required to protect the person from harm. DoLS applications had been made on behalf of people who had capacity to make decisions and, therefore did not uphold people’s right to consent where they were able.

People were provided with support to access health care services in order to meet their needs.

Positive, caring relationships had been developed with staff to ensure people received the support they needed. They were encouraged to express their views and to be actively involved in making decisions about the support they received to maintain the lifestyle they have chosen.

The culture of the service was open, transparent and supportive. People and their relatives were encouraged to express their views and suggestions used by the provider to make improvements.