What life is like for people using this service:

People’s needs were assessed and known risks had been identified this ensure people were fully aware of any risks involved. However, risks arising from the laundry being left unattended and doors left open were not managed effectively. One bathrooms being used a sluice room was not secure. There were also risks to people’s health and wellbeing in the outside areas. We found many disused or broken items stored in the garden and car park adjacent to the home, that could cause harm to people.

People living at Ashleigh house felt safe and well looked after by caring compassionate staff. There were sufficient staffing levels to ensure people were cared for safely. However, people could not be assured they would be cared for in a clean environment. This was also raised at the last inspection see the full body of the report for action we have taken.

Medication was managed in a safe way and people received their medicines as prescribed. There was evidence of investigations when things went wrong and lessons learned from outcomes. Staff were fully committed to reporting incidents and concerns.

Care and support was planned and delivered to ensure people received effective care. Staff were knowledgeable about the people and their needs, but we found gaps in the training matrix. We could not tell if staff had completed any recent training or refresher training. The training matrix was not up to date.

People had sufficient to eat and drink to ensure they had a nutritious diet and were kept hydrated. Staff provided consistent care where necessary equipment was used to ensure people were independent. The home was not tailored to suit people with Dementia. Areas were not fully adapted to meet people’s needs. The outside area was accessed by a ramp, but this was not fit for purpose. There was a thorough approach to planning and coordinating care when people moved to different services. Staff worked within the principles of the Mental Capacity Act.2005.

People were treated with kindness and compassion. There was a visual person-centred culture at the home. People were treated with dignity and respect, which was reflected in all feedback we received from people and their families. Staff had sufficient time to develop relationships and friendships with people they cared for.

People’s Communication needs or information they received was not in a format suitable to their needs as required by the Accessible Information Standard.

People experienced positive impact on their health and wellbeing when participating in activities out in the community that were tailored to their needs. People knew how to raise a complaint or concern. People were confident if they had to raise concerns or complaints the manager would act upon their concerns. Staff were aware of people’s life history and preferences and they used the information to develop relationships and deliver person centred care. There were systems in place to record and plan people’s end of life care, but these plans were not required at the time of our inspection.

There was no registered manager at the service. The manager told us they were in the process of submitting their application. The registered manager left the service in July 2018. The provider did not have effective systems to monitor the quality and safety of people’s care or to ensure timely improvements were made when needed. The manager told us they had plans in place to improve the environment and implement audits and quality monitoring, but not all had been fully implemented. This was also raised at the last inspection. There was an open and transparent culture running throughout the home. The manager submitted notifications required to CQC in a timely manner. More information is in the full report

Rating at last inspection: Requires Improvement (17 August 2017)

About the service: Ashleigh House provides accommodation and personal care for

up to 24 older people in th

This inspection took place on 27 June 2017. Ashleigh House provides accommodation and personal care for up to 24 older people in the Sherwood area of Nottingham. On the day of our inspection 17 people were using the service.

At the time of our inspection there was no registered manager in post. The previous registered manager had deregistered on 1 June 2017. An acting manager was in place and the owner told us they were in the process of recruiting a registered manager. We will continue to monitor this. 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 could not be assured they would always be supported by sufficient amounts of staff or in a clean and hygienic environment. People were protected from the risk of abuse and that their medicines would be administered safely. Risks to people’s safety were assessed and acted upon.

People were supported by staff who received training to help them carry out their roles and responsibilities effectively. Plans were in place to ensure all staff were up to date with the required training. People’s right to make decisions for themselves were respected and staff acted in the best interests of those people who lacked the capacity to make their own decisions. People were supported to maintain their nutrition and healthcare.

People were cared for by staff who were caring and attentive and treated them with dignity and respect. Staff knew people well and respected their choices and preferences. People felt involved in planning their own care and had access to advocacy services if required.

People received care and support in line with their needs and preferences. People provided mixed feedback on the activities provided at the home but were supported to maintain their interests. People felt confident that any concerns or complaints they had would be responded to and records showed this to be the case.

People could not always be assured that the systems in place to monitor and improve the quality of the home were effective in identifying and addressing areas of improvement. People and staff told us the acting manager and the provider were visible, approachable and responsive to any issues. People were given the opportunity to be involved in the development of the home.

This inspection took place on 5 May 2015 and was unannounced. Ashleigh House provides accommodation and personal care for up to 19 people with or without dementia and people with physical and mental health needs. On the day of our inspection 19 people were using the service. The service is provided across two floors with a passenger lift connecting the two floors.

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 our last inspection in September 2013 we found that the provider was not meeting the legal requirements in respect of the safety and suitability of the premises. The provider sent an action plan stating what they would do to become compliant. During this inspection we found that the provider had made the required improvements. People were cared for in an environment that was well maintained and the essential safety checks were carried out.

People told us they felt safe living at the care home and were cared for by staff who knew how to protect them from the risk of abuse. People were supported by a sufficient number of staff and the provider ensured appropriate checks were carried out on staff before they started work. People received their medicines as prescribed and they were safely stored and properly recorded.

Staff were provided with the knowledge and skills to care for people effectively and were supported by the registered manager. People were asked for their consent before care was provided. The Mental Capacity Act (2005) (MCA) was being utilised to protect people when there were doubts about their capacity to make their own decisions about the care they received.

People received support from health care professionals such as their GP when needed. Staff took on board the guidance provided by healthcare professionals in order to support people to maintain good health. People had access to sufficient quantities of food and drink.

Positive and caring relationships had been developed between people and staff. People were able to be involved in the planning and reviewing of their care and made day to day decisions. People were treated with dignity and respect by staff and supported to maintain their independence.

People received care that was responsive to their needs and staff had up to date knowledge about the support people required. Although most people chose not to participate in organised activities, staff made efforts to engage with people, who were also supported to remain independent. People felt able to complain and knew how to do so. The complaints procedure was displayed and any complaints received had been appropriately responded to.

There was a positive, open and transparent culture in the home. There were different ways people could provide feedback about the service and comments people made were acted upon. There were effective systems in place to monitor the quality of the service. These resulted in improvements being made to the service where required.

We spoke with seven people who were using the service to ask if staff sought their consent before providing any care. We were told, “Yes the staff will always ask first and knock on the door and such like.” Another person said, “Staff always check with me if I need any help before doing anything.”

We spoke with two members of staff about the care and support that was provided to people using the service. Staff displayed a good understanding of the needs and current condition of people using the service.

We carried out a detailed tour of the premises. We saw that work had been carried out to improve the standard of the decor in some areas of the home. We saw that work was required to make some areas of the building and exterior safe.

During our inspection we observed that there was always a staff presence in the communal areas of the home. Staff were attentive and asked people using the service if they required any assistance. Where assistance was required this was provided in a timely manner.

We asked people if they would feel comfortable making a complaint should they need to. We were told, “I would have no hesitation, the manager is very approachable.” Another person said, “I would make a complaint if I had to. I am sure it would be dealt with properly.”

We spoke with two people who were using the service during our visit. We were told, “It’s lovely here, they really look after us. The food is good and the staff are lovely.”

We observed that changes had been made to the layout of the communal lounge area. This meant that people were able to sit in an area of their choosing and were able to watch television, listen to music or talk to others.

We spoke with two people who were using the service during our visit. We were told that the home was cleaned to an acceptable standard, “The home is clean, I see the cleaner doing vacuuming every day.”

A relative of a person using the service told us, “I am absolutely sure my relative receives all the care and support she needs, the staff are so supportive now, helpful and obliging. I know there has been a problem with staff turnover over the last few weeks but things are much better now.”

People told us that staff at the home arranged for their general practitioners to visit them when required. Records also showed that chiropodists, specialist community nurses and physiotherapist visited the home when required.

People told us they generally enjoyed the food provided at the home and commented, “The food is not bad at all, we have a nice choice at dinner time, they (care staff) always ask me what I would like to eat, they are very good, I have what I like really. I have plenty of drinks throughout the day, I enjoy a larger as well. I am always asked what I would like for breakfast, I normally have cereals followed by a nice bacon sandwich or eggs and tomatoes on toast, I had that this morning and it was lovely.”

A person using the service told us they felt safe and a visitor to the home told us, “The new manager is brilliant, I have no complaints whatsoever. If I was not happy with any aspect of the care provided here I would remove mum from the home, I have no concerns whatsoever. I have never witnessed anything that gives me any concerns. The staff are respectful, and considerate and they (care staff) respect people 100 percent, I feel people are safe.”

People told us that they were satisfied with the standard of cleanliness throughout the home. They told us that their bedrooms and the communal areas they frequent were cleaned on a regular basis.

We talked to one person about their medicines. This person told us that they received their medicines regularly and said, “This is a good care home”.

We asked a visitor to the home if they felt that staff were confident and competent in performing their duties. Comments included, “The staff are very supportive and obliging, they appear to be very good at what they do.”

People who use the service told us, and records showed that systems are in place to monitor the experiences of people who use the service.

People who use the service said they were satisfied with the standard of cleanliness throughout the home, comments included “It’s always lovely and clean, it’s like a hotel, I couldn’t wish for it to be better”, and “my room is cleaned every day”.

People also expressed satisfaction with the standard of cleanliness throughout the home, which included the lounge and dining room.

People who use the service confirmed that locks are fitted to their bedrooms to promote their privacy and safely. Comments included, “yes, I can lock my door if I want to”. People also stated that they had no concerns in relation to the standard of lighting throughout the home.