This inspection took place on 10 January 2018 and was unannounced. At our last inspection in January 2016, we found the provider was meeting the regulations we inspected and the service was rated "Good". At this inspection, we found that the service continued to be rated "Good".

Ashling House is a care home. People receive accommodation and personal care support as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Ashling House is registered to accommodate 14 older people in one building. Ten people were using the service at the time of inspection.

The provider of the service is an individual who is responsible for the day-to-day management of the service. Therefore they are not required to have a separate registered manager. The provider is the registered manager of the service. 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 continued to receive safe care. There were enough staff to meet people's needs. Staff were appropriately recruited. Sufficient numbers of staff were available to provide care and support to meet people's needs. People were protected from the risk of harm and appropriate risk assessments were in place to provide safe care. People received their prescribed medicines from competent staff who were trained to administer medicines safely.

The care that people received continued to be effective. Staff had access to support, supervision, training and on-going professional development that they required to work effectively in their roles. People were able to see healthcare professionals, such as GPs, when needed and were supported to maintain good health and nutrition.

People continued to receive safe care. There were enough staff to meet people's needs. Staff were appropriately recruited. Sufficient staff were available to provide care and support to meet people's needs. People were protected from the risk of harm and appropriate risk assessments were in place to provide safe care. People received their prescribed medicines from competent staff who were trained to administer medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on going professional development they required to work effectively in their roles. People had access to healthcare professionals as needed and were supported to maintain good health and nutrition.

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. The staff demonstrated good knowledge of people's care needs, significant people and events in their lives as well as their daily routines and preferences. Therefore, people continued to receive care and support that was responsive to their needs.

People and their relatives felt staff were kind and caring. Staff supported people to maintain their independence and respected their privacy and dignity. People were supported to take part in activities based on their own interests.

People, relatives and staff felt the service was well run and the registered manager was approachable. The registered manager worked well with other organisations to ensure people received the care and support they needed.

The registered manager had systems in place to monitor the quality of the service provided to people. People and their representatives were able to raise concerns or complaints if they needed to and felt these were listened to and acted upon.

Further information is in the detailed findings below.

This unannounced inspection took place on 6 January 2016. At our last inspection in February 2014 the service met the regulations we inspected.

Ashling House is registered to provide accommodation and personal care to 14 older people some of whom have dementia. The inspection was carried out by one inspector. At the time of our inspection 11 people were using the service.

People lived in a large detached house in a residential area. All the rooms were well decorated and personalised according to people’s individual taste. The ground floor and garden were accessible to people with mobility difficulties. There was a lift.

The provider of the service is an individual who is responsible for the day-to-day management of the service. Therefore they are not required to have a separate manager. The provider is the registered manager of the service. They have another service nearby which they are also registered to manage. 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 were safe at the service and were cared for by staff who were knowledgeable about safeguarding people. They knew how to report concerns. Medicines at the home were managed safely by competent staff.

The recruitment process was robust to make sure that the right staff were recruited to keep people safe. Staff personnel records showed that appropriate checks were carried out before they began working at the home. There were sufficient qualified and experienced staff to meet people’s needs.

The care plans we looked at included risk assessments which identified any risk associated with people’s care and guided staff about how to minimise these in order to keep people safe.

The manager and staff understood the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff received the support and training they needed to provide an effective service that met people’s needs. The staffing levels were flexible to support with planned activities.

People were provided with a balanced diet and sufficient food and drink to promote their health and wellbeing.

People were supported to see healthcare professionals in order to ensure their general health and wellbeing were maintained.

People were looked after by staff who were caring, compassionate and promoted their privacy and dignity.

People were supported to maintain links with the wider community. They were also supported and encouraged to maintain relationships with family members, who were able to visit them when they wished.

People and their representatives were involved in drawing up care plans which were based upon their individual needs and wishes. Care plans contained detailed information about people’s health needs, preferences and personal history.

There were effective systems in place for responding to complaints and people and their relatives were made aware of the complaints processes.

Quality assurance systems were in place and were used to obtain feedback, monitor service performance and manage risks.

The service was providing care to ten older people. We spoke with four people during the inspection. People using the service said they were happy at the home. One person said, "it's a good home - definitely the best in Hornchurch." People told us they could choose what to do, they liked the staff and enjoyed the activities on offer at the home. The provider assessed people's individual needs and preferences to ensure their care was safe and people's rights were protected.

The home provided support for people with medicines and used a 'monitored dose system'. This meant that people's regular prescriptions were provided in pre-packed capsules to reduce the risk of errors. Staff were trained on managing medicines safely in the home. We saw that the home kept accurate records and audited the way that medicines were administered, stored and stocked.

There were enough staff to meet people's needs. Staff were well qualified and trained for their roles. The home kept accurate and up-to-date records about people's needs and the care they received.

People we spoke with expressed satisfaction with the level of care and support provided at the home. One person said "I am quite satisfied with the attention I get." We saw care plans and risk assessments were in place for people, and that people had access to health care professionals. People told us they were happy with the food, comments included ""it's the kind of food I would cook for myself” and “by and large the food is very good." We saw that people were supported to eat their meals where necessary, and that people were offered a choice of meals.

The physical environment was homely in appearance, and we saw that people could move freely around communal areas. Steps had being taken to ensure the environment was safe, such as testing fire alarms and gas appliances. We found that staff had a good understanding of how to support people. Pre-employment checks were carried out before people could work at the service. These included employment references and Criminal Records Bureau checks. We found that the service had a complaints procedure in place, and people were give a copy of this.

People told us that they were happy with the care they received and felt they had all the home comforts they needed.

People said they had a choice about some things such as what they ate and what time they got up or went to bed. However some people told us that some of the routines in the home were inflexible such as meal times and not having the TV on in the lounge before 4pm. The manager said that people who use services were encouraged to participate with the daily activities of the home or activities of their own choice. Where people wished to watch TV before 4pm, they could do so in their own bedroom.

There was a house cat which people told us they enjoyed having in the home.

Visitors told us that they thought their relatives were well cared for and were treated with respect.