We carried out an unannounced inspection of Ashmeade Residential Home on 27 and 29 March 2018. The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and we looked at both during this inspection. Ashmeade Residential Home provides accommodation and personal care in single and shared rooms for up to 18 people. Nursing care is not provided. At the time of our inspection 17 people were living at the home.

At the last inspection, the service was rated 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.

During this inspection we have made a recommendation about the management of people’s medicines. We found that one person’s allergies had not been recorded on the Medication Administration Record (MAR) and one person’s liquid medication had not been dated upon opening. The registered manager took action during the inspection to address these issues.

Records showed that staff had been recruited safely and the staff we spoke with were aware of how to safeguard adults at risk. People and their relatives told us there were always enough staff available to meet their needs.

People and their relatives told us the staff who supported them were kind and caring. They told us staff provided them with support when they needed it.

People told us staff respected their right to privacy and dignity and encouraged them to be as independent as they could be. We observed this during the inspection.

Staff received an effective induction and appropriate training. People who lived at the home and their relatives felt that staff had the knowledge and skills to meet people’s needs.

People received appropriate support with eating and drinking and their healthcare needs were met. Appropriate referrals were made to community health and social care professionals, to ensure that people’s needs were met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. Where people lacked the capacity to make decisions about their care, the service had taken appropriate action in line with the Mental Capacity Act 2005.

People told us that they received care that reflected their needs, risks and preferences and we found evidence of this. Where appropriate, relatives had been consulted about people’s care and were updated regularly by staff.

Records showed that people were supported regularly to take part in a variety of activities in the home. People living at the home and their relatives told us they were very happy with the activities available.

Staff communicated effectively with people. They supported people sensitively and did not rush them when providing care. People’s communication needs were identified and relevant support was provided, such as information in large print and braille.

The service had a registered manager in post. Relatives and staff were happy with how the service was being managed. They found the registered manager approachable and supportive. They told us any concerns were resolved quickly.

A variety of audits of quality and safety were completed by the registered manager regularly. We found the audits completed were effective in ensuring that appropriate levels of quality and safety were maintained at the service.

The registered manager regularly sought feedback from people living at the home and their relatives through residents meetings and satisfaction surveys. A high level of satisfaction had been expressed by people living at

We spoke with five ladies living in the home, a member of staff and the manager. Three ladies who were able to talk about their care and support told us they were involved in the planning of this, and agreed to the written information in their care plans. People made the following comments: "They talk to us about our care plans and we sign them", "I want to keep as independent as possible and staff know this" and "We don't have to do things we don't want to".

All the ladies we spoke with were very complimentary about the home and the staff looking after them. They felt they received a high standard of care. They made the following comments: "I've been in a few care homes and this is the best", "It's as good as it can be here, but there's always room for improvement", "The staff are really nice; they work so hard. We are well looked after".

All areas of the home we saw were clean and well maintained with no unpleasant odours. There were systems in place to ensure the environment was kept clean, hygienic and in good condition.

Staff told us there was a good system of training and support. They said the manager/owner was very supportive in all matters. We saw she and the staff were committed to providing a good service and a high standard of care.

Senior staff in the home regularly checked and monitored various aspects of the service, such as the environment, the standard of cleanliness, health and safety and progress in the Essential Standards of Quality and Safety.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes were treated with dignity and respect and whether their nutritional needs were met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service and a practising professional.

We talked with five staff and most of the people who live at the home as well as relatives. We looked at the care plans for eight out of 15 people who lived at the home to see how their needs should be met. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experiences of people.

We found that all the people who lived at the home were supported and encouraged to maintain their independence and family contacts.

People living at the home told us that they were satisfied with the food provided by the home and if they didn’t like something they could ask for an alternative and this would be provided.

On the day of our visit we saw that group activities had been arranged and people were encouraged and supported to participate. People told us that they had enjoyed a recent trip out to the ‘Trafford centre’ for a tea dance.

People living at the home told us that they felt safe at the home. They told us they had no concerns or complaints about their care but would speak with the manager or the staff if they needed to.

Records in relation to nutrition and health care needs were up to date, reviewed and were kept securely.

We carried out an unannounced inspection of Ashmeade Residential Home on 20 and 21 January 2016.

Ashmeade Residential Home provides accommodation and personal care for up to 18 older people, including people living with dementia. At the time of the inspection there were 17 people living at the service.

Bedrooms at the home are located over two floors and a lift is available. Twelve rooms are single occupancy and three rooms are shared. Nine rooms have ensuite facilities. There are two lounges and a dining room on the ground floor and all rooms have wheelchair access. There are also suitably equipped toilet and bathroom facilities on each floor.

At the time of our inspection there was a registered manager at 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.

At our last inspection on 8 August 2013, we found that all legal requirements were being met.

The people we spoke with at the home told us they felt safe. One person told us, “I always feel safe. The staff always come quickly if you need them”.

We saw evidence that staff had been recruited safely and the staff we spoke with had a good understanding of how to safeguard vulnerable adults from abuse and what action to take if they suspected abuse was taking place.

People were happy with the staffing levels at the service and during our inspection we found that staffing levels were appropriate to meet people’s needs.

There were appropriate policies and procedures in place for managing medicines and people told us they received their medicines when they should.

People were happy with the care provided at the home. One person told us, “It’s wonderful here. I’ve no complaints at all. The care couldn’t be better”.

We found that staff received appropriate support from the registered manager. They received an appropriate induction, regular supervision and could access training when they needed it.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service had taken appropriate action where people lacked the capacity to make decisions about their care.

People told us they were involved in decisions about their care. We saw evidence that where people lacked the mental capacity to make such decisions, their relatives were consulted.

The people we spoke with were happy with the food at the home and we saw that people were supported appropriately with their nutrition and hydration needs.

People were supported with their healthcare needs and were referred appropriately to a variety of health care services. Four healthcare professionals we spoke with, who visited the home regularly, were happy with the care being provided at the service.

The people we spoke with told us the staff at the service were caring and we saw staff treating people with kindness, affection and respect.

People told us staff respected their privacy and dignity and encouraged them to be independent.

People’s needs were responded to in a timely manner and we saw evidence that their needs were reviewed regularly.

A variety of activities were provided and people were encouraged to take part.

We saw evidence that the registered manager requested feedback about the service from the people living there, their relatives and from staff and used the feedback to make improvements to the service.

People living at the home and their relatives told us they felt the service was well managed and they felt able to raise any concerns with the registered manager.

We saw that the service had a clear mission statement which focused on providing people with high quality care and accommodation.

The staff and the registered manager communicated with people, their visitors and each other in a polite and professional manner.

We saw evidence that a variety of audits were completed regularly by the registered manager and were effective in ensuring that appropriate levels of care and safety at the home were achieved and maintained.