This inspection took place on 9 May 2017 and was unannounced. The service provides accommodation for up to 20 older people with personal care needs. There were 14 people living at the service when we visited. All areas of the service were accessible via stairs. One flight of stairs was equipped with electric stair lift and there were lounges/dining rooms on the ground floor. There was outdoor space accessible from the ground floor, which was unavailable for use at time of inspection due to building work.

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 in January 2016, we identified a breach of regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to make improvements in the area of ensuring the mental capacity and best interests of people who lacked capacity was assessed. At this inspection, we found that improvements had been made and the provider had taken steps to meet the requirements of this regulation.

The registered manager had implemented a system to assess people’s capacity and make best interests decisions for people who were unable to consent to specific decisions around their care. The system was well embedded, with staff knowledgeable about applying the principles of The Mental Capacity Act (2005) into their daily working practice. These systems helped to protect people’s rights and freedoms. Staff understood the need to obtain consent from people before delivering care. Staff treated people with respect and dignity, with their wishes around their care arrangements at the end of their life documented to help ensure their choices were respected.

At our last inspection in January 2016, we identified a breach of regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to make improvements in the area of ensuring the premises and equipment were clean, secure, suitable for

purpose and properly maintained. At this inspection, we found that improvements had been made and the provider had taken action to meet the requirements of this regulation.

The registered manager had implemented systems and processes to ensure the service’s environment was clean and safe for people to live in. They had introduced a regular series of audits and checks to ensure that staff maintained required standards. The service was undergoing building work at the time of inspection. The registered manager regularly carried out risk assessments and management plans to ensure that the building work caused minimal disruption to people living at the service and the environment remained safe and comfortable.

The registered manager gave strong leadership to the service. People, staff and social care professionals told us the registered manager approachable, caring and operated an open door policy. The registered manager sought feedback about the service and the quality of care that staff provided. People told us they understood how to complain and felt the registered manager would take their concerns seriously.

Staffing levels were sufficient to ensure that people’s needs were met. The service followed safe recruitment processes to help ensure that suitable staff were employed to work with people. Staff received training in safeguarding and understood their responsibilities in keeping people safe from harm. Staff received effective training and ongoing supervision to help enable them to be effective in their role. People told us that staff were caring and considerate in the way they supported people and staff were motivated within their role to provide good quality compas

This inspection took place on 29 February 2016. This was an unannounced inspection. We had not inspected this service since it changed ownership in 2015.

Ashwood Rest Home provides care and accommodation for 18 older people some of whom were living with dementia. The home is situated in Shirley, Southampton and is near to the main high street with shops and restaurants.

The home did not have a registered manager: however, the provider had appointed a manager who was undergoing the process of registering with the CQC. 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.

The environment and equipment were not always clean, secure, well maintained or suitable for use. No hand washing sink was available in a toilet, which presented an infection risk. Windows were not secure or safe as they did not have restrictors fitted to stop them from being opened fully. The lift and a bathroom were out of order and in need of repair.

People’s needs were assessed and some risks were identified in people’s care plans. However, there were no risk assessments in people’s care records.

Mental Capacity Act assessments of people’s capacity to make particular decisions were not being completed on behalf of those people who did not have capacity. Records did not always show how decisions were made or why they were in the person’s best interest.

People did not have access to activities within the home as often as they would like. People and staff told us there was not enough to do and people were often left to watch television.

The provider had not regularly audited the service to assess, monitor and identify where the quality of the service could be improved. The manager was developing systems and processes to support staff and improve the quality of the service. An effective complaints procedure was in place and concerns were listened to.

All staff had received safeguarding training and knew how to identify, prevent and report abuse. The manager was aware of how to report and manage any safeguarding concerns. Recruitment practices were safe and ensured suitable staff were appointed to work with people. There were enough staff to meet people’s needs at all times. Staff received appropriate training and supervision.

Medicines were stored, administered and monitored appropriately. We observed people receiving their medicines safely. Staff received training to administer medicines and were assessed as safe to do this.

People received sufficient food and drink and could choose what they wanted to eat. People were supported to access health professionals and treatments both in the home and in the community.

People and their families felt staff treated them with kindness and compassion. People were involved in planning their care and were encouraged to remain as independent as possible. Their dignity and privacy was protected at all times.

People received personalised care from staff who were able to meet their needs. Care plans provided comprehensive information and were reviewed monthly. People and staff described a positive culture that was personalised and included people in their care.

We identified two breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.