About the service:

Ailsa House Residential Care Home provides accommodation with personal care for up to 18 older people, including people living with dementia. The service does not provide nursing care. At the time of our inspection, 17 people were living at Ailsa House.

People’s experience of using this service:

People received safe care. Risks to people had been assessed and managed. Staff knew what to do to keep people safe from avoidable harm. Systems were in place for the safe management of medicines.

Recruitment systems ensured people were supported by staff who had been appropriately employed and there were enough staff to help keep people safe and ensure their care and support needs were met.

On-going training, supervision and observations of staff competence was undertaken to support staff and check they had the skills and knowledge to be competent in their job role and support people safely and effectively.

People were 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 were supported to eat and drink enough to ensure they maintained a balanced diet.

Staff supported people to access health and community care services.

Staff knew people well, and they were kind and sensitive to people’s needs and respectful of people’s privacy, dignity and independence. People received person centred care. A holistic approach was taken to assessing, planning and delivering care and support. Staff had access to up to date information and care and support was provided in line with people’s preferences and needs. There was a complaints system in place.

People had the opportunity to participate in activities, however, not everyone was happy with the activities provided. An activities coordinator had recently been recruited and improvements were planned to ensure activities were more responsive to people’s needs and wishes.

Staff embraced the provider’s visions and values to deliver a high-quality person-centred service. People were encouraged to express their views on the service they received.

There were effective quality assurance systems to monitor the service and drive continuous improvement.

Rating at last inspection:

At our last inspection in March 2018, the service was rated ‘Requires Improvement’ (report published on 14 May 2018). At that inspection, we found one breach of the Regulations. This related to safe care and treatment.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The registered provider was no longer in breach of the Regulation we identified at our last inspection. At this inspection, the service has made sufficient improvements to be rated ‘Good’.

Follow up:

We will continue to monitor this service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection was completed on the 15 and 16 March 2018 and was unannounced.

Ailsa House 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 both were looked at during this inspection. The care home accommodates up to 18 older people and people living with dementia in one building. At the time of the inspection, there were 16 people living at Ailsa House.

Ailsa House is a large detached house situated in a quiet residential area in Westcliff on Sea and close to all amenities. The premises are set out on two floors and there are 12 single and three double bedrooms. Adequate communal facilities are available for people to make use of within the service.

At the last inspection on the 14 December 2015, the service was rated ‘Good’. At this inspection, we found the service was rated ‘Requires Improvement’. This is the first time the service has been rated ‘Requires Improvement’.

Although the registered provider’s company name has recently changed in 2018 and a new registered manager appointed, the majority of staff employed at the service have remained the same. There was therefore no impact on the delivery of care for people using the service.

Our key findings across all the areas we inspected were as follows:

Improvements were required to the service’s arrangements to assess and monitor the quality of the service. The quality assurance arrangements had failed to identify the issues we found during our inspection to help drive and make all of the necessary improvements.

Some aspects of medicines management required further development to ensure people received their medication as they should and in line with the prescriber’s instructions. Not all staff who administered medication had up-to-date medication training. Staff recruitment practices required strengthening as these were not robust and not all newly employed staff had received an appropriate induction.

People were protected from abuse and avoidable harm. People living at the service confirmed they were kept safe and had no concerns about their safety and wellbeing. Policies and procedures were being followed by staff to safeguard people.

Risks to people were identified and managed to prevent people from receiving unsafe care and support. Minor improvements were required to ensure these clearly recorded how risks to people were to be mitigated. People were protected by the provider’s arrangements for the prevention and control of infection. Arrangements were in place for learning and making improvements when things go wrong.

People were treated with care, kindness, dignity and respect. People received a good level of care and support that met their needs and preferences. Support plans were in place to reflect how people would like to receive their care and support, and covered all aspects of a person's individual circumstances. Staff had a good knowledge and understanding of people’s specific care and support needs and how they wished to be cared for and supported. Social activities were available for people to enjoy and experience.

Comments about staffing levels from people using the service and staff were positive. The deployment of staff across the service was observed to be appropriate and there were sufficient staff available to meet people’s needs to an appropriate standard at all times.

People’s nutritional and hydration needs were met and they received appropriate healthcare support as and when needed from a variety of professionals and services. The service worked together with other organisations to ensure people received coordinated care and support.

Staff understood and had a good knowledge of the Deprivation of Liberty Safeguards [DoLS] and the key requirements of the Mental Capacity Act [2005]. Suitable arrangements had been made to ensure that people’s rights and liberties were not re