This inspection took place on 09 June 2017 and was unannounced. We previously inspected the service in July 2016 and found that the service required improvement in some areas. At this inspection, we identified positive developments at the home although we found that some systems required further improvement in order to sustain the quality and safety of the service provided.

Ash House is a residential home which provides support to people who have learning disabilities, autistic spectrum disorders and mental health issues. The service offers support for up to six young adults who are in transition from children’s services. At the time of our inspection, there were six male young adults living at the home.

There was a registered manager in place who was present throughout our inspection. 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 showed that they were at ease around staff and one another, and relatives we spoke with told us they felt that people were safe living at the home. Staff we spoke with were aware of how to recognise and report safeguarding concerns. People were supported by staff who had access to clear guidance about how to manage their risks.

People were supported by enough staff. Recruitment processes had been followed appropriately to help ensure that people were supported by staff who were suitable. People’s medicines were stored safely and records relating to this support were clear.

We saw that staff understood people’s needs, relatives we spoke with confirmed this. Staff received support and guidance to aid their development in the role. Staff understood the principles of the Mental Capacity Act (2005), however the processes at the home had not been developed in line with these principles.

People enjoyed their meals at the home and staff were aware of the need to promote a healthy, balanced diet. People were supported to access further healthcare support when needed.

People were treated with respect and dignity by staff who were kind and caring. Our discussions with staff and relatives confirmed this. People and their relatives were involved in care planning. People’s care records provided guidance about how to meet and respect people’s needs.

People were supported to participate in activities of interest to them at home and in the community. Relatives told us that they felt able to raise concerns, although the registered manager had not always provided clarity to ensure that people and staff understood how to raise concerns, and how their concerns would be addressed.

Relatives and staff spoke positively about the home. Staff were engaged and motivated in their roles. Records were not always robust and did not always demonstrate the quality and safety of the service. The registered manager had not always fully addressed feedback to provide confidence in the leadership and to ensure that people and relatives were involved in the running of the home as far as possible. Areas of improvements that had been identified through ongoing quality assurance processes were being addressed.

This inspection took place on 17 May 2016 and was unannounced. This was the first inspection the home has had after registering with the Commission in March 2015.

Ash House is a residential home which provides support to people who have learning disabilities, autism spectrum disorders and mental health issues. They offer support to young people who are in transition from children’s services. The home is registered with the Commission to provide care for up to six people. At the time of our inspection there were six people living at the home.

There was a registered manager in post who was not available on the day of the inspection. 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 and associated Regulations about how the service is run. During the inspection we spoke with the deputy manager.

We saw that people were comfortable around staff and with the support they were receiving. People had opportunities to participate in a range of activities staff knew they enjoyed. People were supported to maintain relationships which were important to them.

Relatives told us that they were happy with the care provided at Ash House, one relative said, “It is wonderful to see such progress and to know [my relative] is in a safe and loving environment.” Staff were aware of the need to keep people safe and the provider conducted checks to ensure people were supported by staff who were suitable. The storage, administration and recording of medication was good and there were systems for checking that medication had been administered in the correct way. The process for making sure people received their ‘as required’ or PRN medication was not robust.

People were supported to express their preferences. When the support people received risked restricting their freedom, the registered manager had supported people in line with the appropriate legislation. Some people were subject to restraint that was carried out in an appropriate manner but not well documented. Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills.

People were supported to have their healthcare needs met and were encouraged to maintain a healthy lifestyle. The registered manager sought and took advice from relevant health professionals when needed.

People were provided with a good choice of food in sufficient quantities and were supported to eat meals which met their nutritional needs as well as their personal or cultural preferences.

Staff understood the needs of the people they supported and the importance of providing care which was person centred. We saw that they were kind and considerate with people. We noted that staff communicated well with each other about the care and support needs of people. The provider had not checked how effective their monitoring process had been in maintaining or driving up standards of care.