We inspected the service on 24 November 2016. It was an unannounced inspection.

Ash Tree provides accommodation for people with learning difficulties and sensory impairments. There were five people using the service on the day of our inspection.

The service had a registered manager. 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 protected from harm and staff were clear of their role to keep people safe and protect them from abuse. There were enough staff to keep people safe. There was a recruitment policy in place which the registered manager followed. We found that all the required pre-employment checks were carried out before staff commenced work at the service.

Staff received training and support to meet the needs of the people who used the service. People received their medicines as required and medicines were managed and administered safely.

People enjoyed the meals provided and where they had dietary requirements, these were met. People were offered adequate drinks to maintain their health and wellbeing. Systems were in place to monitor the health and wellbeing of people who used the service. People’s health needs were met and when necessary, outside health professionals were contacted for support.

Risks relating to the environment and people’s conditions had been assessed and action taken to reduce the likelihood of harm.

People were supported to make decisions about the care they received. The registered manager had considered the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) by making appropriate referrals to DoLS. However where people’s mental capacity to make decisions could not be presumed assessments of their mental capacity had not been taken and decisions were not taken in people’s best interest.

People’s independence was promoted and staff encouraged people to make choices. People were supported to follow their interests and engage in activities

The registered manager had assessed the care needs of people using the service. Staff had a clear understanding of their role and how to support people who used the service as individuals. Staff knew people well and treated them with kindness and compassion.

People’s relatives and staff felt that the service was well-led. People’s opinions were sought and respected. They knew how to complain should they have needed to and felt confident that the registered manager would respond to their concerns.

The registered manager had implemented range of audit systems in place to measure the quality and care delivered so that improvements could be made. We saw that action had been taken when identified as necessary. The provider demonstrated that there was drive for improvement.