The inspection took place on 12 December 2017 and was announced.

Ashdown Close is a ‘care home’ for two people with autism. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The property is situated in a residential area, close to public transport links, shops and other community facilities. There were two people living in the home at the time of the inspection.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good. The service met all relevant fundamental standards.

People living at Ashdown Close were not able to tell us whether they felt safe living at the home. However, we found the provider had robust measures in place to ensure people were safe.

Medicines were managed safely and people received their medicines as prescribed.

Staff had been trained to administer medicines in order to ensure errors were kept to a minimum.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff were recruited, trained and supported to ensure they had the right attributes and skills to offer effective care to the people living at Ashdown Close. Staff received a programme of mandatory training, which was updated as required. There was sufficient staff on duty to meet people's needs.

The home was well maintained and in good decorative order. Measures were in place to ensure the environment was safe and suitable for the people who lived there.

People's needs were assessed prior to their admission to the home. Care plans were completed to demonstrate the support required. Referrals were made to health care professionals when changes in health care needs were identified.

People are 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.

The staff showed kindness towards the people in the home. The people who lived at Ashdown Close used non-verbal communication. Each person's ways of communicating had been recorded.

People were supported to maintain their independence with activities of daily living (personal care, laundry, shopping). People accessed community services such as pubs for lunch, swimming pools, walking groups, visits to parks and shops.

People received personalised care that was responsive to their needs. Care plans were written for the individual and informed staff of their preferences and wishes.

The provider had a complaints policy in place but no complaints had been received.

We found there to be a person-centred and open culture in the home. Staff reported that managers were "easy to approach" and "very supportive".

There was a manager in post who had applied to the Commission to become the registered manager. Their application was on-going. 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.

Quality assurance and governance processes were in place to assess the safety and quality of the service. The Care Quality Commission (CQC) had been notified of events and incidents that occurred in the home in accordance with our statutory notifications. The rating from the previous inspection of Ashdown Close was displayed in the office; a more visible location in the home is preferable.

The inspection took place on 5 August 2015 and was announced.

Ashdown Close is a detached property in Southport which can accommodate up to two people with autism. The property is situated in a residential area, close to public transport links, shops and other community facilities.

Two people were living at the home at the time of the inspection. One person was present during the inspection.

There was no registered manager in post as they had left some months prior to 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 2008 and associated Regulations about how the service is run. A new manager was in post and was in the process of applying with the Care Quality Commission for the position of registered manager.

People were kept safe because there were arrangements in place to protect them from the risk of abuse. Staff understood what abuse was and the action to take if they should have to report concerns or actual abuse.

The manager advised us that people needed staff support to make decisions about their daily life and care needs. This was in accordance with the Mental Capacity Act (MCA) (2005) Code of Practice.

Staff obtained people’s consent prior to assisting them and encouraged people to maintain their independence.

Medication was stored safely and securely. Staff had completed training in medication administration. The manager told us practical competency assessments were to be introduced with staff to ensure they were administering medication safely. The systems we saw ensured people received their medications safely.

People’s nutritional needs were monitored by the staff. Menus were available and people’s dietary requirements and preferences were taken into account.

Each person who lived at the home had a person centred plan. The plans we looked at contained relevant and detailed information. This helped to ensure staff had the information they needed to support people in the correct way and respect their wishes, their likes and dislikes.

A range of risk assessments had been undertaken depending on people’s individual needs to reduce the risk of harm. Risk assessments and behavioural management plans were in place for people who presented with behaviour that challenges. These risk assessments and behavioural management plans gave staff guidance to keep themselves and people who lived in the home safe, whilst in the home and when out in the community.

Sufficient numbers of staff were employed to provide care and support to help keep people safe and to offer support in accordance with individual need. This enabled people to take part in regular activities both at home and in the community when they wished to. We saw the staff rotas which confirmed this.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff were only able to start work at the home when the provider had received satisfactory pre-employment checks.

Staff received an induction and regular mandatory (required) training to update their practice and knowledge. Records showed us that staff were up-to-date with the training. This helped to ensure that they had the skills and knowledge to meet people’s needs. Staff told us they felt supported in their roles and responsibilities.

Staff had good knowledge of people’s likes and dislikes in respect of food and drinks and people’s routines in respect of meal times. We saw that people who lived in the home had plenty to eat and drink during our inspection.

People at the home were supported by the staff and external health care professionals to maintain their health and wellbeing.

People who lived in the home took part in a variety of activities both in the home and in the community. Some people attended a day centre or college placement.

During our visit we observed staff supported people in a caring manner and treat people with dignity and respect. Staff understood people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people.

A procedure was in place for managing complaints and family members we spoke with were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with the home’s complaints procedure.

The temporary manager was applying for registration with the Commission. We found they provided an effective lead in the home and was supported by a clear management structure.

Systems were in place to check on the quality of the service and ensure improvements were made. This included carrying out regular audits on areas of practice.

We looked around the building. We found it was clean and well maintained. Staff had a rota in place to ensure cleaning was completed daily.

The two people who use the service could not tell us about their experiences of using it or comment about the care and support they received, due to a variety of complex needs. On the day of our inspection they were not at home as they were attending their day time activities.

We spoke to their relatives to gather their views and experiences of the service. Some of their comments included: “Staff understand my relative’s needs. They have helped them develop their skills”, “They have become more independent since moving into Ashdown Close” and “I am always kept informed of their health appointments and the outcome.”

We looked at the care records and found they contained all of the relevant documents to support a person safely. We looked at the policies and procedures kept at the home.

On checking medication management we found that people received their medicines as prescribed. Records regarding medication were completed correctly.

We spoke with the Registered Manager, the home’s Link Manager and one support staff employed at the home.

The home took account of people’s status in terms of decision making and worked closely with people, their families and external professionals. We saw that staff used pictures and symbols to support people in understanding information and making choices.

We looked at the care records for the people living in the home and we saw that up to date and person centred care plans were in place which supported staff to be able to deliver the care required. We found that assessments and care plans were reviewed regularly with formal annual reviews in place to monitor progress and meet the changing needs of people.

The staff we spoke to were knowledgeable about how they would identify abuse and described appropriate actions they would take if they had any concerns. Safeguarding was listed on the induction programme for all new staff and was included in the list of mandatory training.

During our visit we saw that the home had systems in place to support staff to be suitably skilled to meet people's needs. We spoke with a member of staff who had recently begun working in the home and they told us how they had been supported to deliver care through a comprehensive 12 week induction programme. Staff we spoke with told us they had good access to training to help them carry out their work.

The home had accurate and up to date records in place regarding the care and treatment of people using the service and related to the running of the home.

When writing our inspection reports we generally include the views and comments of the people using the service. This ensures we are reflecting their experiences and the support they receive. Due to the different ways that the people living at Ashdown Close communicate we were not able to directly ask them their views on the support they received.

However, during our visit we met with people living there. We spent time observing the support they received from staff with their everyday lives and how they chose to spend their time at home. We have taken this information into account in writing this report.