Ashingdon Hall is a residential care home for up to 18 people Some of whom may be living with dementia. At the time of our inspection 16 people were using the service. Ashingdon Hall is a grade two listed building with extensive and well maintained gardens. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At the time of our inspection the registered manager had just left the service. The provider had recently appointed a day manager to oversee the day to day running of the service. Another manager who was the registered manager for another of the providers services was in the process of applying to become the registered manager. The other service was quite local and they would visit Ashingdon Hall frequently. In the report we will refer to the day manager as ‘day manager’ and the prospective registered manager as ‘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.

The service was safe and people were protected from harm. Staff were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them.

Risk assessments were thorough and personalised. However, we did identify two risks that had not been fully explored within care plans. The manager actioned this immediately and sent us the information required following the inspection. The service had just acquired an electronic care planning and scheduling system and paper care plans and risk assessments were in the process of being uploaded to the electronic system.

Staffing levels were meeting the needs of the people who used the service. Staff spoken with and records seen confirmed training had been provided to enable them to support the people with their specific needs. Recruitment practices were safe and records confirmed this.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow. Their competency was checked regularly. However, on the day of inspection the manager had identified an error and following this inspection they sent us full details of the actions they had taken.

People were supported with maintaining a balanced diet and the people who used the service chose their meals and these were provided in line with their preferences. 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.

Positive relationships were formed between staff and the people who used the service and staff demonstrated how they knew the people they cared for well. People who used the service and their relatives told us staff were caring and treated them with respect.

Care plans were detailed and contained relevant information about people who used the service and their needs such as their preferences and communication needs. Concerns and complaints were listened to and records confirmed this.

People who used the service, their relatives and staff spoke highly of the management team and told us they felt support

The Inspection took place on the 7 and 8 June 2016.

Ashingdon Hall provides accommodation and personal care without nursing for up to 18 persons some of whom may be living with dementia. At the time of our inspection 15 people were living at the service.

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.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager was up-to-date with the law regarding DoLS and made referrals appropriately.

People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were met. The service worked well with other professionals to ensure that people's health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, district nurse, mental health team and palliative care nurse.

Staff were well trained and attentive to people's needs. Staff were able to demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them at the service and in the community. These activities were diverse to meet people’s social needs. People knew how to make a complaint should they need to.

The service had a number of ways of gathering people’s views including talking with people, staff, and relatives. The manager and provider held regular meetings with people and their relatives and used questionnaires to gain feedback. The manager carried out quality monitoring to help ensure the service was running effectively and to make improvements.

We spoke with nine of the 16 people who used the service and four visiting relatives. We also spoke with the provider, the manager, and five members of staff. We looked at four people's care records. Other records viewed included recruitment files, menus, complaints and compliments and quality checks.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service our identity was checked and we were asked to sign the visitor's book. This meant that staff took appropriate actions to ensure that people were protected from others who may not have the right to access their home. People said that they felt safe and comfortable living in Ashingdon Hall. One person told us, “If I ever have anything I am not happy about I would tell the staff and they sort it out for me.”

Staff had received training in safeguarding vulnerable adults from abuse, the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant that staff had been given the information that they needed to ensure that people were cared for safely. The records showed that health and safety checks had been carried out and that any issues had been dealt with appropriately. This showed that the service was safe.

Is the service effective?

People told us that they felt that the service met their needs. One person who used the service said, “This is the best home in the area, the food is home cooked and the staff are all lovely.” Another person who used the service said, “The staff are all good and they help me when I need the help.”

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure their safety and welfare. We saw that the care records had been reviewed and updated. This meant that staff had up to date information about how to meet people's needs.

Is the service caring?

We saw good interaction between staff and people who used the service. Staff spoke to people respectfully, and they were caring and courteous in their manner. People told us that the staff were very caring. One person said, “It is lovely here, the staff care about me, they are all so nice.” Another person said, “All of the staff are lovely, they all treat me well.”

Staff had a good knowledge of people’s likes and dislikes. People told us that the staff treated them respectfully. People’s preferences and diverse needs had been recorded in their care files and care and support had been provided in accordance with their wishes. This showed that people were cared for by kind and caring staff and that their personal preferences had been met.

Is the service responsive?

People told us that they had plenty to do. One person said, “I don’t get bored as there is plenty of life in this house.” People had participated in activities both in the home and outside in the local community. People told us that staff responded to their needs appropriately.

People were supported to see other professionals such as a general practitioner, community dentist, chiropodist, optician, and district nurse. This showed that people’s general health care needs were considered and that the service was responsive to people’s changing needs.

Is the service well-led?

We saw from the records viewed that the service worked well with other agencies. Review and health records showed that the service made sure that people received their care in a joined up way. The service’s quality assurance system included regular discussions with people who used the service. This ensured that people’s changing needs and preferences were always taken into account. The service was in the process of making improvements to its quality assurance system. A new questionnaire was being devised to enable the service to capture the views of all people involved in a person’s care.

Other systems and processes such as the medication system and the care planning processes had been checked to ensure that they were still working well. There were a number of recent compliments praising the service and its staff. The complaints procedure was clear and time limited and people told us that they knew how to complain. The manager told us that the service had not received any complaints. This showed that there was an effective quality assurance system in place and that the service was well-led.

We talked with seven people using the service. They told us they felt safe living at Ashingdon Hall and that the care was good. Comments included, “Everyone’s friendly.” “Staff are lovely.” “Very good care.”

We talked with one relative of a person using the service. They told us that their relative liked living at Ashingdon Hall.

We talked with five staff who told us they felt supported in their work.

We found that the provider had reviewed their systems in place for assessing and monitoring the quality of the service. We found that some improvements were needed in relation to assessment and care planning.

People told us that they were well cared for, happy and safe at Ashingdon Hall. They told us that they were respected by staff and involved in making decisions about the care and support they received.

We saw that care and support was well planned and delivered and that risks to the health, safety and welfare of people were identified and managed.

There were sufficient staff employed at the service to meet the needs of people and staff were aware of their responsibilities to keep people safe and how to report any concerns.

There were effective arrangements for regularly assessing and improving the quality and safety of services provided at Ashingdon Hall.