The inspection took place on 20 October 2016 and was announced. The provider was given 48 hours’ notice of the inspection. This was because the location provides a domiciliary care service. We needed to be sure that the registered manager would be available to speak with us.

Ashlands Mews provides personal care to adults with a variety of needs living in their own homes. This included people with physical disabilities, people with mental health needs and younger adults. At the time of the inspection there were six people using the service. Each person had their own flat that was based around a shared courtyard within the Ashland's complex. People were supported by staff who were based in an an office on the complex.

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 had to wait for their support at certain times during the day. This was because people did not have agreed call times and could request support when they wanted it. We found that people had often requested support at the same time and there were not enough staff available at these times. Staff had been checked for their suitability before starting work.

People were protected from the risk of harm at the service. Staff had undertaken training to recognise and respond to safeguarding concerns. They had a good understanding about what safeguarding meant and how to report it. The provider dealt with accidents and incidents appropriately and reviewed these to try and prevent reoccurrences.

Risks to people’s well-being had been assessed. For example, where people required support with using kitchen equipment, staff had training and guidance available to them.

People’s medicines were handled safely and were given to them in accordance with their prescriptions. People’s GPs and other healthcare professionals were contacted for advice when necessary.

Staff received appropriate support through an induction and supervision. Staff had received training in a range of subjects to provide and update them on safe ways of working.

People chose their own food and drink and were supported to prepare their meals. A healthy diet was encouraged. Staff supported people to contact healthcare services when required to promote their well-being.

People were supported in line with the Mental Capacity Act (2005). People's capacity to make specific decisions had been considered in their support plan. Staff told us that they sought people’s consent before delivering their support.

People received support from staff who showed kindness and compassion. They told us that dignity and privacy was protected by some staff.

People were usually supported to be as independent as they wanted to be. However people told us that they felt that some staff rushed them and did tasks for them. Staff knew people’s preferences and had involved people in planning their own support.

People knew how to make a complaint. The provider had a complaints policy in place that was available for people and their relatives. However, people had not always had their complaints responded to in line with timescales in the provider’s policy.

People had contributed to the planning and review of their support. People had support plans that had included information about their likes, dislikes and history. Staff knew how to support people based on their preferences and how they wanted to be supported.

People and staff felt the manager was approachable. The service was led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009.

Systems were in place which assessed and monitored the quality of the service. People

Ashlands Mews at the time of our visit was providing care and support to 7 people who were living within bungalows for which they had a tenancy for. The services offices are located adjacent to the bungalows. We spoke with two people who used the service; one person was accompanied by a relative. We asked people for their views about the service provided. People told us they received a good service and that staff were available 24 hours a day to provide personal care and support at a time which suited them. People told us they were supported with daily living tasks which included personal care, and shopping, cooking and household chores. People also told us that staff supported them to access the community for leisure and recreational interests.

We found the provider had robust recruitment procedures which meant people who used the service could be confident that staff had been checked as to their suitability to support and care for people who were vulnerable. Systems were in place to ensure newly recruited staff had a robust induction process which was supported by on-going training and supervision from the services registered manager.

We found that there were systems in place to monitor the quality of the service, and make improvements where required.

We spoke to one of the eight people using this service. They told us they managed their own medication. They told us staff respected their wish to maintain their independence in this area. We saw that everyone using the service had an assessment to identify whether they needed support with medicines. The provider had effective systems to protect people from risks associated with medicines.

We did not speak to people using the service about their records. We looked at care records for two people. Both people had been involved in writing and agreeing their care plans. One person had written documents for inclusion in their record. The records we looked at were accurate and up to date. The provider had systems to ensure records were properly maintained.

We spoke with five of the seven people using the service. They told us their needs were met by the service and they felt respected. One person said, “It’s excellent; the quality of care I receive.”

People were encouraged to be independent and they made decisions about their care and treatment. People told us they knew what was written in their care records. We found that these records were not reviewed in line with the provider’s policies. Up to date written information about people’s needs was not always available to care workers.

We found that care workers were trained to support people with their medicines. People told us care workers supported them properly. We found that some records were not properly completed. The provider had not always sought appropriate advice when medicines could not be administered in the prescribed way. There were not effective checks of all aspects of medicines management.

People told us they were confident that care workers who usually supported them were qualified and competent. Two people said, “The staff have been really supportive.” “I can’t fault the support I’ve received.” Some people told us some care workers did not have the right skills to support them. The registered manager had taken account of these views and did not continue to employ care workers if people were not satisfied with them.

We asked the people who use the service about the quality of the care they received at Ashlands Mews. Everybody we spoke to said the care was good. One person told us, “The staff are excellent at hoisting and I tell them if I’m comfortable or not.”

People said their individual needs were met and staff helped them to achieve their aims. One person told us they were planning a holiday and staff were assisting with this. Another said that staff helped them to look after their pet. They commented, “The staff look after my cat very well too, they help me to feed him.”

People also told us they felt safe at Ashlands Mews and knew what to do if they had any concerns. One person said, “If staff were disrespectful I would go to my key worker, then to the manager, then to head office. I’ve got the number for head office if I need it.”

We asked people what they thought of the staff who cared for them. All spoke positively about the staff. One said, “The staff are alright, they ask me if I want a shower and I can refuse if I want. They always ask me before they do things.” Another said, “The staff let me take my time and they don’t rush me.”

People told us they had a say in how Ashlands Mews was run. One person said, “We get questionnaires to fill in and the staff are always asking us if we are happy with the care.” Another commented, “The manager comes to see me and we talk about the care I get. If I wasn’t satisfied I would speak out.”