About the service: Ashwood House provides accommodation, care and support for up to seven people with a learning disability. The service is situated in the village of Buxton. There were seven people living at the service on the day of inspection.

People’s experience of using this service:

¿ People and their relatives made positive comments about the care provided at Ashwood House. Comments included, “I have peace of mind as [person] is totally looked after. I can’t express how happy I am with the care,” and, “I am quite happy with it all.” One person said, “It’s my home. I like living here.”

¿ People received care and support from a stable staff team who knew them extremely well.

¿ Care was delivered in a person-centred way based on people’s preferences.

¿ Staff encouraged people to be as independent as possible.

¿ Risks people were exposed to were assessed and measures were put in place to minimise them.

¿ People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way.

¿ People were involved in their care and support and staff respected their privacy and dignity.

¿ Staff had a good understanding of people’s needs, preferences, histories, and routines.

¿ People received appropriate support to maintain their health and to achieve good health outcomes.

¿ Opportunities were offered and enabled people to take part in a wide range of activities which met their individual choice and preferences. This enabled people to achieve positive outcomes and a good quality of life.

¿ Staff felt listened to and valued and they felt involved in the development of the service.

¿ The service was well managed and systems were in place to check the quality of the care provided.

Rating at last inspection: Good (report published 12 April 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Ashwood House is a service that provides accommodation for up to seven people. It offers residential care for adults with a learning disability, autistic spectrum, people who have been detained under the Mental Health Act 1983, people with mental health issues, sensory impairment and people with a physical disability. On the day of our inspection seven people were permanently living in the service. This inspection took place on 2 March 2016 and was unannounced.

The service had a registered manager (‘the manager’) in post. 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 living in the service were safe and benefited from the support of sufficient numbers of staff, who were well trained, supported and felt valued in their work.

Staff and the management team understood their responsibilities in safeguarding people from harm. When appropriate they contacted the local authority to report concerns. The home knew how to support people’s needs without restricting their freedom.

Appropriate recruitment procedures were followed and pre-employment checks were carried out to ensure staff were suitable to work with people receiving care and support. There was a robust induction programme for new staff.

Medicines were managed and administered safely in the home and people received their medicines as the prescriber had intended.

Staff were skilled and motivated to support and care for people. Staff also knew people and their needs well. All staff received appropriate training and were supported well by the manager.

The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The manager told us that some people living in the home did not have capacity to make certain decisions for themselves. The manager had appropriately made DoLS referrals to the local authority because they were restricting some people’s freedoms in order to keep them safe.

People had enough to eat and drink and the staff who prepared food provided good quality food and catered for individual preferences. People also had access to the community on a daily basis and often had meals out.

People had regular access to healthcare professionals and were supported to attend appointments. Staff managed people’s health appointments and made appropriate health and social care referrals.

All staff at the service were caring and supportive and treated people as individuals. The care provided was sensitive and person centred and people’s privacy, dignity and wishes were consistently respected. Friends and relatives were welcome to visit as and when they wished and people were supported to be as independent as possible.

People appeared happy living in Ashwood House and their interests were encouraged and supported by staff. There was a positive atmosphere in the service and people were supported to have regular access to the community if they wanted to. People were also involved in planning their care.

There was an open and positive culture at Ashwood House. People using the service and their relatives were given opportunities to raise issues about the quality of the care provided. Relatives knew how to make a complaint if needed.

The service was being well run and people’s needs were being met appropriately. The manager was approachable and communication between the manager and staff was frequent and effective.

There were a number of systems in place to ensure the quality of the service was regularly monitored and maintained. The provider carried out regular audits to identify areas that needed improvement and an action plan was put in place for the manager

As well as speaking with people, we used a number of different methods to help us understand the experiences of people, such as looking at records, speaking with staff and observations.

One person animatedly told us that they had had a “…good day…” and indicated that they had been for a drive out. By their gestures and facial expressions, we could see that this was something they had enjoyed.

The people we observed during this inspection were content and relaxed and the interactions we witnessed between staff and people living in the home were consistently warm, friendly and engaging.

There were policies in place to safeguard people living in this home and the manager had kept the Care Quality Commission informed of any notifiable incidents or safeguarding concerns.

We observed that medication was stored securely in a lockable trolley, with a designated member of staff holding the keys.

When we asked people questions about the staff, we received positive responses either by them saying, “yes” or by nodding, smiling and giving us a ‘thumbs up’ gesture. We also saw that people were comfortable in the presence of the staff on duty.

Observations of one person during our inspection, showed them to be comfortable and relaxed. We saw that staff regularly interacted with the person and included them in conversations and friendly banter.

The person we spoke with told us that they had chosen what they wanted for lunch that day and said they liked it. This person also told us they liked doing bowling on the WII machine.

Other comments made by the person we spoke with included that they didn't want to go to their day service anymore and so they now did things at home with the staff. They also told us that new steps had been bought for the bus, to help them get on and off more easily.

This person told us they had recently got some new furniture for their room, which they were very happy with.

When we asked staff if anything could be changed to make people's lives better in the home, three staff responded with comments such as: "Ashwood is a lovely home and the tenants are happy and settled. I wouldn't change anything." "I feel the home is currently run well and is a happy home." And: "We provide a high standard of care." One person commented that they would like even more activities and opportunities for people.

Additional comments made by staff included that the home had improved for the better over the last few years, the training provided was to a very high standard and that it was a very rewarding job.

We are unable to clearly state the full experience of people who live at Ashwood House as we could not talk directly to the people who live at this home due to people being out or ill in bed. What we have found is that all the comments written in surveys, that we have seen, and issues addressed in the minutes that have been written in tenants meetings, is that for most of the time the people who live at Ashwood House are happy and content.