This inspection took place 15 May 2018 and was unannounced, which means they did not know we were coming. 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 on-going 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.

Astley Hall is a ‘care home’. 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.

Astley Hall accommodates 45 people across three separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia.

There was a registered manager in place at the time of our 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.

People continued to tell us they felt safe with the care they received from the staff who supported them. Staff demonstrated good knowledge in how they were to protect people from harm, they recognised the signs of abuse and knew how to report this. The registered manager had identified potential risks to people and had put plans in place to support staff. This was to reduce the risk to people without taking away people’s right to make decisions about their care. There were enough staff to support people’s care needs. People were supported with their medicines in a safe way. Staff understood the importance of reducing the risk of infection to keep people safe.

People’s care continued to be assessed and reviewed with external healthcare professionals involved from the start. People were supported to have a healthy balanced diet. Where people required additional support with their eating and drinking staff knew who required this support. 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 support this practice. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people.

People’s views and the decisions they had made about their care were respected by staff who supported them. People and relatives felt the staff team were kind and friendly and treated them with respect.

People received personalised care which met their needs in a timely way. People’s individual hobbies and interests were encouraged and celebrated by staff. People had access to information about how they could complain about the service. Where the registered manager had received complaints, these had been responded to, with a satisfactory outcome and learning shared.

People told us they had the opportunity to raise their suggestions and ideas about how the service was run. People felt they could speak with the registered manager when they wanted to and they would listen to them. Staff said they felt supported by the registered manager and provider to carry out their roles and responsibilities effectively, through training and daily contact. Staff felt involved in the service and said they felt able to share their ideas about the way in which the service was run. People, relatives and staff felt the registered manager was approachable and listened to them. We found checks the registered manager and the provider completed on the service focused upon the experiences of people.

We found a number of people who lived at the home had limited communication. We were able to speak with two people who used the service and a relative of a person who used the service.

We found some people who were able to express their views and had been involved in making decisions about their care and treatment.

People were complimentary about the home and the care and support they received. One person told us, “I like it here, I can please myself what I do. A relative told us: “I can’t fault it, they have been great”.

Staff we spoke with told us they knew about people’s important relationships, families, likes and dislikes and promoted people to be independent where possible.

People’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. Staff told us they were aware of each person’s needs and how to give care and support to meet those needs.

People told us that they felt safe living at the home and knew who to speak to if they had any concerns. Staff had received training on how to recognise signs of abuse and knew how to report concerns.

Staff told us they were supported. They were trained to an appropriate standard and participated in regular supervisions and team meetings.

The provider had an effective system in place that monitored the quality of the service.

The inspection took place on 18 and 22 September 2015 and was unannounced.

The home provides accommodation for a maximum of 45 people requiring personal or personal care. There were 37 people living at the home when we visited. A registered manager was in post when we inspected the service. 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 and associated Regulations about how the service is run.

People felt safe with the staff that cared for them and reassured by their presence. Staff had received training and understood how to keep people safe. Care staff and the registered manager understood their roles and responsibilities in ensuring people were kept safe.

People were positive about care staff and felt staff were around to support if they needed their help. People felt assured that if they called for help, a staff member would respond. The backgrounds of staff at the service were checked to be certain it was safe for staff to work there.

Staff understood people’s health and the risks to their health. They understood what was needed to maintain people’s health needs.

Staff understood people’s medicines and how people preferred to take their medicines. Staff ensured people received the medicines as they were prescribed. Regular checks were made so that the registered manager could be certain that people received their medicines correctly.

Staff understood how to care for people. Staff received regular supervision and support and felt able to discuss issues they were unsure about with the registered manager.

The registered manager understood their obligations under the law and ensured people were able to consent to care and treatment. When people were not able to make a decision for themselves, appropriate action was taken.

People enjoyed the choices of food they were offered and actively took part in planning and deciding what was included on the menu. People’s diet reflected their health needs and if people required special meals or support, these were offered.

People saw a variety of health care professionals that complimented the care they received at the service. People were able to see professionals about their teeth, hearing aids as well as any other medical needs they had.

People liked the staff that cared for them and staff in turn understood people’s needs. People responded positively to staff that engaged with them in a warm and affectionate manner.

People were treated with dignity and care and staff took pride in understanding what delivering care with dignity meant. Staff also supported families come to terms with changes in their family member’s health.

Family members visited whenever they chose and did not feel restricted from visiting in any way.

People discussed their care needs with staff to ensure they received the care they wanted. Staff encouraged people to maintain their interests.

People understood they could talk to staff about any issues or concerns they had. People and their relatives were also aware of the complaints process and knew what to do should they want to make a complaint.

People and their families liked the registered manager and felt able to approach and discuss any issues they had. Staff also described an easy and open relationship where they could raise issues they were unsure of.

The provider made regular checks on how the registered manager ran the service. The registered manager understood the providers expectations and provided regular updates outlining what had been delivered and how quality was being measured.