About the service: Ashely Phoenix Home is a care home. It was providing accommodation and personal care to eight people who are Deaf or Deafblind and who have additional complex needs at the time of the inspection.

People’s experience of using this service:

• People appeared happy and relaxed living at the service, and relatives told us staff were kind, caring and patient.

• Staff knew people well, and care and support was personalised and reflected people’s needs and preferences.

• People were protected from the risk of harm. Policies, procedures and checks were in place to protect people and staff.

• There were enough staff to meet people’s needs. Safe recruitment practices ensured prospective staff were suitable to work in the service.

• People's medicines were administered as prescribed and managed safely by competent staff.

• Care records were clear and detailed. These were reviewed regularly to ensure they continued to meet people’s needs. Relatives told us they were consulted with and informed about people’s care.

• Staff received training in a range of relevant subjects, although some update training was required. Staff received regular supervision and appraisals and felt supported in their roles. They spoke positively about the management of the service.

• Regular checks and quality assurance systems were in place. Some frequent checks required more detailed recording. Action plans were in place to monitor and improve quality where needed.

• People were supported to make choices where possible and participate in activities which reflected their interests and preferences. People’s independence was promoted in day to day tasks.

• People accessed routine and specialist healthcare appointments, and relevant professionals were involved in care planning and regular reviews.

• The service worked in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

• The service continued to meet the characteristics of Good in all areas; more information is in the full report.

Rating at last inspection: Good (report published 5 August 2016)

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

Follow up: We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.

This inspection took place on the 17 June 2016 and was unannounced. When the service was last inspected in July 2013 there were no breaches of the legal requirements identified.

Ashley Phoenix Home is registered to provide accommodation for eight deaf or deaf/blind people who may need additional support for conditions such as autism, learning or physical disability or their emotional development. At the time of our inspection there were eight people living at the service.

A registered manager was in post at the time of 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.

Risk assessments relating to the health, safety and welfare of people were reviewed regularly. The risk assessments did not indicate that there had been a close liaison with the person or their representative when carrying out the risk assessments. This is essential to achieve outcomes that matter to them. The family members we spoke with felt fully involved in the level of care provided to their relative. The registered manager acknowledged the need to demonstrate in their records the person’s and their representative’s involvement in the risk assessment process.

People who used the service were unable to tell us of their experience of living in the house. We found that people’s rights were being upheld in line with the Mental Capacity Act 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. There was documentation related to a service user’s capacity to make decisions and how to support a service user when there was evidence that they lacked capacity to make informed decisions.

Staff endeavoured to keep people safe because they understood their responsibilities should they suspect abuse was taking place and knew how to report any concerns they had.

People had their physical and mental health needs monitored. All care records that we viewed showed people had access to healthcare professionals according to their specific needs.

Relatives were welcomed to the service and could visit people at times that were convenient to them. People maintained contact with their family and were therefore not isolated from those people closest to them.

There were enough staff on duty to meet people’s needs, both within the home and when people wished to go out. Staff we spoke with felt the staffing level was appropriate. The provider’s recruitment procedures helped ensure that only suitable staff were employed to work in the service

People’s medicines were managed safely. People were supported with their medicines by staff and people had their medicines when they needed them.

Staff were caring towards people and there was a good relationship between people and staff. People and their representatives were involved in the planning of their care and support. Staff demonstrated an understanding of the needs and preferences of the people they cared for. Staff treated people with respect and supported them in a way that maintained their privacy and dignity.

People’s individual care plans reflected the most up to date care people required. Care plans were person-centred and focused on the individual and their specific needs. People had access to a wide range of activities which were both individualised as well as being meaningful for people.

There were systems in place to assess, monitor and improve the quality and safety of the service.

Ashley Phoenix was divided into two living areas. People who lived in both Ashley unit and Phoenix unit had very complex needs. Because of their complex mental health needs we were not able to communicate with service users. We gathered evidence of people's experiences by observing the care provided, looking at records and talking with staff.

We saw interactions between staff and people who used the service were kind and caring. The staff took time to make sure they understood the way people wanted to be supported. Staff members were able to describe people’s care plans and their hopes and aspirations for the future.

We saw there was assistance for people to maintain their personal hygiene and that their privacy and dignity was respected when using the bathrooms.

We saw people's rooms were well decorated and comfortable. Each room had a regular "makeover" and was decorated to each person’s individual tastes. A staff member told us people who used the service also made daily choices about the clothes they wore.

We saw the manager monitored and analysed the levels of accidents, incidents and complaints to ensure people who lived in the home were safe.

When we visited Ashley Phoenix we saw that it is divided into two smaller living areas. The manager told us that people who live in both Ashley unit and Phoenix unit had very complex needs. Because of their complex mental health needs we were not able to communicate with service users, we gathered evidence of people’s experiences by observing the care provided, looking at records and talking with staff.

We saw interactions between staff and people who used the service were warm, supportive, reassuring and efficient. The staff were able to convey to us a good understanding of the needs of people who used the service and what kind of care and support each person needed.

We saw there was an activity room that was well used by people who used the service. We saw lots of pictures that people had created on the walls of the room.

People had been on holiday abroad in the last year and there were frequent trips into the community.

We saw there was a system in place to ensure staff members received appropriate training to assist them meet the assessed needs of people who used the service.

When we visited Ashley Phoenix we saw that it is divided into two smaller living areas. The manager told us that people who live in both Ashley unit and Phoenix unit have very complex needs. She told us “Signing between staff and people is minimal as people here have very complex needs. People have many of their own signs which are unique to them and staff are able to understand what they mean".

We saw that the staff members, who were on duty, at the time of our visit, were caring and kind in her manner towards the people who use the service. We saw members of the staff team helping people in a positive and considerate way.

A staff member told us "I like working here. The manager is very supportive. Most of the team have been here about five years".

We saw a staff member encourage people to assist in the food preparation. A staff member told us “Its important people get involved even if it’s just a small job".

We saw there was assistance for people to maintain their personal hygiene and that their privacy and dignity was respected. We saw that people’s rooms were well decorated and comfortable.