Ashdene House

At the last inspection in May 2017 the service was rated 'Requires Improvement'. There was a breach of the Health and Social Care Act 2008 (Regulated Activities) 2014. We asked the provider to complete an improvement plan to show what they would do and by when to improve the key questions of Safe and Well- Led to at least 'Good'. At this inspection we found that improvements had been made and the breach in Regulation had been met. Improvements had been made to maintain the standard of the environment.

Ashdene House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service has been developed and designed 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 using the service can live as ordinary a life as any citizen.

Ashdene House provides care for up to 18 adults with a learning disability, in Ramsgate. At the time of our inspection there were 11 people using the service. Eight people lived in the house and three in a cottage within the grounds. A day centre unit in the grounds was used for various activities. During the day everyone spent time together or taking part in activities outside the service.

The registered manager worked at the service each day and was supported by a deputy manager. A registered manager is a person who has registered with CQC 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 told us and indicated that they felt safe living at Ashdene House. They were protected from discrimination, abuse and the risk of avoidable harm. Staff knew how to keep people as safe as possible. Risks to people were managed and monitored. People received their medicines safely from staff who were competent to do so. The registered manager reviewed accidents and incidents and checked to make sure people received the support of health care professionals when they needed it.

People were supported by staff who had been recruited safely. Staff knew people well, kept their knowledge up to date and met with the registered manager for one to one supervision meetings.

The service was clean and tidy and the garden was maintained. Checks were completed to make sure the environment and any equipment were safe and well maintained. People had access to private space and communal areas, including a garden. Visitors were welcome at any time.

People were involved, as far as possible, with planning their care and support. Their needs were assessed prior to moving to Ashdene House to ensure staff could meet their care and support needs. People were supported to have maximum control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. They were supported by relatives and advocates when they needed additional help to make decisions about their care.

People were offered choices of healthy home-cooked meals. They were supported to stay as healthy as possible and staff worked collaboratively with health care professionals to promote this.

People were supported by staff who were patient, kind and caring. Their privacy and dignity were respected and their independence promoted. People, their relatives and staff had developed strong, trusting relationships. Staff understood the importance of confidentiality and made sure people's records were stored securely.

Each person had a care plan which had been written with them and the people who knew them best. These gave staff the guidance they needed to make sure they provided the correct levels of care and support in the way people preferred.

People were encouraged and supported to stay active, to take part in group activities and to follow their own interests. People were supported to follow their religious, spiritual and cultural beliefs.

People's preferences for their end of life care were recorded to ensure their wishes could be followed. They were supported at the end of their life to have a comfortable, dignified and pain-free death.

People did not have any complaints but felt confident the right action would be taken if they had a concern. They felt confident to speak with the registered manager or staff if they were worried about anything.

People, their relatives and staff thought the service was well-led. There was a culture of fairness and inclusivity where people were valued and treated as individuals and equals. The staff team worked with health care professionals to promote joined up care.

The leadership at the service was visible. The registered manager understood their regulatory responsibilities and notified CQC according to guidelines. Checks and audits were completed to monitor the quality of service and, when needed, action was taken to drive improvements. The most recent CQC report was displayed in the service and a link to the latest report was on the provider's website in line with guidance.

The five questions we ask about services and what we found