Ashington Gardens

We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

Under the previous registration there was a breach of the regulation about safe care and treatment. This was in relation to medicines management. Improvements were found at this assessment and theproviderwas not in breach of this regulation.However, some issues were found about the reasons for administering and assessing the impact of as and when required (PRN) medicines.

Medicines were stored, administered and disposed of safely by staff trained in medicine management.

Under the previous registration there was a breach of the regulation about safeguarding. This was in relation to staff not being confident in reporting issues, relatives not confident in reporting processes and allegations of abuse not being reported. Improvements were found at this assessment, and the provider was not in breach of this regulation.

At this assessment we found people were protected from avoidable harm. Staff were confident to report and management action had improved. A recent safeguarding had highlighted some ongoing issues relating to identifying risk and communication with other professionals but these matters had been addressed. Mental capacity assessments were regularly reviewed and deprivation of Liberty Safeguards (DoLS) were in place.

Under the previous registration there was a breach of the regulation about staffing. This was in relation to lack of intervention training and conflicting advice given to staff from managers. Improvements were found at this assessment, and the provider was not in breach of this regulation.

There were enough staff to cover all shifts despite some dependency on agency staff. Staff had received all required training and were confident to apply what they had learned. Messaging from managers was consistent. There was a new registered manager who had experience working at the service.

Accidents and incidents were appropriately reported and recorded and any learning from incidents was shared with staff. Previous concerns relating to safe transitions had improved, with communication clearer between the service and relatives and other professionals. Known risks to people were documented and staff knew how to respond if things went wrong. Infection prevention and control measures and policies were in place, and the environment was clean and presented a safe place for people to live.

Under the previous registration there was a breach of the regulation about person centered care. This was in relation to people’s needs not being fully assessed, poor feedback from relatives and support needs not being shared with all staff. Improvements were found at this assessment, and the provider was not in breach of this regulation.

A thorough needs assessment process was in place which included pre-assessment as well as ongoing changes to people’s care needs. Relatives all told us they were happy with how their loved ones were assessed. All needs were now shared with staff.

Care provision for people was improving with lessons learned from a recent safeguarding investigation being put into practice. Some of these processes required time to fully take effect. Some relatives told us that written updates from the service were often received late however overall communication was effective. Not all relatives knew where to find the complaints policy however all were confident to raise issues if needed. People were supported with access to health and social care appointments, and all had a busy, self-led, activities schedule.

Under the previous registration there was a breach of the regulation about governance. This was in relation to a lack of positive culture at the service and no action taken by managers to improve and staff feeling unsupported. Improvements were found at this assessment, and the provider was not in breach of this regulation.

The new registered manager had a clear vision of service improvement and had already made a positive impact on the service. Most staff told us they felt supported by an approachable management team although some told us the long hours worked and the dependency on agency still was still having an effect on staff morale.

Staff had a voice at the service and were confident to raise issues and concerns and share good and poor practice through team meetings or staff supervision meetings. Effective auditing processes were in place overseen by the registered manager. The working relationship between the service and other health and social care professionals had improved but still needed some time to fully embed. Diversity and inclusion policies were in place, and staff reported a safe place to work where differences were accepted.

Improvements were evident in the way the service communicated with other professionals and relatives. This led to the best care and support being provided to people. People were supported with their nutrition and hydration needs and were encouraged to follow healthy diets. Staff were aware of the need to gain consent from people and the steps to take if tasks or activities were refused.

Staff treated people with kindness and respected their privacy and dignity at all times. People presented in different ways, different preferred communication, likes, dislikes and preferred routines. Staff were aware and supported this. People were encouraged to be as independent as safely possible with staff always available to support when needed. People’s needs were promptly responded to.