Ascot House

Ascot House is an intermediate care service provided by Trafford Council and Pennine Care. It provides therapy led rehabilitation for adults. Intermediate care is a service which helps people to recover from illness or an accident, to regain independence and to remain in their own homes. Ascot House is registered to provide accommodation for persons who require nursing or personal care, for up to 45 people. There are 45 single rooms across five individual units. Nine of the rooms are used as step-down beds for people waiting for residential care or additional care and support packages at home. There are lounge and kitchen facilities within each unit and areas for rehabilitation and exercise to be undertaken. The service aims to provide a 21-day turnaround for rehabilitation to enable people to return to their own home. At the time of inspection, the service was supporting 26 people for rehabilitation and nine people in the step-down beds.

At out last inspection, we rated the service overall requires improvement, as medication was not always safely managed and there was a lack of supervision for staff. At this inspection, we found there had been improvements made and the service is now rated as good in all of our key questions.

A registered manager was 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 felt safe being supported at the service. Staff had received training in safeguarding vulnerable people from abuse and were confident any concerns they raised would be listened to and acted up on. People felt comfortable to raise any concerns they had with the staff team.

Staff were recruited safely. Appropriate checks were in place to ensure staff were suitable to support vulnerable people.

People had the risks they presented assessed and reviewed, when there were changes. People were supported with equipment to help them reduce levels of risk and as their mobility improved.

The safety of the premises was monitored both internally and externally. Regular checks were in place for fire safety, gas, electric, the passenger lift, equipment and legionella.

People were assessed to ensure they were suitable to receive rehabilitation at the service. Assessments ensured people were fit for discharge from the hospital and could understand what would be required from

them in terms of regular exercise plans with the therapy team. Staff were able to read information about people before they arrived at Ascot House and could arrange equipment to be ready for their arrival.

Health needs were still met when people stayed at Ascot House. People were registered with a local GP service to monitor their health and make referrals to other services if necessary. Weekly multi-disciplinary meetings were held to discuss people's progress and plan for returning home. District nurses worked in the service to complete nursing roles, such as to administer insulin or attend to dressings.

Staff received training appropriate to their job role. Staff enjoyed the training and were able to complete additional qualifications to enhance their knowledge. Staff received an induction into the service which accompanied the training. Many of the staff had work for the organisation for many years.

People had their nutritional needs catered for and monitored while staying at the service. Meals were healthy and nutritious and there was plenty of choice on the menu. If people did not like what was on the menu, an alternative meal would be offered. Meal times were relaxed and a social event.

The building was accessible for people with mobility concerns. There was adequate space for rehabilitation exercises to taken place in and for people to be mobile in. Sensors could be fitted to chairs and beds to alert staff when people might be at risk of falling.

People felt cared for and we observed caring interactions between staff and people who used the service. Staff told us they were happy knowing they had assisted people to improve their mobility and independence to enable them to return back to their home.

We saw examples of dignity and respect as staff knocked and people's doors and gained permission to enter. Staff explained to people what they were doing, such as personal care.

Personal information relating to people was kept securely locked away. Confidential conversations were held in private.

Care plans captured people's needs and identified the support needed to improve people's mobility. Care plans gave goals for people to work towards. Goals were agreed with people on admission and reviewed as progress was made.

Discharge planning ensured people's properties were safe for them to return home to. Referrals were made where people required support in their own home and follow up calls were made to ensure people had settled in, once they had returned home. The Ascot House – Care at Home service could be requested to follow up people for a short period once they had left Ascot House.

People told us they knew who to complain to if they had any concerns. Complaints were responded to in a timely manner and outcomes shared.

Staff felt supported by the registered manager. The registered manager was supported by the head of service and had responsibility for managing the manager of the care at home service as well as the Ascot House staff team.

Staff from other services that supported Ascot House felt the teams worked well together.

There were audits in place to monitor and improve the service. Improvements has been made to the

auditing of medicines to ensure they were safely managed.

People and staff felt that Ascot House provided a valued service which enabled people to return to their own home.

Feedback from people who used the service stated that people were likely or very likely to recommend the service to others.

The five questions we ask about services and what we found