Ashton Grange Nursing & Residential Home

People's experience of using this service and what we found: The registered manager and provider had made significant improvements to the governance and oversight arrangements, implementation of systems and processes to safely assess and manage risks to people, including with their medicines. The improvements made, needed more time to be sustained, maintained and fully embedded into the culture of the service.

People received care and support that was safe. One person said, "I feel safe and comfortable, the staff are so kind and polite." One relative explained this was the third experience of residential care and said, "This one has won hands down-really wished this had been the first home."

People received safe care and support by staff who had been appropriately recruited, trained to recognise signs of abuse or risk and understood what to do to safely support people. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible. We observed medicines being given safely to people by trained and knowledgeable staff, who had been assessed as competent.

Staff were committed to delivering care in a person-centred way based on people's preferences and wishes. There was a stable staff team who were knowledgeable about the people they supported and had built trusting and meaningful relationships with them. Staff had all received training to meet people's specific needs. During induction, they got to know people and their needs well. One staff member said, "It's really lovely here, the people are so special and the staff team supportive." People's nutritional and health needs were consistently met with involvement from a variety of health and social care professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Everyone we spoke to was consistent in their views that staff were kind, caring and supportive. One health professional described the service as, "The atmosphere is positive, there have been improvements, especially in the leadership, the presence of the manager on the floor has improved communication." A visitor said, "It's a busy home, the activity lady is tremendous fun, a live wire, gets people motivated." People

were relaxed, comfortable and happy in the company of staff and engaged in a positive way. People's independence was considered important by all staff and their privacy and dignity was also promoted.

Activities were tailor-made to people's preferences and interests. People were encouraged to go out and form relationships with members of the community. Staff knew people's communication needs well and we observed them using a variety of tools, such as specific sign language, pictures and objects of reference, to gain their views.

People were involved in their care planning. End of life care planning and documentation guided staff in providing care at this important stage of people's lives. Visitors told us that they had discussed their loved one's wishes and one visitor said, "I personally felt they had prepared me, not only my wife." End of life care was delivered professionally and with compassion.

People, their relatives and health care professionals had the opportunity to share their views about the service. Complaints made by people or their relatives were taken seriously and thoroughly investigated. The provider and registered manager were committed to continuously improve and plans to develop the service and maintain their care delivery to a good standard.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk