Ash House

This inspection was carried out to follow up on action we told the provider to take at the last inspection when we found they were in breach of the legal regulations relating to safe care and treatment and good governance. Some improvements were found at this inspection and the provider was no longer in breach of the regulations.

During this inspection we spoke with people who lived at the service, their relatives, staff, the manager, deputy manager and an area manager. We reviewed care plans, recruitment files, health and safety records and quality assurance records. Following our visit, we sought feedback from other health and social care professionals.

The provider had acted to address issues identified at our last inspection and was no longer in breach of regulations. However, some of these improvements needed to become embedded in staff and management practice to ensure consistency in implementation. Three managers had been appointed since our last inspection of the service, but all had left after short periods of time. The long-term lack of consistency of management at the service meant further improvements were required to ensure the model of care was in line with ‘Right support, right care, right culture’ and people were experiencing the best life possible. Relatives needed more confidence they were respected and listened to by leaders and that their feedback and suggestions were used in developing and evaluating improvement and innovation initiatives. A lack of communication by the provider meant important messages were not shared in a timely way which eroded confidence in their leadership.

Staff described improvements in the culture of the service that had a positive impact on the quality of care provided. However, some staff felt there were further improvements required to promote good teamwork and build a cohesive workforce that reflected the provider’s policies on inclusion and diversity.

Health and social care professionals told us whilst staff were appreciative of their guidance, they did not always work well together. They were not always confident advice shared with managers was communicated to the care team.

Risks to people’s health and wellbeing were identified and mitigated against and there was a process in place to manage and respond to accidents and incidents. People received their medicine in a safe way.

Staff received training to ensure they were competent to provide safe care and understood their role in protecting people from abuse and discrimination. Staff treated people as individuals, respected their privacy and dignity and understood the importance of giving people opportunities to make choices.