Archived: Ash House Residential Home

Updated 14 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 31 October 2018 and was unannounced. The inspection team consisted of two adult social care inspectors and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience in caring for older people.

Prior to the inspection we gathered information from a number of sources. We reviewed the information we held about the service, which included correspondence we had received and notifications submitted to us by the service. A notification should be sent to CQC every time a significant incident has taken place. For example, where a person who uses the service experiences a serious injury.

We gathered information from the local authority’s contracts team who also undertake periodic visits to the home. They gave us feedback from their recent visit which was considered as part of this inspection.

We asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR was completed and returned as requested. This information was considered as part of our inspection.

During the inspection we spoke with 12 people who used the service and four visiting relatives. We spoke with a director, the home manager, the deputy manager, the cook, two domestic assistants, two senior care assistants and two agency care assistants. We also spoke to one visiting health professional.

We spent time observing daily life in the home including the care and support being offered to people.

We looked at documentation relating to the people who lived at the service, staff and the management of the service. This included three people’s care records, nine medicine administration records, three staff records, accident and incident records and other records relating to the management of the service.

Updated 14 December 2018

This inspection took place on 31 October 2018 and was unannounced. This means no-one connected to the home knew we were visiting that day.

Ash House Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ash House is registered to provide accommodation and personal care for up to 40 older people, some of whom are living with dementia. At the time of the inspection there were 27 people living at the home. The service is a detached building in its own grounds and divided into two units. Beech Walk unit specialises in care for people living with dementia. Beech View unit is a residential unit. There are two double and 36 single rooms. Communal lounges and dining rooms are provided on both units.

Our last inspection at Ash House Residential Home took place on 14 September 2017 and we rated the service requires improvement overall. We found the service was in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009, Notification of other incidents. When we completed our previous inspection in September 2017 we found the registered manager was not always submitting notifications to the CQC every time a significant incident had taken place. At this inspection we found the service had made sufficient improvements to meet compliance with this regulation. However, other aspects of the service provision had deteriorated since the previous inspection and we found two breaches of regulation and the rating remains requires improvement. We have also made three recommendations to the provider where we expect improvements.

There was a manager at the service who had been in post since June 2018. The manager informed us it was their intention to be registered with the CQC. 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 and associated Regulations about how the service is run.

People living at the service told us they felt safe. Staff were aware of their responsibilities in protecting people from abuse. We found systems were in place to make sure people received their medicines safely so their health needs were met. Regular checks and audits to medicines management were undertaken to make sure full and safe procedures were adhered to. On the day of the inspection we found there were sufficient numbers of staff to meet people’s needs and it was evident that staff had been safely recruited. However, we have had asked the provider to make improvements to the consistency of staff at the home.

The service worked collaboratively with external health services to promote people's wellbeing. People’s care records contained detailed information and reflected the care and support being given. All staff told us they enjoyed working at the service and had received support and supervision to help them to carry out their support role effectively. However, we found gaps in some care staff members training records, which meant we could not see clear evidence they had the right skills and knowledge for the role. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. We found people’s nutritional needs were met.

During the inspection we observed staff treated people with respect and dignity, and staff supported them in a way which met their needs. We received mixed feedback about the quality of the activities provided and people said there were limited opportunities for meaningful social opportunities.

There were systems in place to monitor and improve the quality of the service provided. We also saw an action plan was in place to drive continuous improvements at the service, which identified actions for completion by who and by when. During the inspection the manager demonstrated she was responsive to our feedback and understood further improvements were needed.