We carried out a review of the data available to us about Ashfield (Skipton) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ashfield (Skipton), you can give feedback on this service.
We found the following examples of good practice.
Local restrictions on visiting were in place at the time of the inspection and alternative measures such as window visits and video calls were being used.
Systems and processes were in place to safely admit people to the home. There was no movement of residents between the units and occupancy on one unit was being carefully managed to minimise risk. The layout of the home had changed to encourage social distancing and minimise footfall through the service.
All staff, essential visitors and people were screened for symptoms of COVID-19 and had access to testing and personal protective equipment (PPE). A designated area and staff member were allocated to carry out testing.
The provider updated family and friends using a monthly personalised newsletter which included pictures of activities happening within the home.
Ashfield (Skipton) is a residential care home providing accommodation and personal care for to up to 29 older people including people living with dementia. The home is arranged over two floors, the upper floor is accessible via a lift. People living with dementia have separate accommodation on the ground floor. At the time of our inspection there were 15 people living at the home.
People’s experience of using this service and what we found
People told us they received good care and felt safe. Staff were aware of how to care for people safely, however care plans and risk assessments did not always contain full information about how to manage health conditions and risk. Accidents and incidents were recorded. We recommended the provider review their accident and incident process to ensure records are updated following an occurrence.
The registered manager ensured safeguarding concerns were investigated and reported to the relevant authorities. Staff had been recruited safely. Arrangements were in place to ensure medicines were safely administered.
There were enough staff to meet people’s needs. 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.
Peoples needs were fully assessed before they started using the service. Staff treated people with dignity and respect whilst encouraging and supporting people maintain independence as far as possible.
The provider had a complaints procedure in place. People were aware how to raise complaints, one person said, "If I have complaints they [staff] know how to straighten things up". The registered manager had an open-door policy and people knew how to raise any concerns. Since the last inspection quality assurance systems had improved and the provider had been carrying out an annual audit at the home.
People, relatives and professionals were all positive and complimentary about the home. Staff knew people well and treated people with kindness. People commented "Staff always offer to support me or give me privacy when needed".
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 26 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Ashfield (Skipton) is a care home without nursing for up to 30 older people, some of whom maybe living with dementia. The home is arranged over two floors which can be accessed via a lift. There is also a separate unit for people living with dementia. The home has a garden which people can access and it is close to local amenities. At the time of our inspection 18 people lived at the service.
We saw the registered provider had worked to develop a new care plan system which would improve the records relating to risk assessment and mental capacity assessment for people. The registered provider displayed a positive attitude towards continuous improvement. We discussed with the registered manager our findings and the areas of improvement still required in relation to medicines, training compliance and the quality assurance system. The registered manager explained the registered provider was keen to make such improvements. People and their families were positive about the leadership of the service.
We saw staff recruitment was safe which ensured candidates were suitable to support vulnerable people. Staff were aware of the signs of potential abuse and how to report their concerns. Staff told us they received appropriate training and support to enable them to perform their role. We saw some records to confirm this.
People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.
People were happy with the choice of food they received and we observed a positive mealtime experience. People were supported to have access to healthcare support and their health needs were monitored well by staff.
People and their relatives told us they found staff to be caring, kind and friendly. We observed positive and warm interactions between staff and the people who used the service. People were offered choices and were supported to maintain their independence.
People’s preferences were recorded in their care plans and staff were aware of them when delivering support. People had access to a wide range of activities, which included their own personal hobbies and access to the community.
People, their families and members of staff had opportunities to provide feedback on the service and their views were listened to and acted upon. This meant the service was run in the best interests of the people who lived there.
We undertook this unannounced inspection on the 10 February 2015. We also returned on the 16 February 2015 to complete the inspection. We last inspected Ashfield (Skipton) on the 29 September 2013. At that inspection we found the home was meeting the regulations that were assessed.
Ashfield House is owned and managed by North Yorkshire County Council. The care home is registered to provide personal care for up to 30 people and is within a short drive of the centre of Skipton. It is a purpose built two-storey care home and is set in large grounds and has enclosed gardens. There is a small unit, which can accommodate five people living with dementia. There is also a day centre attached to the service.
The home employs a registered manager who had worked at the home for over two years. 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.
The service was safe. People who used the service spoke positively about the care they received at Ashfield and they said they felt safe. We saw there were systems and processes in place to protect people from the risk of harm.
Medicines were administered, stored and disposed of safely and people using the service received their medicines as prescribed.
We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show that staff employed were safe to work with vulnerable people.
Staff we spoke with understood how to make an alert if they suspected anyone at the home was at risk of abuse. Training had been given to staff about safeguarding procedures.
Safety checks were carried out within the environment and on equipment to ensure it was fit for purpose. We found that the main open plan lounge/dining area was sometimes cold and people told us that they were cold during one of our visits. We have asked the registered provider to make improvements.
Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions for themselves.
Staffing levels at the home were flexible to ensure people who used the service had the support they needed.
People were provided with nutritious food. Assistance and prompting was given by staff where necessary to assist people. Adapted cutlery and crockery were available to people for them to use to help maintain people’s independence.
Staff were seen to be attentive and kind to people and they respected people’s individuality, privacy and dignity.
Care plans were person centred and up to date. Risks to people’s health and wellbeing had been identified. These risks were being monitored and reviewed which helped to protect people’s wellbeing. However, we found that risk assessments we looked at needed some improvement as staff at the home were recording identified risks in different areas of people’s care plans. This meant that records were not kept consistently, using the same template which would make any changes to people’s care difficult to monitor.
Activities took place in the main part of the home but not always in the small dementia care unit.
The service was well led. The registered manager had an effective quality assurance system in place which ensured that the home remained a pleasant place for people to live.
We received information from Healthwatch. They are an independent body who hold key information about the local views and experiences of people receiving care. CQC has a statutory duty to work with Healthwatch to take account of their views and to consider any concerns that may have been raised with them about this service. We also consulted the Local Authority to see if they had any concerns about the service, and none were raised
On the whole, people's care plans contained a level of information that ensured their needs were being met. However, not all information was being followed up in relation to people who had lost weight and some care plans had not been reviewed in a timely way. This meant that people's care needs could be overlooked. People told us they were happy with the care provided. One person told us, 'I am more than satisfied with the care here.'
People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
There were enough staff on duty to meet people's needs. Staff were receiving training on a regular basis and this was monitored by the manager.
There were quality monitoring programmes in place, which included people giving feedback about their care and treatment. This provided a good overview of the quality of the service provided and meant the quality of the service was being kept under review.
We found that all of the records we reviewed were accurate, up to date and had been regularly reviewed and evaluated.
We looked at staff records and found staff were recruited using a robust system and saw there were good systems in place to ensure staff were well supported in their work.
People told us they thought that staff were knowledgeable regarding their individual care needs. They said they were treated well and their experiences in the home were positive. Five people told us that if they had a complaint they would talk to the manager and they were confident any issues would be dealt with properly.
Staff talked positively about their work. Staff said they made every effort to provide a person centred service and that they worked as an effective team.
People were protected against the risks associated with medicines because appropriate arrangements in place to manage medicines.
They also told us that they felt they were kept up to date with information and could take part in meetings and activities as and when they wished.
People said staff treated them well and respected their dignity. They felt that they could approach the staff at the home and felt able to raise concerns.
People said that they enjoyed the meals and there was always a good choice, they told us that they were happy with the environment and the home was kept clean and tidy.
Relatives told us that they were pleased with the care at the home and were always made to feel welcome.