You are here

Ashview House Residential Care Home Inadequate

We are carrying out checks at Ashview House Residential Care Home using our new way of inspecting services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Inadequate

Updated 10 November 2017

We inspected this service on 4 September 2017. This was an unannounced inspection. Our last inspection took place on 12 January 2017. At that inspection, we identified a number of Regulatory breaches and we told the provider that improvements were needed to ensure people consistently received care that was safe, effective, caring, responsive and well-led. The service was rated as ‘inadequate’ and remained under special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

As a result of previous enforcement action, a condition was placed on the provider’s registration with us that prevented them from admitting and re-admitting people to the service without our authorisation. This condition was made to promote people’s safety and remains in place. This condition has been breached by the provider since our last inspection and we are taking action to address this.

The service is registered to provide accommodation and personal care for up to 22 people. People who use the service may have a physical disability and/or mental health needs, such as dementia. At the time of our inspection nine people were using the service. However, one of these people was in hospital as a result of a safety incident that had occurred at the service.

There was a registered manager at the home. 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.

At this inspection, we identified a number of continued and new Regulatory breaches. The overall rating for this service remains ‘Inadequate’ and the service therefore remains in ‘Special measures’ whilst we continue our enforcement action.

We found that the provider continued to have ineffective systems in place to assess, monitor and improve the quality of care. This meant that poor care was not being identified and rectified by the registered manager or provider.

A notifiable safety incident had not been reported to us, which meant that we could not accurately monitor safety at the service.

Risks to people’s health, safety and wellbeing were still not always assessed, planned for, managed and reviewed to promote people’s safety.

Safe recruitment systems were still not in place to ensure staff were of suitable character to work with the people who used the service.

Safety incidents were not always analysed and responded to effectively and promptly, which meant the risk of further incidents was not always reduced.

Medicines were not always managed safely.

Some people told us they still experienced occasional delays in receiving the care and support they required. Staffing levels were not consistently reviewed to ensure safe staffing levels were maintained.

We were still not assured that people’s health needs were consistently monitored and advice from health care professionals was not always followed to promote people’s health, safety and wellbeing.

Accurate records were not maintained to show staff had received the training they needed to meet people’s needs and keep people safe. Staff reported that they had not received all the training they required.

An effective complaints system was not in place to ensure complaints were recorded and managed appropriately and promptly.

Deprivation of Liberty Safeguards (DoLS) requests were made when restrictions were placed on people. However, these were not always completed in line with the Mental Capacity Act 2005 (MCA). People’s capacity to consent to their care was not regularly assessed and reviewed in line with the MCA.

Some improvements had been made in relation to people’s receiving care that met their individual care preferences. However, further improvements were needed to ensure people could access activities that were meaningful and therapeutic to them.

Although people were involved in the initial planning of their care, they were not involved in regular reviews of their care to ensure their care preferences had not changed. This meant people were at risk of receiving care that did not meet their changing preferences.

People could choose the foods they ate, but detailed information about people’s specialist dietary needs was not always readily accessible to ensure consistent care.

Some people spoke fondly about the staff and at times, we observed some positive interactions between staff and people. However, we found that people were not consistently treated in a dignified manner.

People were supported to make day to day choices about their care and the choices people made were respected. People’s right to privacy was promoted.

Staff knew how to identify and report incidents of potential abuse and neglect.

The provider was now displaying their inspection rating on line as required.

Inspection areas

Safe

Inadequate

Updated 10 November 2017

The service was not safe. Risks to people’s health, safety and wellbeing were still not always assessed, planned for, managed and reviewed to promote people’s safety.

Effective systems were still not in place to ensure staff were suitable to work with the people who used the service.

Medicines were not always administered safely.

Some people told us they still experienced occasional delays in receiving the care and support they required. Staffing levels were not consistently reviewed to ensure safe staffing levels were maintained.

Staff were trained to identify incidents of potential or alleged abuse.

Effective

Inadequate

Updated 10 November 2017

The service was not effective. People’s health needs were not effectively monitored and managed and professional advice was not always sought or followed to promote people’s health, safety and wellbeing.

The requirements of the Mental Capacity Act 2005 were not always followed to ensure people’s ability to consent to their care was assessed and reviewed.

Staff did not always have the knowledge and skills needed to meet people’s needs effectively and safely.

People could choose the foods they ate, but detailed information about people’s specialist dietary needs was not always readily accessible to ensure consistent care.

Caring

Requires improvement

Updated 10 November 2017

The service was not consistently caring. People’s dignity was not always promoted.

People were supported to make day to day choices about their care and the choices people made were respected.

People were supported by staff who knew their likes and dislikes and people told us the staff were kind and caring.

People could access private areas of the home when they wished to do so.

Responsive

Inadequate

Updated 10 November 2017

The service was not responsive. People were not always supported to participate in social and leisure based activities that were meaningful or therapeutic to them.

An effective system was not in place to ensure all complaints were recorded and managed to improve people’s care experiences.

People were involved in the initial planning of their care. However, they were not involved in reviewing their care needs. As a result, people were at risk of receiving unsuitable care as their care preferences changed.

Well-led

Inadequate

Updated 10 November 2017

The service was not well led. The registered manager and provider did not have effective systems in place to consistently assess, monitor and improve the quality of care.

Effective systems were not in place to respond to themes relating to safety incidents, so prompt action was not always taken to reduce the risk of further harm occurring.

The registered manager and provider did not always report notifiable incidents to us as required.