Archived: Ashwood Court

Updated 22 April 2017

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 is 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 11 January 2017 and was unannounced. A second day of inspection took place on 12 January 2017 and was announced. The inspection team consisted of two adult social care inspectors and an expert by experience on the first day, and two adult social care inspectors on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we reviewed information we held about the home, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.

Before the inspection we also contacted the local authority commissioners for the service, the local authority safeguarding team, the clinical commissioning group (CCG) and the local Healthwatch to gain their views of the service provided. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection we spoke with eight people living at the service and seven relatives. We also spoke with the registered manager, the registered provider, two nurses, one senior care worker, six care assistants, the head chef and two members of domestic staff.

We reviewed five people's care records and records for three members of staff. We also reviewed 10 people’s medicines administration records, supervision and training information and records relating to the management of the service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 22 April 2017

This inspection took place on 11 January 2017 and was unannounced. A second day of inspection took place on 12 January 2017 and was announced.

Ashwood Court is a care home which provides nursing and personal care for up to 30 people with mental health or general care needs. There were 27 people living there at the time of our inspection, some of whom were living with dementia.

The service had a registered manager. 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.

We last inspected the home in December 2015 and found the provider had breached Regulations 12 (safe care and treatment), 17 (good governance) and 18 (staff training) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to submit an action plan setting out how they would become compliant with the breaches identified at the previous inspection.

At the last inspection we found that the registered provider did not have accurate records and procedures to support and evidence the safe administration of prescribed creams. Staff had not received regular one to one supervision with their line manager and some essential training was overdue for most staff. Records of appraisals were unavailable. The provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure people received appropriate care and support. Opportunities for people to give their feedback on the service were limited, and we could not be sure if people’s feedback was acted upon.

During this inspection we found the provider had made some improvements in these areas. However, we found the provider had continued to breach Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because some medicine records we viewed contained gaps and inaccuracies and one person’s medicine file did not contain important information about their allergies. The provider's quality assurance processes needed to be sustained over time to address the areas for improvement we identified during this inspection. We have made a recommendation about staff training.

You can see what action we told the provider to take at the back of the full version of the report.

Accidents and incidents were recorded and dealt with appropriately but the analysis lacked detail. Information relating to times of falls and the amount of staff on duty was not analysed which could help the provider identify trends.

Fire drills were not carried out in line with the frequency specified in the provider’s fire safety policy.

The arrangements for prescribed cream had improved which meant people received them when they needed them. Medicines were stored securely and at the appropriate temperature for safe storage.

All staff members had a completed disclosure and barring service (DBS) check within the last three years which complied with the provider’s policy. These checks help employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups.

Safeguarding incidents were recorded and investigated appropriately. Appropriate action had been taken following safeguarding incidents.

Staff supervisions and appraisals were up to date. Staff told us they felt supported.

Decisions made about any necessary restrictions to keep people safe had been made in line with legal requirements and were in people’s best interests.

People were supported to maintain a healthy and varied diet. People received support to eat and drink when they needed it. Drinks and snacks were available throughout the day.

People spoke positively about the care and support they received. One person told us, “I’m well looked after. The staff are kind.” Another person said, “The staff listen to us and if I’m down they put things right as they want us to be happy.”

Relatives we spoke with said their family members were well cared for. A relative said, “The staff here deserve a medal for what they do, they’re fantastic.”

Staff had good relationships with people and their relatives. There was a welcoming atmosphere and lots of laughter in the home.

Care records contained detailed information and guidance about how to support people based on their individual health needs and preferences. Individual hygiene sheets had been introduced since the last inspection which was more person-centred. Care records were reviewed and updated regularly or when people's needs changed.

People we spoke with told us if they had a problem or concern they would speak to staff. Relatives we spoke with knew how to make a complaint.

Staff meetings were held regularly and staff told us they had enough opportunities to provide feedback about the service.

Relatives and staff told us the manager was approachable and the service was well-run. A relative said, “The manager is really approachable and the atmosphere is good. Things are much better now.”