Archived: Ashwood Court

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.”

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found '

Is the service safe?

We found there were sufficient numbers of suitable staff to ensure people were supervised and appropriately stimulated and engaged. We saw that risk assessments clearly identified the potential hazards and the control measures in place to manage the risk. The provider had developed policies and procedures in relation to safeguarding adults. We viewed these policies and saw that they contained information for staff to refer to about safeguarding, such as what constituted abuse, key responsibilities and how to report concerns. The provider had a system for logging and investigating safeguarding concerns.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We saw that DoLS had been submitted appropriately and relevant staff had been trained to understand when an application should be made.

Is the service effective?

Each person had individual care plans which set out their specific care needs and people had been involved in the assessment and planning of their care. Relatives we spoke with told us they were also involved in the planning of care. We saw that care plans and risk assessments were up to date and reflected people's individual needs and we observed staff supporting people in a caring and sensitive way.

We found that care records had been written using a person-centred approach. This meant that they described the person's abilities and how they preferred their care needs to be met. Staff we spoke with told us the manager was approachable and accessible at all times. The provider had systems in place to ensure that staff training was kept up to date.

Is the service caring?

People were supported by calm, kind and attentive staff. We saw that care workers showed patience and gave encouragement when assisting people. Staff spent time engaging with people about their interests in a warm and involving manner. We saw staff guided people in a way that supported them to retain their dignity. Staff told us they knew what interested people by reading what was written in the person's care plan and also spending time with them.

People who used the service and their family members all gave positive feedback about the service and the staff members who delivered care. People commented, 'Yes I get good care' and 'I can easily get in touch with staff, very likeable people.' Family members comments included; 'The carers are lovely, I cannot fault it'. 'My relative gets well cared for'; and 'The manager is lovely.' Our observations of the care provided and discussions with people showed us that individual wishes for care and support were taken into account.

Is the service responsive?

People were given the opportunity to make decisions for themselves. Records showed that people's preferences, interests and needs had been taken into account and care and support had been provided in accordance with people's wishes. We saw that where necessary people had been referred to other professionals. For example, we saw people had been referred to the Speech and Language Therapy Team for input into their care.

Is the service well led?

The provider had a registered manager in place to manage the service. They shared the legal responsibility for meeting the requirements of the law with the provider. The provider undertook regular audits to check the quality of service. They gathered the views of family members and healthcare professionals responsible for the care of people, in order to measure the effectiveness of the service they delivered.