We carried out a review of the data available to us about Ash Cottage 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 Ash Cottage, you can give feedback on this service.
Ash Cottage is a residential care home providing accommodation for persons who require nursing or personal care to up to 24 people. The service provides support to older people and those living with dementia. At the time of our inspection there were 22 people using the service.
People’s experience of using this service and what we found
Everyone we spoke with said that they felt safe living at Ash Cottage. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. Staff had received safeguarding training and there were policies and procedures to support this. Risks to people's health and wellbeing had been identified and plans were in place to mitigate risk.
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 assessed, and staff had received training to support this. People were supported to maintain a healthy and balanced diet.
People who used the service were treated with respect and equality. Care was person centred and staff understood the importance of promoting choice, consent and independence. Peoples dignity and privacy were maintained, and the staff approach was described as, “Patient” and “Helpful.”
Peoples were supported to maintain social relationships and their communication needs were being met. People and their relative’s views were sought, and they had opportunities to provide feedback. Meaningful activities were not always available to people, we made a recommendation about this. Recruitment for an activities co-ordinator was ongoing.
Staff members and people spoke positively about the management of the home. Relatives told us communication with management was open and frequent. Quality checks and auditing were in use and there was a lessons learned process for when things go wrong. Actions and improvements from these were recorded and completed.
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 21 May 2019).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Recommendations
We have made a recommendation about providing meaningful activities for people.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Prior to our inspection, we received information of concern about infection prevention and control measures and cleanliness at this service. During our inspection, we found some areas where cleanliness was not always up to standard. There was designated domestic staff but the cleaning schedules did not include sufficient detail to guide staff. Regular checks of the environment and cleanliness were carried out but some shortfalls found during the inspection, had not been identified as part of the audit. We discussed our findings with the registered manager and regional manager. We were assured appropriate action was being taken to respond to the shortfalls.
There were enough stocks of personal protective equipment (PPE). Staff had received training in the use of PPE, infection control and hand hygiene. We observed staff and management were using PPE correctly and there were procedures in place to support staff with its use. Signage was in place to remind staff, visitors and people about the use of PPE, the importance of washing hands and regular use of hand sanitisers.
There were effective processes to minimise the risk to people, staff and visitors from catching and spreading COVID-19. These included regular testing of staff and people living in the home and testing of visitors to the home. Safe visiting processes were followed and the vaccination status of all visitors to the home was checked in accordance with the current guidance.
There were sufficient staff to provide continuity of support should there be a staff shortage. All staff had access to appropriate support to manage their wellbeing should it be required. Recruitment of additional care and domestic staff was underway.
Infection prevention and control policies and procedures were kept under review. Business contingency plans were in place. People were being admitted safely to the service in line with current guidance.
We found the following examples of good practice.
At the time of the inspection, local restrictions were in place. However, visitor assessments were carried out to consider temperature checks, current health needs and COVID-19 symptoms and any recent travel that may impact on the safety of people living in the home.
People living in the home were familiar with staff wearing face masks. Staff took the time to explain the reasons why they needed to wear masks and offered reassurance when needed.
The home looked clean and hygienic. Sufficient domestic staff were on duty and detailed cleaning schedules were being followed.
Further information is in the detailed findings below.
Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an extended converted farm cottage and provides accommodation on four floors accessed by a passenger lift.
People’s experience of using this service
People were happy about the way the home was managed and were complimentary about the registered manager and staff. The registered manager considered people’s views about the quality of care provided and used the feedback to make improvements to the service. The registered manager and the provider monitored all aspects of the service and took appropriate action to improve the service.
People told us they felt safe and staff were kind and caring. The provider had safeguarding adults' procedures and staff understood how to protect people from abuse. Recruitment processes ensured new staff were suitable to work in the home. There were sufficient numbers of staff to meet people's needs and ensure their safety. People received their medicines when they needed them from staff who had been trained and had their competency checked. The temperature and security of medicine storage areas were not appropriate. The registered manager addressed this immediately. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People were protected from the risks associated with the spread of infection.
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 supported this practice. People's care needs were assessed prior to them living in the home. Arrangements were in place to ensure new staff received induction training. Staff received ongoing training, supervision and support. The training records were not reflective of the training carried out. The registered manager provided an accurate record following the inspection. People enjoyed the meals and were supported to eat a nutritionally balanced diet. People had access to various healthcare professionals, when needed. People were happy with their bedrooms and the communal areas. We found areas of the home needed refurbishment and redecoration. Plans indicated extensive refurbishment work would be carried out from July 2019.
Staff treated people with dignity, respect care and kindness. They spoke with people in a friendly and patient manner. Staff knew people well. They knew about their backgrounds and about their routines and preferences. Whilst people received the care they needed and wanted, we found the care plans did not always fully reflect what staff knew about people's likes and dislikes; the registered manager agreed to review this in the new care planning system. People or their relatives, where appropriate, had been consulted about their care needs and had been involved in the care planning process. People’s access to a range of activities had improved recently. They told us they enjoyed the activities. People could raise any complaints or concerns if they needed to and had access to a complaints procedure.
Rating at last inspection
At the last inspection, the service was rated Requires Improvement (published 1 August 2018).
Why we inspected
This was a planned inspection based on the previous rating.
At our last inspection of July 2018, we found a breach of regulations as the quality assurance processes were not effective in identifying shortfalls. Following the inspection, the provider sent us an action plan advising how the service would be improved. During this inspection, we found sufficient improvements had been made. The registered manager was monitoring all aspects of the service and had taken appropriate action to address any shortfalls.
Follow up
We will continue to monitor the service to ensure that people receive safe and high-quality care.
Further inspections will be planned for future dates.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
At our last inspection in June 2017 we found a breach of legal requirement in relation to medicines management. Following the inspection, we asked the provider to take action to make improvements and to send us an action plan. During this inspection, our findings demonstrated there had been an improvement in the management of people’s medicines.
During this inspection, our findings demonstrated there was a breach of the regulations in respect of the provider's quality monitoring systems. Following the inspection, we asked the provider to take action to make improvements and to send us an action plan.
This is the second consecutive time the service has been rated as 'Requires Improvement'.
Ash Cottage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Ash Cottage provides accommodation and care and support for up to 24 people, some of who were living with dementia. The service does not provide nursing care. There were 18 people living in the home at the time of the inspection.
Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an extended converted farm cottage first built in 1886 and has a listed status and provides accommodation on four floors accessed by a passenger lift. The gardens are well maintained with a small car park for visitors at the front of the house.
The service was managed by 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.
Whilst the quality assurance and auditing processes had identified some shortfalls that had been actioned by the registered manager, they had not been fully effective. We noted that a new system was being introduced and would help the provider and the registered manager to identify and respond to matters needing attention. We will review this at our next inspection.
There were systems to obtain people’s views of people. There was evidence that people were listened to.
People told us they felt safe in the home and they were happy with the service they received. People appeared comfortable in the company of staff. Safeguarding adults' procedures were in place however the reporting processes needed to be updated. Staff understood how to protect people from abuse. Staff treated people respectfully and their privacy was respected.
The systems in place to manage people’s medicines had improved. Staff administering medicines had been trained and supervised to do this safely.
Risks associated with the environment and with people’s health and welfare had been assessed. There was a system in place to record accidents and incidents. However, the registered manager was aware further action was needed to analyse any incidents and accidents to identify any patterns and trends and to prevent a re-occurrence.
New robust recruitment policies and procedure had been introduced to ensure new staff were suitable. Arrangements were in place to make sure staff were trained and competent. People considered there were enough staff to support them when they needed any help.
Appropriate Deprivation of Liberty Safeguard (DoLS) applications had been made to the local authority and people's mental capacity to make their own decisions had been assessed. However, additional information was needed to ensure people’s preferences were met.
People had access to activities inside the home and were supported to maintain relationships with friends and family. People told us they enjoyed the meals and their dietary preferences were met. People had access to a GP and other health care professionals when they needed them.
People told us they were happy and did not have any complaints about the service they received. They knew how to raise their concerns and complaints and were confident they would be listened to.
People’s care and support needs and their preferences and routines were being recorded. However, the registered manager was aware further improvements were needed to ensure the records reflected the care given.
The home was clean and bright and appropriate aids and adaptations had been provided to help maintain people’s safety, independence and comfort. Equipment was safe and serviced.
Ash Cottage provides accommodation and care and support for up to twenty people some of whom were living with dementia. The service does not provide nursing care. There were 19 people accommodated in the home at the time of the inspection. The service was registered with the Care Quality Commission (CQC) on 22 June 2016. This was the first ratings inspection since that date.
Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an extended converted farm cottage first built in 1886 and has a listed status and provides accommodation on four floors accessed by a passenger lift. The gardens are well maintained with a small car park for visitors at the front of the house.
The service was managed by 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.
During this inspection, we found one breach of the regulations in respect of medicines management. You can see what action we told the provider to take at the back of the full version of the report.
People told us they felt safe and staff were caring and friendly. Safeguarding adults' procedures were in place and staff understood how to safeguard people from abuse. The registered manager and staff were observed to have positive relationships with people living in the home. People were relaxed in the company of staff and there were no restrictions placed on visiting times for friends and relatives.
We found staff were respectful to people, attentive to their needs and treated people with kindness, patience and respect. The atmosphere in the home was happy and relaxed. It was clear staff knew people well and were knowledgeable about their individual needs, preferences and personalities.
People considered there were sufficient staff to support them when they needed any help. We observed they received support in a timely and unhurried way. The recruitment process was being reviewed to ensure it was safe and fair. Arrangements were in place to make sure staff were trained and supervised.
Whilst there were some good processes in place to manage people's medicines safely we found some improvements were needed. Staff administering medicines had been trained and supervised to do this safely.
Appropriate Deprivation of Liberty Safeguard (DOLS) applications had been made to the local authority and people's mental capacity to make their own decisions had been assessed and recorded in line the requirements of the Mental Capacity Act 2005. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Each person had a care plan that was sufficiently detailed to ensure they were at the centre of their care. People’s care and support was kept under review and they were involved in decisions about their care. However, they had not been involved in formal reviews of the care plans. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs changed.
People lived in a comfortable, clean and well maintained environment. Appropriate aids and adaptations had been provided to help maintain people’s safety, independence and comfort. Some people had arranged their bedrooms as they wished and had brought personal possessions with them.
Activities were appropriate to individual needs. People told us they enjoyed the meals and were provided with a nutritionally balanced diet that catered for their dietary needs and preferences.
People were kept up to date with the day to day running of the home. They had no concerns or complaints but were aware of how to raise their concerns and were confident they would be listened to.
People considered the service was managed well and felt they received a good service. There were systems to monitor the quality of the service; we noted a number of shortfalls had been identified and appropriate action taken.