Archived: Ashcroft - Bromley

Updated 1 March 2018

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 30 and 31 January 2018 and was unannounced. A specialist nurse advisor, one inspector and an expert by experience inspected on 30 January 2018. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector returned on 31 January 2018 to complete the inspection.

Before the inspection we looked at all the information we held about the service. This information included the statutory notifications that the service sent to the Care Quality Commission. A notification is information about important events that the service is required to send us by law. The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also contacted health and social care professionals involved in people’s support, and the local authority safeguarding team for their feedback about the service. We used this information to help inform our inspection planning.

During the inspection we spoke with four people and ten relatives, nine members of staff, one external healthcare professional and the manager. Not everyone at the service could communicate their views to us so we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We looked at six people’s care records and nine staff records. We also looked at records related to the management of the service such as the administration of medicines, accidents and incidents reports, Deprivation of Liberty Safeguards (DoLS) authorisations, health and safety records, and the provider’s policies and procedures.

Updated 1 March 2018

This inspection took place on 30 and 31 January 2018 and was unannounced. Ashcroft - Bromley is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ashcroft – Bromley accommodates 22 people in one adapted building. There were 21 people using the service at the time of our inspection.

At the last inspection on 27, 28 and 29 November and 05 December 2016 we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because staff had not always received appropriate training. Following that inspection the provider sent us an action plan showing how they planned to make improvements. We undertook a focused inspection on 18 May 2017, to check that they had followed their action plan with regard to staff training and found they complied with the regulations. However, although improvements have been made, we were unable to change the rating of this key question at that inspection. This was because there were other areas such as supervision and appraisals in the key question that were rated as requires improvement at the last comprehensive inspection that we did not look at during the focused inspection.

At this inspection, we found the provider trained staff to support people and meet their needs. People and their relatives told us that staff were knowledgeable about their roles and that they were satisfied with the way staff looked after them. The provider supported staff through bi-monthly supervision and yearly appraisal.

The service did not have a registered manager in post. The previous registered manager left the service in March 2016. However the provider appointed a new manager to run the home. The new manager’s application to the CQC to become the registered manager was being processed. 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.

Staff knew how to keep people safe. The service had clear procedures to support staff to recognise and respond to abuse. The manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service and they were up to date with detailed guidance for staff to reduce risks.

The service had an effective system to manage accidents and incidents, and to prevent them happening again. The service carried out comprehensive background checks of staff before they started working and there were enough staff to support to people.

Medicines were managed appropriately and people were receiving their medicines as prescribed. Staff received medicines management training and their competency was checked. All medicines were stored safely. The service had arrangements to deal with emergencies and staff were aware of the provider’s infection control procedures and they maintained the premises safely.

The manager and staff understood their roles and responsibilities under the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS). They had taken action to ensure the requirements were followed for the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People consented to their care staff provided them.

Staff assessed people’s nutritional needs and supported them to maintain a balanced diet. Staff supported people to access the healthcare services they required, and monitored their healthcare appointments. The manager and staff liaised with external health and social care professionals to meet people’s needs.

People or their relatives, where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing.

Staff supported people in a way which was kind, caring, and respectful. Staff protected people’s privacy and dignity.

The provider recognised people’s need for stimulation and social interaction. People had end-of-life care plans in place to ensure their preferences at the end of their lives were met. Staff completed daily care records to show what support and care they provided to each person.

The service had a clear policy and procedure about managing complaints. People knew how to complain and told us they would do so if necessary.

The service sought the views of people who used the services, their relatives, and staff to improve the service. Staff felt supported by the manager. The provider had effective systems and processes to assess and monitor the quality of the care people received which helped drive service improvements. The service worked effectively with health and social care professionals, and commissioners.