Ash Court Care Centre - Camden

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment, we rated this key question requires improvement. At this assessment, the rating has improved to good.
This meant people were safe and protected from avoidable harm.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were systems to help safeguard people from abuse. We saw clear safeguarding policies in place. Any concerns were reported to relevant parties swiftly. Safeguarding concerns were recorded clearly with actions, outcome and preventive steps taken.

Examples were shared with staff to promote learning from experience. Discussion with staff demonstrated understanding of safeguarding practices, how to identify if someone may be at risk and how to escalate any concerns.

People who were subject to Deprivation of Liberty safeguards to protect them from harm, had their assessments well documented and included in their care plans. Staff understood key principles of the Mental Capacity Act 2005 and their role in supporting people who are deemed to lack capacity in a given area.

Care plans we reviewed showed evidence of decisions being made in a person's best interests where they were unable to make informed choices themselves and advocates were contacted to support where people did not have friends/family to support them.

One relative told us, “My [relative] is totally safe here. The carers are so good - I can’t speak highly enough about the way they support [them]”

There were safe systems to support transitions. This included a digital system accessible by all within the organisation called Radar that contained details of any incidents, accidents or injuries. This supported tracking and monitoring to ensure any actions are taken in a timely way.

Ash Court had clear processes in place for people moving to the home and for those transitioning into or out of hospital. We saw that admission plans and subsequent care plans involved people, their relatives and other relevant professionals.
Hospital passports, a tool for supporting communication between the person, the service and hospitals, were present in care files we reviewed and regularly updated.
Partner agencies told us that transitions from community or hospital settings to Ash Court are carried out safely and thoroughly. They told us that staff pursue colleagues if they are missing any details and notify regularly visiting partners such as the GP of new arrivals promptly.
 

There were systems to help safeguard people from abuse. We saw clear safeguarding policies in place. Any concerns were reported to relevant parties swiftly. Safeguarding concerns were recorded clearly with actions, outcome and preventive steps taken.
Examples were shared with staff to promote learning from experience. Discussion with staff demonstrated understanding of safeguarding practices, how to identify if someone may be at risk and how to escalate any concerns.
People who were subject to Deprivation of Liberty safeguards to protect them from harm, had their assessments well documented and included in their care plans. Staff understood key principles of the Mental Capacity Act 2005 and their role in supporting people who are deemed to lack capacity in a given area.
Care plans we reviewed showed evidence of decisions being made in a person's best interests where they were unable to make informed choices themselves and advocates were contacted to support where people did not have friends/family to support them.
One relative told us, “My [relative] is totally safe here. The carers are so good - I can’t speak highly enough about the way they support [them]”
Partner agencies said the following in relation to managing safeguarding concerns, “Their approach enables concerns to be swiftly triaged and to ensure that lessons are learned.”
 

The provider managed risks to people’s safety and wellbeing. Care plans included relevant risk assessments to people’s needs. For example, risk of falls. These detailed any support needed including equipment. People who had capacity to do so were supported to make decisions around risk and what support was or was not given to them according to their preferences. Where people did not have capacity to make risk taking decisions, relevant people were involved in their risk assessments to ensure decisions were taken in a person’s best interests and were not more restrictive than was necessary to ensure safety.
Partner agencies told us they were informed of concerns regarding mental, physical or wellbeing needs of people who live at Ash Court.
 

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The environment was not always safe. During our on-site inspection, we found 1 bathroom to be missing an emergency pull cord. This meant that people and staff would be unable to raise the alert in event of an emergency. We also saw that 2 further pull cords were wound above floor level in toilets meaning that someone would not be able to reach them to raise the alarm in the event of a fall.

Once brought to the attention of the registered manager, this was swiftly rectified.

We observed 1 fire escape route in which the fire extinguisher was behind a large planter. We also saw wooden spindles, maintenance debris, left on the floor behind fire stairs which posed a potential obstacle. These things were identified to the registered manager and resolved immediately.

The environment more generally would benefit from being more dementia friendly in its decor, both in terms of colours to aid those with impaired depth perception, as well as in relation to reminiscence. Following our assessment, Forest Healthcare released their 3 year dementia strategy for all of their care homes including Ash Court which includes investment in improving environments.

There was an on-site member of maintenance staff so problems were able to be rectified quickly in most cases. Equipment checks were up to date and carried out regularly to ensure safety.

Fire safety policies and drills were detailed and accounted for those with mobility issues. We saw evidence of individual evacuation plans in care records. Fire safety inspections did not highlight any areas for concern in relation to fire evacuation or alarm systems.

Ash Court had a detailed business continuity plan in place for a variety of potential scenarios including extreme weather and power loss. This included plans for alternative accommodation if needed, transport, key contacts and staff roles.

There were enough suitable staff to care for people and keep them safe.

We reviewed staff recruitment files and policies whilst at Ash Court. We saw evidence of relevant skills, good references and criminal checks being completed prior to staff being employed to work there. These were recorded and scheduled for renewal using a digital platform to help manage recruitment and staffing.There was a well-structured induction period that included shadowing of other staff and close supervision. Staff training was recorded and tracked to ensure each member of staff had undergone new and refresher required training.
Staff we spoke with told us they felt well supported and skilled to carry out their roles. They also advised that the registered manager encouraged progression and supported staff to develop and gain additional skills.
Regular supervision took place for all staff and focussed both on work achievements and individual wellbeing. These were recorded and showed clear objectives for staff.
Staff scheduling rotas showed that adequate staff were available across various skill levels, including nursing and care staff. This was the case overnight as well as during the day. Although some people we spoke with indicated they felt staff were rushed, this was not a reflection of a lack of staff available.
One person told us, “The carers support me well and, as a result, I feel safe and very comfortable here.”
Partner agencies praised the staff at Ash Court, with one professional saying, “I enjoy working with Ash Court healthcare staff who always show great interest and enthusiasm to learn more to provide the best care they could.”
 

There was effective infection prevention and control practices at Ash Court.
Policies in the event of an infection outbreak had clear actions and routes for escalation. This included the notification of all relevant agencies including local and public health bodies.
People were able to access seasonal and other vaccines, with this provided by visiting healthcare professionals.
We observed staff using protective equipment, such as disposable gloves, face masks and aprons. People we spoke with told us staff always wore these items when providing personal care. Staff advised supply of these items was never a concern.
The kitchen staff understood good food hygiene practices and food was stored and labelled correctly with prominent date information. Storage temperatures were monitored and an
effective cleaning schedule was in place with cleaning recorded as it took place. Cleaning of Ash Court was audited with a comprehensive check list to ensure all areas were tended to. Any concerns were noted and actions put in place to resolve. The registered manager also carried out regular observations of cleanliness. During our visit, Ash Court appeared clean and odour free.
 

This service maximises the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.
The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. People were involved in planning, including when changes happened.
Medicines, including controlled drugs, were being managed safely. People received their medicines for when they were prescribed, including medicines that were time dependent.
Areas where medicines were kept were clutter free and access was restricted to authorised staff.
The service had an effective process for ensuring that people were supported to receive their time sensitive medicines as prescribed.
When people were given their medicines covertly (without their knowledge), this was administered and recorded in line with national guidance and legislation.
Medicines that were used “when required” (PRN) were offered regularly and the effectiveness of doses were followed up by staff. We saw PRN protocols which guided staff on how or when to offer or administer these medicines. Whilst these were not always person centred, staff could describe the needs of the people they were supporting.
Medicines given topically were recorded on a topical medicines administration record (TMAR).
The service had positive relationships with external healthcare services, including GPs and hospitals. We saw regular input to people’s care from consultants and pharmacy teams at the local hospital.
Medicines records were recorded on a digital medicines administration record (EMAR). This supported with individual medicines management.

Staff received regular training and support to carry out their role. Staff’s medicines administration competency was regularly assessed. Staff were encouraged to develop their skills. For example, some carers had been supported to qualify as nurses whilst working in the service.