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Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 June 2018

Askham House is a care home with nursing. People in care homes receive accommodation and nursing or personal care as a 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.

Askham House is one of five care homes on one site, on the outskirts of the village of Doddington. Each home is registered as a separate location. There are some shared facilities such as a café and function room where some activities take place. Askham House accommodates up to 29 people in one adapted building, which reopened in January 2018 following a complete refurbishment. The home provides care to older people and people living with dementia.

At our previous inspection in January 2016 Askham House was rated Requires Improvement. During that inspection one breach of a legal requirement was found. This was because people who used the service were not protected against the risk of their care being delivered without valid and lawful consent. Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key question, effective, to at least Good.

During the inspection visit on 10 April 2018 we found that this area of the service had improved. People were being cared for in a way that did not deprive them of their rights to liberty and to make their own decisions.

This inspection was carried out earlier than planned as we had received some concerns. These were about the environment and about lack of staffing. We wrote to the provider about both matters and they assured us that any shortfalls had been met. However, during this inspection we found that there were shortfalls in both these areas.

The registered manager had left the home in March 2018. A new manager had been appointed and had been in post for one week when we visited. This new manager had previously been registered to manage this home. A registered manager is a person who has registered with the CQC to manage the home. 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 home is run. The new manager told us she would be applying to the CQC to be registered as manager of Askham House.

There were not enough staff deployed to make sure that people’s needs, including social and emotional needs were fully met and people were kept safe.

Staff had received training in safeguarding people. Not all incidents had been recognised as a safeguarding so had not been reported to the safeguarding team. Assessments of a number of potential risks to people had been carried out but some risks had not been assessed or managed successfully.

Staff had not all received up to date fire safety training, in particular in relation to the new building. Staff had not responded appropriately to a recent fire drill.

Medicines were managed well and people had received their medicines safely and as they had been prescribed. Staff followed infection prevention and control procedures so that the home was clean and hygienic. There was an effective recruitment process in place to reduce the risk of unsuitable staff being employed.

Assessments of people’s support needs were carried out before the person was offered a place at the home. This was to ensure that the staff could provide the care and support that the person needed and in the way they preferred. Technology and equipment, such as call bells, pressure mats and hoists were used to enhance the support being provided.

Staff received induction, training and support to enable them to do their job well. People were provided with healthy, nutritious and appetizing meals and special diets were catered for, although people did not always get the support they needed at mealtimes. A range of external health and social c

Inspection areas

Safe

Requires improvement

Updated 23 June 2018

The service was not always safe.

There were not enough staff deployed to fully meet people’s needs and ensure that people were kept safe at all times.

Staff did not always recognise when an incident needed to be reported to the safeguarding team so incidents were not always reported in a timely manner.

Some risks had not been assessed or managed effectively, putting people at risk. Staff had not responded appropriately to a recent fire drill.

Medicines were given safely and staff followed infection prevention and control procedures to keep the home clean and hygienic.

Effective

Requires improvement

Updated 23 June 2018

The service was not always effective.

The new building was not being used effectively to meet people’s diverse needs.

People were not always supported effectively with their needs to eat and drink well.

Staff received training and support to enable them to carry out their roles.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Caring

Requires improvement

Updated 23 June 2018

The service was not always caring.

Staff did not always treat people with kindness and compassion. People’s need for privacy was not always met. Confidentiality was not always upheld.

Staff made some efforts to communicate with people in a way they could understand.

Visitors were made to feel welcome. Confidential information was stored securely.

Responsive

Requires improvement

Updated 23 June 2018

The service was not always responsive.

Staff were not always aware of changes to people’s care so care delivered was not always as up to date as it should have been.

There were not enough activities delivered, based on individual interests and preferences, to keep people occupied and their minds stimulated.

Care plans gave staff guidance on how to meet each person’s needs in the way that person preferred.

End of life care was delivered well.

Well-led

Requires improvement

Updated 23 June 2018

The service was not always well-led.

The quality assurance system was not robust enough to fully recognise areas where improvements were needed.

Arrangements for people to formally air their views and put forward ideas for improvement were not yet fully in place.

Staff were aware of their responsibility to provide a high quality service in line with the provider’s values and ethos.

A staff recognition scheme was in place and staff had opportunities to express their views about the service being delivered.