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Archived: Ash House Residential Home Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 14 December 2018

This inspection took place on 31 October 2018 and was unannounced. This means no-one connected to the home knew we were visiting that day.

Ash House Residential Home 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. Ash House is registered to provide accommodation and personal care for up to 40 older people, some of whom are living with dementia. At the time of the inspection there were 27 people living at the home. The service is a detached building in its own grounds and divided into two units. Beech Walk unit specialises in care for people living with dementia. Beech View unit is a residential unit. There are two double and 36 single rooms. Communal lounges and dining rooms are provided on both units.

Our last inspection at Ash House Residential Home took place on 14 September 2017 and we rated the service requires improvement overall. We found the service was in breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009, Notification of other incidents. When we completed our previous inspection in September 2017 we found the registered manager was not always submitting notifications to the CQC every time a significant incident had taken place. At this inspection we found the service had made sufficient improvements to meet compliance with this regulation. However, other aspects of the service provision had deteriorated since the previous inspection and we found two breaches of regulation and the rating remains requires improvement. We have also made three recommendations to the provider where we expect improvements.

There was a manager at the service who had been in post since June 2018. The manager informed us it was their intention to be registered with the CQC. 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 and associated Regulations about how the service is run.

People living at the service told us they felt safe. Staff were aware of their responsibilities in protecting people from abuse. We found systems were in place to make sure people received their medicines safely so their health needs were met. Regular checks and audits to medicines management were undertaken to make sure full and safe procedures were adhered to. On the day of the inspection we found there were sufficient numbers of staff to meet people’s needs and it was evident that staff had been safely recruited. However, we have had asked the provider to make improvements to the consistency of staff at the home.

The service worked collaboratively with external health services to promote people's wellbeing. People’s care records contained detailed information and reflected the care and support being given. All staff told us they enjoyed working at the service and had received support and supervision to help them to carry out their support role effectively. However, we found gaps in some care staff members training records, which meant we could not see clear evidence they had the right skills and knowledge for the role. 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 support this practice. We found people’s nutritional needs were met.

During the inspection we observed staff treated people with respect and dignity, and staff supported them in a way which met their needs. We received mixed feedback about the quality of the activities provided and people said there were limited opportunities for meaningful social opportunities.

There were systems in place to monitor and improve the qu

Inspection areas


Requires improvement

Updated 14 December 2018

The service was not always safe.

There were enough staff deployed to ensure people�s support needs were met. However, we found the service regularly relied on care agencies to maintain staffing numbers.

The provider had systems in place for managing medicines and people received their medicines in a safe way.

Staff knew how to safeguard people from abuse.


Requires improvement

Updated 14 December 2018

The service was not always effective.

Not all staff had been provided with relevant training to make sure they had the right skills and knowledge for their role. Staff told us they felt supported.

People�s nutritional needs were and had access to a range of healthcare professionals to maintain their health.

Staff understood the requirements of the Mental Capacity Act (MCA) 2005 and considered people�s best interests.



Updated 14 December 2018

The service was caring.

Staff respected people�s privacy and dignity.

People living at the home, and their relatives, said staff were very caring in their approach.


Requires improvement

Updated 14 December 2018

The service was not always responsive.

Feedback gathered from people who used the service about the quality of activities provided was mixed.

People�s care plans contained a range of information which had been reviewed to keep them up to date. Staff understood people�s support needs, however we were concerned that the reliance on agency staff meant that people did not always receive personalised care.

People living at the home, and their relatives, were confident in reporting concerns to the manager and felt they would be listened to.


Requires improvement

Updated 14 December 2018

The service was not always well-led.

During the inspection we identified improvements with the service provision and subsequently we have made three recommendations in this report.

Staff were clear about their roles and responsibilities. They told us they felt supported by their managers, who they said were approachable.