You are here

Ashefields Residential Care Home Good

Reports


Inspection carried out on 3 December 2019

During a routine inspection

About the service

Ashfields Residential Care Home provides personal care for up to 20 people aged 65 and over. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection, 19 people were using the service.

People’s experience of using this service and what we found

Systems and processes were in place to protect people from harm and abuse. Staff had received training and understood their responsibilities to report any incidents to the registered manager. The registered manager reported allegations of abuse to the relevant safeguarding authorities and to CQC. At the time of the inspection there was no ongoing investigations.

Risk assessments had been completed to enable people to be as independent as possible while remaining safe. Where risks had been identified staff had the knowledge and skills to minimise the risk of harm. Specific risks in relation to mobility, nutrition and pressure area care were detailed and reviewed monthly. Care plans described the support people needed to maintain their mental and physical health. Changes to people’s needs were quickly identified and amendments were made to reflect their up to date care.

Recruitment and selection of staff continues to be robust. This helped the registered manager make sound decisions when employing new staff. Staff had received training to enable them to meet the needs of people. There was enough staff on duty to meet people’s needs and keep them safe.

People received their medicines as prescribed. Staff were responsible to ensure the correct procedures were followed. Regular audits were carried out so that any error was picked up quickly. People had access to a wide range of health and social care professionals. People living well with dementia had their mental health monitored by consultants and community psychiatric nurses.

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.

Mealtimes were relaxed, staff offered appropriate assistance where needed. People who were identified at risk of becoming malnourished were provided with additional support and were monitored closely by the staff.

The environment was clean and tidy and was suitable for people living well with dementia. There was clear signage around the service and people personalised their bedrooms with things to make them feel at home.

Relatives and people we spoke with were happy with the care provided which was dignified and they told us staff were very respectful. Relative said they were aware of the complaints procedure but had no complaints. They told us the registered manager and staff provided an excellent service.

Staff knew people very well and they were able to tell us how people communicated their wishes when they could not express them verbally. People had access to a range of activities including entertainment from in the community. For example, pat dogs which were popular.

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 2 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Ashefields Residential Care Home on our website at www.cqc.org.uk.

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 8 December 2016

During a routine inspection

This inspection was unannounced and took place on 8 December 2016. The service was registered to provide accommodation for up to 20 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection, 16 people were using the service.

There was a registered manager in post. 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.

At our last inspection on 21 December 2015, we told the provider to make improvements in relation to levels of staffing available to meet people’s needs and keep them safe. The provider sent us a report on 13 February 2016 explaining the actions they would take to improve. At this inspection, we found the required improvements had been made. There were enough staff available to meet people’s needs and keep them safe.

We had also told the provider to make improvements to ensure the way they checked the quality of the service was more effective. Again, we found that the necessary improvements had been made. There was a programme of audits in place that were effective in driving continuous improvement.

Staff gained people’s consent before support was given. However, when people were unable to make decisions about their care, the provider had not assessed their capacity regarding this and was not able to show why decisions made on behalf of people were in their best interests.

People were safe and protected from harm and abuse. Staff were knowledgeable in safeguarding people and the provider referred any incidents as needed. Risks to people were assessed, managed and reviewed to minimise potential harm. People’s medicines were managed safely by staff who were trained to do this. The provider had safe recruitment processes in place.

Staff were equipped with the knowledge and skills needed to carry out their roles. People were supported to maintain a balanced diet and enabled to maintain good health. When people were not able to make decision about their care and were being restricted, the provider ensured this was authorised legally.

People were supported by staff who were respectful and kind towards them. Staff knew people well and cared for people in a dignified manner. People’s privacy was respected and their independence promoted. Visitors were made to feel welcome.

People were involved in the assessment and planning of their care. The service responded to people’s changing needs and people received support that was individual to them. Staff knew about people’s needs and preferences. There were opportunities for people to participate in activities they enjoyed. People knew how to raise any concerns or issues and the provider acted on this.

There was a positive culture within the home and staff felt supported by the management team.

Inspection carried out on 21 December 2015

During a routine inspection

This unannounced inspection took place on 21 December 2015.

There was a registered manager in post. 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.

At our last inspection on the 13 and 15 August 2013 we found the provider was not meeting all of the standards we inspected. At that time we had concerns about the care and welfare of people, the arrangements for safeguarding people from harm and the way staff were supported to fulfil their role. The provider submitted an action plan to us detailing how they would achieve the required improvements. At this inspection, we saw that the required improvements had been made. We identified some concerns about the number of staff available to meet people’s needs and the reporting of safeguarding concerns.

Staff knew how to protect people from harm but had not recognised that some incidents should have been reported to the local safeguarding authority, to ensure people were fully protected. The number of staff available was not determined by the needs of people and we found that at times there were insufficient staff to care for people safely. The registered manager was monitoring the quality of the service but was not identifying trends and patterns in incidents.

People were provided with a choice of suitable food and were encouraged to take adequate fluids to support their health. People’s health and wellbeing needs were regularly monitored and when necessary people received additional support from health care professionals.

Staff received support to improve their skills and knowledge to care for people. People were happy with the management of the home and staff felt well supported.

We saw that people were routinely asked for their consent before their care was provided. When people lacked the capacity to make decisions for themselves we saw that staff supported them in line with the requirements of the Mental Capacity Act 2005.

People were treated kindly by staff and their rights to privacy and dignity were recognised and maintained. Staff recognised people’s individuality and provided care which met their preferences. People were encouraged and supported to maintain the relationships which were important to them.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 13, 15 August 2013

During an inspection in response to concerns

We spoke with ten people who used the service and two relatives.

People able to express their views said they were happy with the care they received, and felt that their needs were being met. One person told us "the staff are helpful and caring. The home is suburb; nothing is too much trouble��. Another person told us ��I am happy living here; I spend my day doing what I want to do and go to bed and get up when I want��.

People told us that they received the support they needed as there were usually enough staff on duty. They also said that they felt that the daily routines were flexible, taking into account their wishes. However we found that some routines were not set around individual needs.

People able to express their views said that they felt safe and able to raise concerns with staff if they were unhappy with their care or the service. We found that senior staff were not aware of local safeguarding procedures, to protect people against the risk of abuse.

Relatives we spoke with told us they were satisfied with the care and support their family member received, and felt involved in decisions about their care and treatment.

People said that they liked the staff that supported them. We found that arrangements were not in place to ensure that all staff received appropriate training, supervision and appraisal to carry out their work effectively.

Inspection carried out on 21 December 2012

During an inspection to make sure that the improvements required had been made

We found that arrangements had been put in place to gain and review consent from people who lacked the capacity to make certain decisions, and to show that decisions were made in their best interests.