Ascot House - Nottingham

Updated 28 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by 3 inspectors Two inspectors visited Ascot House. A third inspector remained off-site and reviewed documents that were emailed across by the staff team.

Service and service type

Ascot House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ascot House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also spoke to the local authority stakeholders to review information they held about the service. We reviewed information and concerns we had received about the service. We used all this information to plan our inspection.

During the inspection

We were unable to speak to people at the service. This is because they were either unable to communicate with us or did not want to talk to us. Instead, we observed the care provided, to help us understand peoples experiences of their care. We spoke with 5 staff members and the registered manager.

We reviewed a range of records. This included the relevant parts of 5 people's care records and multiple medication records. We looked at 3 staff files in relation to the safety of recruitment. A variety of records relating to the management of the service, including policies, training records and procedures were also reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 28 July 2023

About the service

Ascot House is a residential care home. It provides support to a maximum of 20 people. At the time of the inspection, the service specialised in supporting people with mental health and/or substance miss-use difficulties. At the time of our inspection there were 19 people using the service.

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

People did not always have good outcomes. Staff did not have the training, competency or supervision to carry out their roles safely.

The environment was unclean and not safe. Medicines were not given hygienically or safely. Lessons were not learnt when thing went wrong.

Health professionals visited the service; however their recommendations were not always clearly followed.

The governance of the service did not ensure that high quality care was provided. Reviews and audits were not effective at identifying and driving improvements. Staff were not always safely recruited.

There were enough staff to support people safely. Staff knew how to report concerns of abuse.

The provider had notified CQC of events that occurred at the service. People’s complaints had been responded to.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 9 November 2019).

At the last inspection, the provider was in breach of 3 regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of these regulations.

Why we inspected

The inspection was prompted in part due to concerns received about neglectful care and environmental safety. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ascot House on our website at www.cqc.org.uk

Enforcement

We have identified breaches in relation to safe care and treatment, staff skills, and governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.