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Ashview Requires improvement

Reports


Inspection carried out on 27 January 2021

During an inspection looking at part of the service

About the service

Ashview is a ‘care home’. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Ashview accommodates up to 13 people who may have a learning disability, in one adapted building. At the time of our inspection, eight people were using the service.

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

Staff did not always follow the provider’s COVID-19 policy or government infection and protection guidelines. This posed a risk of staff transferring infection.

Quality assurance arrangements and governance systems were in place to assess, monitor and improve the quality of the service. However, we found the quality assurance monitoring had not been completed or had been ineffective in identifying and managing concerns.

People’s medicines were managed safely. However, where people had been prescribed medicines that were taken when required, guidance for staff had not always been provided.

Peoples risks in relation to their health care needs had been assessed and were being managed safely.

People and staff were encouraged to share their views through regular meetings. Staff felt able to raise concerns with the management.

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 30/01/2018).

Why we inspected

This was a planned inspection based on the previous rating and partly prompted by concerns reported by the service in relation to people's safety. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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 Ashview on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and governance at this inspection.

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.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress.

We will return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.

Inspection carried out on 15 January 2018

During a routine inspection

Ashview is a ‘care home’. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. Ashview accommodates up to eight people who may have a learning disability, in one adapted building. At the time of our inspection, five people were using the service.

This inspection took place on 15 January 2018. The inspection was unannounced, this meant the staff and provider did not know we would be visiting.

At the last inspection on 7 October 2015, the service was rated ‘Good’. At this inspection we found that the service remained good.

A registered manager was 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.

We found that improvements needed to be made to the outdoor area to ensure that this was accessible, and that the décor within the service would benefit from being updated. We have recommended that the provider updates the décor and external areas of the service, and ensures that people are involved with these decisions.

People spoke positively about the service and told us they were listened to by staff that were kind and caring towards them. People told us that they felt safe and staff understood what abuse was. They knew what steps they should take to protect people and keep them safe. Risks to people’s daily life had been assessed and contained detailed information to ensure people were kept safe from harm.

Checks were undertaken on staff suitability for the role and there were sufficient numbers of staff available to meet people’s needs in a safe way. However, we did find that when staff did not turn up to work that this had an impact on people and staff. We have made a recommendation to increase and maintain consistent staffing levels.

There were adequate systems in place for the safe administration of medication and people received their medicines as prescribed.

Staff received an induction to prepare them for their role and additional training was provided to support their learning and development. The manager assessed staff’s competency to ensure that staff had understood the training and were able to put it into practice.

Staff had understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People who lived in the home were positive about the quality of the food and our observations were that people enjoyed their meals. People had meaningful activities offered to them but when staff did not turn up to work this prevented them from going out from time to time.

Care plans were written holistically and reflected people’s needs. Information about people’s health and support needs were available to people in a way that they understood. Assistive technology enabled people to speak with staff and share their views.

No complaints about the service had been received over the last 12 month, but systems were in place so that if a complaint was made, this would be appropriately investigated.

There were systems in place to drive improvement and audits were carried out on a regular basis, which looked at the quality of the service people received. The registered manager had a clear oversight of the service.

Inspection carried out on 7th October 2015

During a routine inspection

The inspection took place on 07 October 2015 and was unannounced. Ashview provides accommodation and personal care and support for up to up to 13 people who have learning disabilities and/or physical disabilities. At the time of our inspection there were 11 people who lived in the service.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

The service had appropriate systems in place to keep people safe, and staff followed these guidelines when they supported people. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time. The provider also had a robust recruitment process in place to protect people from the risk of avoidable harm.

People’s health needs were managed by staff with input from relevant health care professionals. Staff supported people to have sufficient food and drink that met their individual needs. People’s privacy and dignity was respected at all times.

People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately and people’s healthcare needs were well managed. Staff interacted with people in a caring, respectful and professional manner, and were skilled at responding to people’s care and support needs.

People were encouraged to take part in interests and hobbies that they enjoyed. They were supported to keep in contact with family and develop new friendships so that they could enjoy social activities outside the service. The manager and staff provided people with opportunities to express their views and there were systems in place to manage concerns and complaints.

There was an open culture and the management team demonstrated good leadership skills. Staff were enthusiastic about their roles and they were able to express their views. The management team had systems in place to check and audit the quality of the service. The views of people and their relatives were sought and feedback was used to make improvements and develop the service.

Inspection carried out on 9 May 2013

During a routine inspection

We observed care within the service to help us determine what it was like for people living at Ashview House. We found that staff interactions with people who live at the service were positive. One person told us �I am very happy here, the staff are good and always help me.�

We found that staff had been well trained and saw that they had a good understanding of people's individual needs. People were treated respectfully, their individuality and diversity understood. People enjoyed good levels of activity and were able to access the local community.

We found that the provider consulted with people and families and also monitored the service to ensure that standards would be maintained.

Inspection carried out on 20 December 2012

During a routine inspection

We spoke with most of the people who use the service during our visit in December 2012. Some of the people who live in Ashview House had limited communication so they shared their views through body language and facial expressions.

All of the people that we spoke with either indicated or told us that they were happy. One person said, �It�s good here, I like the staff and we do lots of things. I go on holidays and went to Blackpool this year.�

We looked at a sample of care files and found them to be detailed and informative. They had been regularly reviewed and updated to reflect any changes. We found that staff had been trained and had received regular updates in their training. Staff told us that they felt well supported to do their work.

The records showed that regular quality assurance surveys had been undertaken. The manager had carried out regular audits and the provider visited monthly to check on the quality of the service.

Inspection carried out on 28 September 2011

During a routine inspection

People told us that they were involved in their care. They said that they had helped to write their care plans and daily notes. People told us that they often visited the local market and shops and that they were due to go on holiday shortly, which they were looking forward to. People said that they felt respected and that staff treated them well.

People told us they were happy with the care they received. One person said that staff were nice but could sometimes get on their nerves. People told us that they have asked for more outings and that they now got them. People told us that they were happy with their rooms and one person told us that they had chosen their own furnishings. They told us that staff had helped them to keep their room clean and tidy.

People told us that they were happy with the quality of the service they received at Ashview House.

Reports under our old system of regulation (including those from before CQC was created)