Archived: Ashmill Residential Care Home

When we inspected the home 15 people lived there. We looked at two care files, the medicine administration records for seven people and looked at how the service stored and managed medicines. We spoke with two staff, the manager, business manager and two people that lived there. People spoken with told us they were happy with the changes that had been made. One person said, 'Staff spend a lot more time with us now. There are more staff to help us.' Another person said, 'Things are a lot more organised here so we get to go out more because they all have more time. It's great.'

We found that appropriate arrangements had been undertaken in order to manage the risks associated with the unsafe use and management of medicines. Records showed that medication had been given to people as prescribed by their doctor so as to ensure their health needs were met. Records of people's daily activities, nutritional and fluid intake were now detailed and comprehensive which meant that the risks to people had been reduced.

We saw that improvements had been made to the provider's quality assurance systems and that the necessary checks were being undertaken. Areas of improvements included the implementation of a robust and effective audit system to ensure that standards of care, records of the care delivered and medication administration were regularly monitored. Lessons had been learned from previously identified errors or problems with medicine management and to prevent them happening again. Robust audit systems and quality monitoring processes were now in place to ensure that people received quality care that met their needs and protected their safety.

On this inspection18 people lived at the home. We looked at six care files, five staff files, spoke with five staff, the deputy manager, business manager and 10 people that used the service and or their relative.

We saw that staff knocked on doors and included people in their care choices. People told us they were happy with the care they received and that staff treated them with respect.

People's needs were assessed and care planned so that people's needs were met. Risk assessments had been reviewed and updated so that staff always had up to date information to enable them to support people with their assessed needs safely in the way that people wanted. One person said, 'It's good here now, better than before.' Another person said, 'We go out most days now we have the new bus. I am happy and there are more happy staff as well.'

People were protected from harm. Recruitment processes were robust and staff training ensured staff had the skills and knowledge to meet people's needs safely. One staff member said, 'We have had more staff and new training such as safeguarding and medicines. We have staff meetings and meet with our manager. It's much better.'

Some records did not show that medication had been given to people as prescribed by their doctor so as to ensure their health needs were met.

Quality monitoring processes had improved, but they were not sufficiently robust to ensure that people received quality care that met their needs.

Some people's records of daily activities, nutritional and fluid intake were missing which placed them at risk in emergency situations related to their health and prescribed doses of medication.

We saw that some staff did not knock on doors or include people in their care choices. People who lived in the home did not always have their privacy and dignity respected.

Information about the home and care plans were not in an accessible format for all of the people who lived in the home.

People's needs were assessed by external healthcare professionals. Care plans did not reflect the level of care that was being given because care plan and risk assessment reviews were not up to date. This meant that staff did not have the information they needed to meet people's identified needs.

Safeguarding information was not available to ensure that people had the information they needed if they had any concerns or there was an allegation of abuse.

People did not receive their medicines as prescribed by their doctor to ensure their health needs were met.

Staff were not fully trained and supported in their role to ensure that people's needs were met by skilled staff who received the appropriate professional development.

Systems to audit the safety and quality of the care were not robust and up to date so that the need for improvement could be identified to ensure that people received quality care that met their needs.

The home did not carryout regular reviews of care plans and risk assessments to meet people's individual needs and reduce risks.

Staff knew how to safeguard people from harm and felt confident that if they had to report any abuse, action would be taken to protect people.

Before staff started working at the home, appropriate checks were done to ensure they were suitable to work with the people living there.

The home did not have a robust quality assurance system in place to ensure that any risks to people's safety and welfare could be identified and improvements could be made.