We carried out a review of the data available to us about Ashfield Court - Harrogate on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Ashfield Court - Harrogate, you can give feedback on this service.
We found the following examples of good practice.
The service had a visitors pod and a room with window access to allow people who lived at the service to see relatives. For essential visitors who entered the building, the service screened visitors for signs of COVID-19. There was also Personal Protective Equipment (PPE) and hand sanitiser at the main entrance. Visitors who were not part of a routine COVID-19 testing programme would have a “rapid” COVID-19 test before being able to enter the service.
The service had PPE stations, hand sanitiser and posters throughout the premises for staff and people living at the service to use. Members of staff had detailed knowledge of taking on and taking off PPE and the risks around COVID-19. People living at the service spoke positively of the staff. One person told us “I’m very happy with the care. The house keepers clean my room each day.”
Members of staff had their temperature taken before starting each shift and people living at the service had their temperature taken twice per day. Staff had three COVID-19 tests per week and people living at the service had a COVID-19 test every 28 days.
At our last inspection in March 2017 we rated the service as requires improvement because there were breaches of regulation 12 and regulation 17. The breaches were in relation to management of medicines, recording keeping and ineffective quality monitoring of the service.
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions: Is the service safe? Is the service responsive? And is the service well-led? To at least good. At this inspection we found the provider had met the breaches of regulation.
Ashfield Court is a large detached house which has been extended and adapted for its current use. There are two main parts to the service; the original house area and a newer extension, known as "The wing." The service is situated near The Stray in Harrogate.
Ashfield Court is registered to provide nursing and residential care for up to 45 people, although we were informed that the maximum number the service would accommodate now would be 42, due to changes in room configuration. There is disabled access into and throughout the home. The accommodation is set on three floors and there is a passenger lift serving all floors. At the time of the inspection there were 34 people living at the home, all in single rooms.
People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
There was a registered manager in post who had been at the service for more than six years. A registered manager is a person who has registered with 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 2008 and associated Regulations about how the service is run.
Medicines were administered safely. We raised some minor concerns about medicines on day one of our inspection in regard to the use of topical medicines. The medicine management practices were reviewed by the registered manager immediately and action was taken to address our concerns. By day two when we rechecked the system we found no further concerns or issues.
People told us they felt safe and were well cared for. The provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed to assist people in a timely way.
Staff had completed relevant training. We found that the nurses and care staff received regular supervision and yearly appraisals, to help them fulfil their roles effectively.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.
People were able to talk to health care professionals about their care and treatment. People could see a GP when they needed to and they received care and treatment when necessary from external health care professionals such as the district nursing team.
People had access to adequate food and drinks and were assessed for nutritional risk. They were seen by the speech and language therapy (SALT) team or a dietician when appropriate. People who spoke with us were satisfied with the quality of the meals.
People were treated with respect and dignity by staff. People and relatives said staff were caring and they were happy with the care they received and had been included in planning and agreeing their care.
People had access to community facilities and the range of activities provided in the service ensured people could engage in stimulating and interesting social activities.
People and relatives knew how to make a complaint and were happy with the way any issues raised had been dealt with.
People told us that the service was well managed and organised. People and staff were asked for their views and their suggestions were used to continuously improve the service. We found the service to be well managed and organised.
Ashfield Court is a large detached house which has been extended and adapted for its current use. There are two main parts to the home; the original house area and a newer extension, known as “the wing.” The home is situated near The Stray in Harrogate.
The home is registered to provide care for up to 45 people, although we were informed that the maximum number the home would accommodate now would be 42, due to changes in room configuration. At the time of the inspection there were 37 people living at the home, all in single rooms. There was disabled access into and throughout the home. The accommodation is set on three floors and there is a passenger lift serving all floors. There is access to a secure courtyard garden area.
The home had a registered manager in place and our records showed she had been formally registered with the Care Quality Commission (CQC) since August 2011. A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.
People said they felt safe living at the home and said staff treated them well. Staff had received training with regard safeguarding vulnerable adults and demonstrated an understanding of potential abuse. Windows in the corridor area of “the wing” did not have restrictors or devices that met with current Health and Safety Executive guidance for care homes and no risk assessments were in place. Other checks and risk assessments on fire equipment, water systems and electrical and gas installations had been undertaken.
The home was maintained in a clean and tidy manner throughout the inspection. The home used an electronic system to help manage medicines safely. Systems in place to ensure people received topical medicines (creams and lotions) were not safe or managed consistently. Topical medicines were not always in date or dated when opened. The use of topical medicines was not always recorded and some creams prescribed for one person were used on others, who had not been prescribed the item. There was some overstocking of medicines.
Suitable recruitment procedures and checks were in place, to ensure staff had the right skills to support people at the home. A dependency assessment and staff rota documents demonstrated staffing hours at the home were maintained above the provider’s recommended hours.
People and relatives told us they felt staff had the right skills and training to support them. Staff confirmed, and records showed, there was access to a range of training. Regular supervision and annual appraisals took place. Some supervision records were photocopied.
People told us they were happy with the standard and range of food and drink provided and could request alternative dishes, if they wished. Kitchen staff had knowledge of specialist dietary requirements. Soft or pureed diets were presented in a manner that supported people’s dignity.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom. The assistant manager told us no one currently living at the home was subject to a DoLS. Assessments of people’s capacity had been undertaken, but these were not always reviewed. There was some evidence decisions had been made in people’s best interests, in line with the MCA. One relative had signed a consent form without the home being clear they had the authority to do so. Some people with capacity to make decisions had not always been asked to sign consent forms. We have made a recommendation about this.
People’s health and wellbeing was monitored, with evidence of regular access to general practitioners and other specialist health staff.
People told us they were happy with the care provided. We observed staff treated people patiently and appropriately. Staff demonstrated an understanding of people’s particular needs. People said they were treated with respect and their dignity maintained during the provision of personal care. Most people said they were involved in their care planning, although others were unclear about this. There were regular ‘residents’ and relatives’’ meetings and we sat in on one such event during the inspection.
Care plans were not always up to date, did not always contain specific or personalised detail and had not been reviewed effectively or had incorporated new information during the review process. Some activities were offered for people to participate in including; outside visitors conducting exercise classes, group events and some individual support. Most people and relatives told us concerns or complaints were dealt with appropriately.
The quality assurance manager told us regular checks were carried out on people’s care and the environment of the home. These audits and checks had not identified some of the short falls highlighted at this inspection. Staff were positive about the registered manager and the wider management support. Staff told us there were regular meetings at which they could express their views or make suggestions. Records were not always maintained and did not always contain detail of the care and support offered. Copies of the most recent quality questionnaires for people, relatives and professionals were overwhelmingly positive about the home.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to Safe care and treatment and Good governance. We have also made a recommendation to the provider in relation to ensuring the home complies with the requirements of the MCA. You can see what action we told the provider to take at the back of the full version of the report.
We undertook this unannounced inspection on the 20 January 2015. We last inspected Ashfield Court on the 14 November 2013. At that inspection we found the home was meeting the regulations that were assessed.
Ashfield Court is a large detached house which has been adapted for current use to a care home. The home is situated near the Stray in Harrogate. The home provides nursing and residential care for up to 45 older people. The home has single and double bedrooms and there is disabled access into and throughout the home. The accommodation is set on three floors and there is a passenger lift serving all floors. There are comfortable lounge areas and a conservatory to the front of the home.
The home employs a registered manager who had worked at the home for over four years. 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.
The service was safe. People spoke positively about the care they received at Ashfield Court and they said they felt safe and we saw there were systems and processes in place to protect people from the risk of harm.
We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show that staff employed were safe to work with vulnerable people.
People were provided with nutritious food. Assistance and prompting was given by staff where necessary to assist people. Adapted cutlery and crockery were available to people for them to use to help maintain people’s independence.
People who lacked capacity were protected under the Mental Capacity Act 2005 as the provider was meeting the requirements of the Deprivation of Liberty Safeguards. While no applications had been submitted, appropriate policies and procedures were in place. Staff had received training to understand and ensure safeguards would be put in place to help to protect people.
People’s physical health was monitored. This included the monitoring of people’s health conditions and symptoms, so that appropriate referrals to health professionals were made.
Staff were kind and caring and they respected people’s privacy and dignity and we observed this throughout our visit. Staff we spoke with knew people they were caring for well. People’s care needs were recorded in detail in their individual care records
Medicines were administered, stored and disposed of safely and people using the service received their medication as prescribed.
The registered manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. People we spoke with did not raise any complaints or concerns about living at the home.
The home was well led as the culture at the home was open and transparent with staff working together as one large team. The manager was pro-active and was committed to improving the service. This ensured that the home remained a pleasant place for people to live. Effective managements systems were in place to assess the quality of the service and promote people’s safety and wellbeing. During our visit we observed in one of the dining rooms during lunch, that people who were able to walk independently struggled to manoeuvre passed chairs, tables and wheel-chairs in a congested area. We have asked the provider to look at how this could be improved to ensure people were not put at risk.
We received information from Healthwatch. They are an independent body who hold key information about the local views and experiences of people receiving care. CQC has a statutory duty to work with Healthwatch to take account of their views and to consider any concerns that may have been raised with them about this service. We also consulted the Local Authority to see if they had any concerns about the service, and none were raised.
There were robust recruitment and selection processes in place. People were supported by suitably qualified, skilled and experienced staff. Staff were described as 'well trained and competent.' People who used the service and visitors we spoke with gave us the impression that their experiences of the service provided was good and that they received a good standard of care and support.
Audits and quality checks were undertaken to ensure that people experienced a safe and effective care service.
There was an effective complaints system available. At the time of our visit there were no outstanding complaints.
We spoke with a number of people who use the service and they told us that the manager visited them before they came into the home and they had an opportunity to discuss what support they needed.
We asked people whether their privacy and dignity was respected and everyone we spoke with said it was. One person told us that staff always knock on my door and respect my independence.
We asked people about their experience of living at the home and they told us the staff were excellent, very kind and attentive. They described the home as very family like with staff being very helpful and patient.
People told us that there was always something on offer to do, and that the home was starting a choir. They told us about the celebrations they had for the jubilee.
We asked people about making complaints if they were unhappy about any aspect of the service and without exception the people we spoke with said they would talk to a member of the management team and they felt confident that any complaints would be dealt with swiftly.
We asked people if they felt there were enough staff on duty and everyone we spoke with said that although staff were busy they still had time to spend with them and that support was unhurried.
Staff told us that support was very good and the staff team worked well together; they said that training was excellent and there were always opportunities to go on specialist training'.