30 July 2022
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.
The inspection was carried out by one inspector, a specialist nursing adviser and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Ashby 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. Ashby House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a manager in post who had applied to CQC to become the registered manager.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 used all this information to plan our inspection.
During the inspection
We spoke with four people who used the service and eight relatives about their experience of the care provided. We spoke with, and received email feedback from, 15 members of staff including the regional manager, manager, nurses, senior care staff, care staff, activities, administration and maintenance staff.
We reviewed a range of records. This included aspects of eight people’s care records and multiple medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance audits, staff training and supervision records were reviewed.
Following the inspection, we reviewed further records submitted by the manager, including training data and updated care records.
30 July 2022
About the service
Ashby House is a residential care home providing personal and nursing care to up to 64 people. The service provides support primarily to older people, some who require nursing care and some who are living with dementia. At the time of our inspection there were 60 people using the service.
Ashby House is a purpose-built care service with all accommodation and facilities on one floor. There are three separate units to support people with differing primary needs.
People’s experience of using this service and what we found
The manager was in the process of making improvements to assessment and decision-making documentation for people who lacked capacity to make their own decisions, or whose capacity fluctuated. Staff understood how to support people who may not always have mental capacity to make certain decisions.
Staffing levels were determined using a dependency tool and we saw there were sufficient staff to meet people's care needs. Staff provided mixed feedback about staffing levels. The staff team were becoming more stable after a period of change in recent months. Safe recruitment processes were used to ensure staff were suitable for their roles.
Accidents and incidents were recorded and followed up appropriately. These were regularly reviewed to identify if any actions could be taken to reduce the risk of recurrence.
Systems were in place to safeguard people from the risk of abuse, and staff knew how to use them. People received their medicine safely from trained staff.
Risks associated to people's care were assessed, monitored and regularly reviewed. This ensured staff had the right information and guidance to ensure safe care provision. Infection prevention and control measures were followed to reduce the risk of infection spread.
The manager promoted an open culture in the service. Most of the feedback we received from people, relatives and staff was positive about how the service was run.
Audit processes were embedded in all key areas of the service so the provider could assure themselves of the quality and safety of service provision. The manager also had an action plan which identified and prioritised areas of improvement.
Staff worked with a range of health and social care professionals to ensure people's care and treatment needs were assessed, monitored and met.
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 but records required updating.
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 good (published 10 July 2018.)
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 COVID-19 and other infection outbreaks effectively.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.