During our inspection in April 2015, we found that people were not protected from the risks of infection, as there were ineffective cleaning processes in place. Communal areas within the service, and people’s bedrooms had not been cleaned effectively. We found that cleaning within the service was not satisfactory or robust. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We also identified that the systems in place for assessing risk factors for people were not robust. Risks around people’s needs were not always recognised or appropriately assessed. As a result of this, the care and support provided to people could have been compromised. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We further identified that the systems in place for medication management were not robust. The systems and processes used for recording, administration and disposal of medication were not safe. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
In addition to the above breaches, we also identified that the systems in place for monitoring record keeping and ensuring that people’s individual records were up to date were not used effectively. Care records and risk assessments had not consistently been updated which meant they were not reflective of people’s current needs. This was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Following the inspection the provider sent us an action plan detailing the improvements they were going to make, and stating that improvements would be achieved by 14 August 2015.
This report only covers our findings in relation to the outstanding breaches of regulation. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Ashby House Nursing Home’ on our website at www.cqc.org.uk.
Ashby House Nursing Home is registered to provide accommodation and support for 64 older people who require nursing or personal care, and who may also be living with dementia. On the day of our visit, there were 52 people living in the home.
The inspection was unannounced and took place on 14 and 15 September 2015.
The service did not have a registered manager. Management cover was being provided by a general manager who had submitted their application to the Care Quality Commission to become the registered manager. 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.
During this inspection, we found that improvements had been made to the systems in place within the service, to ensure that appropriate standards of cleanliness and hygiene had been maintained. Staff had reviewed their practice in respect of cleaning, and had worked hard to ensure this was now more thorough.
We reviewed the medication systems in place, and found that these had been strengthened. The processes in place were more robust and more regular audit checks were taking place of all aspects of the medication systems, including recording and disposal. Because of this issues were now identified and addressed in a timelier manner.
We also reviewed people’s risk assessments and care plans to ensure they had been updated in accordance with any changes in their care needs, or general condition. We found that steps had been taken to review care records on a monthly basis so that they remained reflective of people’s care and support needs.
While improvements had been made we have not revised the rating for this key question; to improve the rating to ‘Good’ would require a longer term track record of consistent good practice. We will review our rating for safe and well-led at the next comprehensive inspection.