• Care Home
  • Care home

Ashtead House

Overall: Requires improvement read more about inspection ratings

153 Barnett Wood Lane, Ashtead, Surrey, KT21 2LR (01372) 810330

Provided and run by:
Ashtead House Limited

Latest inspection summary

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Background to this inspection

Updated 4 May 2023

The inspection

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.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team was made up of 3 inspectors.

Service and service type

Ashtead 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. Ashtead House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. We were supported on the inspection by the regional manager and a deputy manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We used this information to plan our inspection.

During the inspection

We spoke with 3 people and 3 relatives about their experience. We spoke with 6 members of staff including the deputy manager, regional manager, and care staff. We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Overall inspection

Requires improvement

Updated 4 May 2023

About the service

Ashtead House provides accommodation and personal care for up to 10 people who have a learning disability and autism or have a mental health diagnosis. At the time of our inspection, there were 7 people living at the service. The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Risk associated with people’s care were not always managed well by staff. There were not sufficient staff deployed to ensure the safety of people. The service was not well maintained, and the décor was outdated.

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. People told us they felt safe, and staff were knowledgeable on safeguarding procedures. People had access to external health care support.

Right Care

Staff were not trained effectively, and their competencies were not assessed. Assessments of care were not completely sufficiently to ensure people’s needs and preferences were considered. There were times people were not treated in a kind and respectful way. People did not have access to meaningful person-centred activities. Meals did not always look appetising, and people did not have a choice at mealtimes.

Right Culture

The recruitment of staff was not always undertaken in a robust way. There had been a lack of management oversight at the service. Systems in place to audit the service were not robust and actions were not always taken where shortfalls were identified.

Incidents and accidents were reviewed, and actions taken to mitigate the risks. There had been a delay in responding to complaints, but this was being addressed by the providers team.

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 March 2020). At our last inspection we recommended that staff were supported to obtain the necessary skills to meet people’s needs and to ensure documents in care plans were accurate and properly analysed. At this inspection we found the provider had not acted on these recommendations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive 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.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

Enforcement and Recommendations

At this inspection we have identified breaches in relation to people not being protected from unsafe care, staff not being appropriately trained and supervised, and people not being supported appropriately with meaningful activities. We also identified breaches in relation to dignity and respect and the lack of robust oversight.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk