Ashbrook House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had developed a positive learning culture within the care home. People were encouraged and supported to raise safety concerns with managers and staff. Managers and staff understood the importance of reporting safety concerns. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated and when lessons needed to be learnt this was used to continually improve staff practice. The registered manager told us, “I ensure my staff record and report any safety concerns and incidents that occur which I will always investigate and learn lessons where needed, so we’re constantly improving the care we deliver to people at Ashbrook House.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Managers gathered information about people’s individual needs and wishes, and risks to their safety, prior to them using the service. This information was used to develop person-centred care and risk management plans which were shared with staff to help them provide safe and appropriate care to people from the moment they started living in the care home. Managers and staff worked closely with all the relevant external health and social care professionals and bodies to make sure care plans and risk assessments reflected people’s current needs and wishes.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living in the care home and with the staff who supported them there. One person told us, “I do feel very safe living here. The staff know how to take care of us.” A relative added, “My [family member] is more than safe living at this care home, which is so much better than the last place they lived.” Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I would tell the person in-charge of the shift or the manager if I saw anyone being abused at the care home.” Managers worked proactively with the relevant agencies, when a concern was raised, and took appropriate action to safeguard people from further risk, when this was required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People’s care records contained sufficiently detailed information for staff to follow to ensure risks to people were mitigated, so people remained safe when taking part in activities and events of their choice. Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to reduce or safely manage them. A member of staff told us, “We have positive behavioural support plans in place for people who need them, so we can safely deescalate and support individuals if they become distressed. I know to give people enough time and space when they look like they might be distressed.” An external care professional added, “Staff are risk aware and proactively identify risks to people’s safety.” Throughout our site visits we observed staff were visibly present, attentive and aware of people’s whereabouts in the care home and any changes that might indicate they needed additional support. Risk assessments and management plans were reviewed at regular intervals and updated according to reflect any changes in people’s needs.

The service did not always detect and control potential risks in the care environment. They did not always make sure the environment was well-maintained and learning disability friendly.

Uncovered portable radiators were being temporarily used in some people’s bedrooms, contrary to best health and safety practice. This had placed some people at risk of harm. The registered manager responded immediately during the inspection and removed all the unsafe portable radiators and reminded staff not to use these portable radiators in future. We saw the portable radiators were no longer in use at the time of our second site visit. The registered manager confirmed maintenance work to repair the service’s heating system had now been completed.

In addition, parts of the care home’s interior were not always maintained to a good standard. For example, most of the cabinets in the kitchen were damaged and worn and needed replacing.

Furthermore, the care homes environment was also not particularly ‘learning disability friendly.’ For example, there was not enough easy to understand pictorial signage used throughout the care home to help people with a learning disability or autistic people orientate themselves and identify the function of rooms that were important to them, such as toilets, bathrooms, lounge, dining room, kitchen and bedrooms. We discussed these issues with the managers at the time of our assessment who acknowledged the kitchen was well overdue refurbishing and better, easy to read signage needed to be used throughout the care home. The registered manager confirmed both these issues were identified during recent internal quality assurance audits and actions plans were in place for them to be addressed within the next 3 to 12 months.

People told us the care home was a comfortable place to live. One person said, “It’s always nice and warm in the home. I do feel comfortable living here and have everything I need in my room.” The care home environment was free from unnecessary slip or trip hazards. which enabled people to move safely around the care home. Safety systems and equipment was maintained and serviced at regular intervals. Staff told us they had clear guidelines available to help them deal with emergencies. Personal emergency evacuation plans were in place to help staff evacuate people in the event of a fire.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider employed enough permanent care staff and only used temporary agency staff in exceptional circumstances. This meant people received their personal care from staff who were familiar with their individual needs, preferences and daily routines. Staffing rotas were planned based on people’s dependency and individual needs. Staffing levels matched the staff duty rota on both days of our site visits. Managers and staff were visible throughout the service during the assessment and were quick to respond to people’s questions and requests for support. People told us the care home was adequately staffed. One person said, “There’s always staff around to help us whenever we need them.” A relative added, “From what I have seen on my visits there always seem to be enough staff on duty in relation tothe number of residents living here.”

Staff were supported with their learning and development needs and encouraged to continually improve in their role. They received the right mixture of e-learning and in-person practical and theoretical training and competency-based assessments which were being routinely refreshed and updated. A member of staff told us, “The training I’ve received since working here has been excellent, especially my induction.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their managers and co-workers. One member of staff said, “The managers here always make sure we have regular one-to-one supervision and work performance appraisal meetings with them so they know how we’re doing and what we might need.”

The provider operated safe recruitment practices and only suitable staff were employed to work at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People lived in a clean, hygienic environment. Staff followed current best practice to reduce the risk of infections spreading. A relative told us, “The home is always clean whenever I visit.” An external care professional added, “The home is always clean and tidy.” Staff were provided with relevant training to help them prevent and control the risk and spread of infection in the care home. They had access to resources and equipment to help them reduce infection risks and used this appropriately, which included adequate supplies of personal protective equipment (PPE). A member of staff told us, “We have enough PPE we can access.” Staff appropriately maintained cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks at the service.

The provider made sure that medicines were safe and met people’s needs, capacities and preferences.

Medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their medicines as prescribed. A relative told us, “My [family member] is given all the medicines they are prescribed at the appropriate times.” Care records contained detailed guidance for staff about how people needed and preferred their prescribed medicines to be administered. Sufficiently detailed risk assessments and protocols for use were in place to guide staff including, 'as required' medicines. A member of staff told us, “We have clear protocols in place for the use of ‘as required’ medicines, so we know exactly when and how to administer them safely. For example, we know we must only use this type of medicines to help people who have become distressed as a ‘last resort’ when all other strategies to manage the situation had been tried without success.” Staff received relevant medicines training and their competency to continue managing medicines safely was routinely assessed. There were regular internal and external audits of the care homes medicines practices.