Background to this inspection
Updated
11 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 04 September 2018 and was unannounced.
The inspection was carried out by one inspector, a specialist advisor nurse 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.
Prior to this inspection we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law. We asked for feedback from the local authority and the local clinical commissioning group (CCG).
Before the inspection the provider sent us a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
As part of the inspection we spoke with seven people and three relatives. We spoke with the registered manager, the clinical lead, one nurse, three care staff and a care companion. We reviewed care plans for six people, including risk assessments and daily notes. We looked at medicines records, mental capacity assessments and applications to deprive people of their liberty. We also looked at a variety of audits, surveys, meetings minutes and other documents relevant to the management of the service.
Updated
11 October 2018
The inspection took place on 4 September 2018 and was unannounced. Our last inspection was in July 2017 where we identified one breach of the legal requirements in relation to medicines and infection control. At this inspection, the provider had taken action to meet the legal requirements of the regulations.
Ashton Manor Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Ashton Manor Nursing Home provides care to up to 39 people in one adapted building. They provide support to older people, people with physical disabilities and long term medical conditions. They also provided support to people living with dementia. At the time of our visit, there were 32 people living at the home.
There was a registered manager in post. 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.
Risks to people were assessed and actions were identified and implemented to keep people safe. Staff understood people’s clinical needs and appropriate support was provided to meet them. People had regular access to healthcare professionals and staff worked collaboratively with them. People’s medicines were managed and administered in line with best practice and staff had received medicines training and their competency had been assessed. Nursing staff had support to maintain their competencies and the provider had checked that nurses were registered with the Nursing & Midwifery Council (NMC).
There were sufficient numbers of staff to meet people’s needs safely and the provider had carried out checks on staff to ensure they were suitable for their roles. Staff underwent training before working with people and this had been regularly refreshed. Staff had regular one to one supervision meetings and there was an appraisal and competency framework in place to allow staff to develop themselves. Staff felt supported by management and there were systems in place to enable communication between staff.
Staff understood their roles in safeguarding people from abuse and records showed staff responded appropriately to incidents. The provider monitored incidents and clinical risks such as weight loss and infections. There were a variety of checks and audits undertaken at the service to identify and respond to any issues. People were regularly asked for their feedback and regular meetings took place to involve people in the running of the home. There was a complaints policy in place and records showed complaints were responded to in line with this policy.
People’s care was planned in a person centred way and staff knew what was important to people. We observed that staff were kind and caring and got on well with people. Staff offered people choices and involved them in their care. People were encouraged to maintain skills and independence and staff provided support in a way that was respectful of people’s privacy and dignity. End of life care was planned sensitively and delivered in a personalised way, by trained staff.
Staff supported people to eat food that matched their preferences and met their dietary needs. There was a wide variety of activities taking place at the home which covered a range of interests. People lived in a clean home environment that had been adapted for their needs. Relatives told us they were made to feel welcome and staff knew what was important to people.