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The Ashton Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 25 January 2019

The Ashton Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Ashton Care Home is located in the town of Hinckley, Leicestershire. It provides accommodation for up to 72 people who require nursing or personal care. Accommodation is provided on three floors. Residential care on the ground floor, dementia care on the first floor and nursing care on the second floor. On the day of our inspection there were 64 people using the service.

We inspected The Ashton Care Home on 11 and 12 December 2018. The first day of our visit was unannounced. This meant the staff and the provider did not know we would be visiting.

At the last inspection in September 2016, the service was rated Good. At this inspection we found the service Required Improvement.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Appropriate numbers of staff had not always been suitably deployed to meet people’s needs in a caring, safe or timely manner.

Systems in place to monitor the quality and safety of the service being provided were not always effective.

Care records kept to demonstrate people were being supported in line with their plan of care were not always accurate, up to date or completed.

The providers infection control policy had not always been followed. Protective personal equipment, such as disposable gloves and aprons were readily available, though not always used.

People’s needs had been considered prior to them moving into the service and the risks associated with their care and support had been assessed and managed.

There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Appropriate checks had been carried out when new staff members joined the service and relevant training had been provided. Not all of the staff team had received training on how to support people at the end of their life. We have made a recommendation about this.

The staff team supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected. Where people lacked the capacity to make their own decisions, these had been made for them in their best interest and in consultation with others.

People's food and drink requirements had been assessed and a balanced diet was being provided. People received on-going healthcare support and had access to the relevant healthcare services.

People told us the staff team were kind and caring and treated them with respect.

The staff team felt supported by the registered manager and the senior team and told us there was always someone available to talk with should they need guidance or support.

People were supported with their medicines in a safe way. Systems were in place to regularly audit the medicines held and the appropriate records were being kept.

People were provided with a clean and comfortable place to live and there were appropriate spaces to enable them to either spend time with others, or on their own.

Relatives and friends were encouraged to visit. People were provided with the opportunity to have a say and to be involved in how the service was run.

Inspection areas

Safe

Requires improvement

Updated 25 January 2019

The service was not consistently safe.

Sufficient numbers of staff were not always deployed in order to meet people’s care and support in a safe or timely way.

Staff understood their responsibilities for keeping people safe from avoidable harm.

The providers infection control policy was not always followed.

Risks to people had been assessed and managed and lessons were learned when things went wrong.

Effective

Good

Updated 25 January 2019

The service was effective.

People’s care and support needs had been assessed prior to them moving into the service.

People were supported to maintain a balanced diet and were assisted to access health care services when they needed them.

People's care and support needs were met by the adaptation, design and decoration of the premises.

People’s consent to their care and support was sought and the staff team understood the principles of the Mental Capacity Act 2005.

Caring

Requires improvement

Updated 25 January 2019

The service was not consistently caring.

Staffing numbers meant the staff team had little time to focus on people’s wellbeing.

The staff team were kind and caring and treated people with respect.

People were supported to make decisions about their care and support on a daily basis.

The staff team respected people's personal preferences and choices.

Responsive

Requires improvement

Updated 25 January 2019

The service was not consistently responsive.

Records did not demonstrate people’s plans of care were always followed.

People who were able had been involved in the planning of their care with the support of their relatives.

There was a formal complaints process in place and people knew what to do if they were unhappy about anything.

People’s wishes at end of life were being explored. Not all of the staff team had received training in how to support people at the end of life.

Well-led

Requires improvement

Updated 25 January 2019

The service was not consistently well led.

Monitoring systems used to check the quality of the service being provided were not always effective.

People had been given the opportunity to share their thoughts on how the service was run.

The registered manager worked in partnership with other organisations including the local authority and safeguarding team.