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The Ashton Care Home Requires improvement

Reports


Inspection carried out on 11 December 2018

During a routine inspection

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 carried out on 6 September 2016

During a routine inspection

This inspection took place on the 6 and 7 September 2016. The first day of our inspection was unannounced.

The Ashton Care Home 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. There were 61 people using the service at the time of our inspection.

The service had a 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.

People told us they felt safe living at The Ashton Care Home. Relatives we spoke with agreed. The staff team were aware of their responsibilities for keeping people safe from avoidable harm and knew to report any concerns to the management team.

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.

Plans of care had been developed for each person using the service and the staff team knew the needs of the people they were supporting.

People had received their medicines as prescribed. Systems were in place to regularly audit the medicines held at the service and the appropriate records were being kept.

Checks had been carried out when new members of staff had started working at the service. This was to make sure that they were suitable and safe to work there.

The staff team had received an induction into the service and training on a variety of topics had been provided to enable them to meet people's needs.

The majority of people we spoke with felt that there were enough staff on duty to meet people’s needs; some however thought there were not. The registered manager told us that they would monitor the staffing levels so that appropriate numbers of staff were deployed on each shift.

People told us the meals served at The Ashton Care Home were good. People’s nutritional and dietary requirements had been assessed and a nutritionally balanced diet was being provided.

For people who had been assessed to be at risk of not getting the food and fluids they needed to keep them well, records were kept showing their food and fluid intake.

People were supported to maintain good health, have access to healthcare services and receive on going healthcare support.

People told us that the staff team were kind and caring and they treated them with respect. The relatives we spoke with agreed. Throughout our visit we observed the staff team treating people in a kind and friendly manner.

The staff team supported people to make decisions about their day to day care and support. Where people lacked the capacity to make their own decisions, we saw that decisions had been made for them in their best interest.

There was a formal complaints process which was displayed for people’s information and people we spoke with knew what to do and who to speak with, if they had a concern of any kind.

Relatives and friends were encouraged to visit and were made welcome by the staff team.

Meetings were held and surveys were used to gather people’s views on the service provided.

There were systems in place to regularly check and monitor the quality and safety of the service being provided.

Inspection carried out on 22 & 24 September 2015

During a routine inspection

This inspection took place on the 22 and 24 September 2015 and was unannounced.

The Aston Care Home provides accommodation for up to 72 people who require nursing or personal care. There were 53 people using the service at the time of our inspection including people living with dementia.

The service had a 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.

Not everyone we spoke with felt there were always enough staff on duty to meet the needs of the people using the service. The management team had acknowledged this and were currently looking at the staffing levels at the service.

People told us they felt safe living at The Ashton Care Home. The staff team were aware of their responsibilities to keep people safe and told us they would report any concerns to the management team. The management team had not always referred concerns onto the relevant authorities.

The risks associated with people’s care and support had been assessed. This provided the registered manager and the nursing team the opportunity to identify, assess and address any risks associated with people’s care and support.

Recruitment processes had been followed and checks had been carried out on new staff members to check they were suitable to work at the service.

People on the whole had received their medicines as prescribed, though there were some inconsistencies within people’s medication administration records.

People had been involved in making day to day decisions about their care and support and when necessary, assessments had been carried out to assess their mental capacity to make decisions for themselves. The assessments we checked however were not decision specific and we could not determine which part of the person’s care and support they related to.

People’s nutritional and dietary requirements were assessed and a balanced diet was provided, with a choice of meal at each mealtime. Monitoring charts used to monitor people’s food and fluid intake were not always completed consistently.

The staff team felt supported by management. Training had been provided and they had been given the opportunity to meet with a member of the management team to discuss their progress.

People told us they were treated with respect and the staff team were kind and considerate. Relatives agreed.

Relatives and friends were able to visit at any time and they told us they were always made welcome by the staff team.

People had access to all the required healthcare services, they were supported to maintain good health and received on-going healthcare support.

There was a formal complaints procedure which was displayed throughout the service. People knew how to complain and they felt that any issue that was raised would be dealt with appropriately.

Staff meetings and meetings for the people using the service and their relatives were being held. This provided people with the opportunity to be involved in how the service was run.

There were systems in place to regularly check the quality and safety of the service being provided and regular checks had been carried out on the environment and on the equipment used to maintain people’s safety. The monitoring of records had not always been effective in identifying shortfalls.