Ashmill Residential Care Home

We found the following examples of good practice.

Staff wore personal protective equipment (PPE) in line with guidance. Staff were knowledgeable about what PPE was required for different tasks.

People were supported to keep in touch with loved ones using video calls. The registered manager had considered how to safely facilitate visitors for a person who was receiving end of life care.

Regular cleaning routines were in place and the premises appeared clean and hygienic. People’s rooms were ventilated daily to support the control of infection.

People’s records included a section about COVID-19. This meant that people’s specific needs relating to the pandemic had been considered.

Further information is in the detailed findings below.

Ashmill Residential Care Home is a care home providing care to 17 people at the time of the inspection. The service can support up to 19 people with a physical disability in one adapted building.

Peoples experience of using the service and what we found

Quality assurance systems were in place but needed further development to ensure they consistently identified and addressed shortfalls. Improvements were needed to the systems regarding medicines. Some areas of management of risk needed to be improved. Improvement was needed to make sure all staff were aware of recently approved Deprivation of Liberty authorisations.

People told us they felt safe from abuse and relatives felt their family members were safe. Staff had a good understanding of how to protect people from harm and recognised different types of abuse and knew how to report it.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual care and support needs. We received some mixed views from people and relatives regarding staffing arrangements. Staff followed infection control guidance and had access to personal protective equipment.

People's care needs had been assessed and reviews took place with the person and where appropriate their relative. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people.

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

Staff treated people as individuals and respected the choices they made. Staff spoke to people in a respectful way.

People were supported to take part in activities of interest and their preferences, likes and dislikes were known to staff. The provider had a complaint process which people and relatives were aware of. People's end of life care wishes were recorded in line with their preferences in a respectful and dignified way.

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

Rating at last inspection

The last rating for this service was requires improvement (published 29 January 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

• People’s rights to privacy were not always respected by the staff that supported them and their dignity was not always maintained.

• Staff had not received equality and diversity training and their knowledge of the subject area was basic. Staff supervision was inconsistent and discussions were not recorded.

• Quality assurance and audit systems were not always effective for monitoring service provision and daily records were not being completed fully as staff were not always clear about their roles and responsibilities.

• People were kept safe and secure from risk of harm. Potential risks to people had been assessed and managed appropriately by the provider. People received their medicines safely and as prescribed and were supported by sufficient numbers of staff to ensure that risk of harm was minimised.

• Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual care and support needs.

• Staff sought people’s consent before providing care and support. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible.

• People were treated with kindness and compassion. People were supported to express their views and be actively involved in making decisions about their care and support needs.

• People’s choices and independence were respected and promoted. Staff responded appropriately to people’s support needs. People received care from staff that knew them well.

• People using the service, their relatives and staff were confident about approaching the registered manager if they needed to. The views of people and their relatives on the quality of the service, were gathered and used to support service development.

At the last rating inspection in June 2016, the service was rated Good. At this inspection we found the service was rated as Requires Improvement.

Rating at last inspection: Good. The last report for Ashmill Residential Care Home was published on 15/06/2016.

About the service: Ashmill Residential Care Home is registered to provide care for 19 people. The service cares for people with learning disabilities or autistic spectrum disorder, mental health, dementia, eating disorders, drug and alcohol misuse, physical and sensory impairments. and at the time of our visit they were providing care and support for 16 people.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has now been rated as Requires Improvement overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

Ashmill is registered to provide accommodation for up to nineteen people who require nursing and personal care. At the time of our inspection there were eighteen people living at the location.

At the time of our inspection 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.

There were inconsistencies amongst staff seeking people’s consent before providing care and support.

Staff understood when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) should be followed.

People received care from staff that knew them well and benefitted from opportunities to take part in activities that they enjoyed, although a wider variety of activities was requested by people, relatives and staff.

The provider had management systems in place to audit, assess and monitor the quality of the service provided, although these were inconsistent and not all people and their relatives felt involved.

People were safe and secure because risks had been assessed and managed appropriately. Staff were able to identify possible abuse and take actions to alert the appropriate professionals so that they could be protected.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual needs.

People safely received their medicines as prescribed to them.

People were supported to have food that they enjoyed and meal times were flexible to meet people’s needs.

People were supported to stay healthy and had access to health care professionals as required. They were treated with kindness and compassion and there was positive communication and interaction between staff and the people living at the location. Staff were aware of the signs that would indicate a person was unhappy and knew what action to take to support people effectively.

People’s right to privacy was promoted and people were encouraged to be as independent as possible.

The provider had management systems in place to audit, assess and monitor the quality of the service provided.

People were safe and secure because risks had been assessed and managed appropriately. Staff were able to identify possible abuse and take actions to alert the appropriate professionals so that they could be protected.

Staff had been recruited appropriately and had received relevant training so that they were able to support people with their individual needs.

People’s right to privacy was promoted and people were encouraged to be as independent as possible.