8 & 9 April 2015
During a routine inspection
Ashlea Court Care Home is registered to provide nursing and personal care for up to 48 older people. The home was purpose built and has been extended. Accommodation is provided over two floors with both stairs and lift access to the first floor. Local facilities and amenities are within walking distance.
The service had 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.
This inspection was unannounced and took place over two days. The previous inspection of the service took place on 28 May 2013 and was found to be compliant with all of the regulations inspected.
The registered manager and senior management team completed quality checks on areas such as the environment, medicines and records. We found this had not been effective and had missed areas that required improvement. Also we found people’s care plans were not written in a person centred style, some had not been updated to reflect changes in needs and not everyone who used the service had plans of care to support all their needs. This meant staff may not have guidance in how to meet people’s needs, staff may not support people in the way they preferred and there was a risk important care could be missed.
These issues meant the registered provider was not meeting the requirements of the law regarding monitoring the quality of the service and assessing and planning care for people. You can see what action we told the registered provider to take at the back of the full version of the report.
Staff completed safeguarding training and knew what measures to take to help to protect people from the risk of abuse or harm. Risk assessments were completed, although we found these lacked some important information to guide staff in how to minimise risk which the registered manager confirmed they would address.
People received their medicines as prescribed and they were held securely. The registered manager told us they were reviewing the storage arrangements so medicines were stored at safe temperatures.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider had followed the correct process to submit applications to the local authority for a DoLS where it was identified this was required to keep them safe. At the time of the inspection there were no DoLS authorisations in place and the service was waiting for assessments and approval of the six applications they had submitted.
Staff supported people to make their own decisions and choices where possible about the care they received. When people were unable to make their own decisions staff mostly followed the correct procedures and involved relatives and other professionals when important decisions about care had to be made. Improvements were needed with the assessment and recording of decisions about the use of bed rails and for decisions about resuscitation.
Our observations showed staff were attentive to people’s needs and were always available. People who used the service told us there were enough staff on duty who would respond quickly to their requests or needs. There were recruitment systems in place that would ensure all employment checks were carried out prior to staff starting work at the service.
Staff approach was seen as caring; they took time to speak to people, they respected privacy and dignity and they involved them in day to day decisions. Staff had developed positive relationships with people and their families. We saw people were encouraged to participate in activities, to maintain their independence and to access community facilities.
People felt able to raise concerns and the registered manager was available for people who used the service, their relatives and staff to talk to. People’s views were sought in meetings and via questionnaires about the service.