Ashton View Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment since this provider took over ownership of the home. This key question has been rated good. This meant people were safe and protected from avoidable harm

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents, incidents and complaints had all been logged on the provider’s electronic governance system. Records detailed what had occurred, actions taken, outcomes and lessons learned. Where required, root cause analysis had been completed to identify patterns and trends, and support learning.

Clinical review meetings were completed. These included a review of incidents and accidents and considered whether actions taken had been appropriate, and whether any additional learning could be shared with be wider staff team.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider ensured documentation was shared with other organisations and professionals when people moved between services. Detailed information about people’s needs, how they wished to be cared for and any potential risks to be aware of, often referred to as a hospital passport, were generated and accompanied people when they were admitted to hospital, to help ensure continuity of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider had up to date safeguarding policies in place. Any safeguarding concerns had been reported in line with local authority guidance. A log was used to monitor any safeguarding concerns. Records detailed what had occurred, actions taken, outcomes and any lessons which had been learned.

Staff had received training in safeguarding, which was refreshed regularly and knew how to identify the different types of abuse and report any concerns.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care records contained a mix of generic and individual risk assessments, covering areas such as skin integrity, nutrition, oral health, mobility, falls and choking. These assessments detailed any risks and how these would be managed. Where people had risks specific to them, for example, becoming distressed during aspects of their care, personalised assessments had been completed, to ensure staff had the necessary information to keep themselves and people safe when carrying out care tasks.

One person’s care record stated they required close supervision due to risks to themselves and others. On 2 occasions during our site visits, this person came to chat to us in the room we were using, without staff being aware they had done so, until we flagged this with them. On both occasions, staff told us they thought the person had gone to their bedroom. We raised this with the provider who reiterated the importance of ensuring effective monitoring was completed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Risk assessments of the environment and equipment used within the home had been completed, to ensure these were fit for purpose and used correctly. Ongoing safety checks had also been completed in line with legislation, with certification in place to confirm compliance. This included checks of gas and electrical safety and equipment such as the passenger lift and hoists. The provider had an up-to-date business continuity plan, which explained what action would be taken in an emergency, for example if the home were to have no power, heating or access to water.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider used a system for determining how many staff were required on shift per day to meet people’s needs, often referred to as a dependency tool. Rotas had been completed in line with this. Despite the tool indicating enough staff were deployed, we received mixed feedback from people, relatives and staff. Comments included, “I think there is enough staff, but I do have to wait quite a while when I need the toilet during the day”, “No, I don’t think there are enough staff, though the staff are lovely and do their best” and “Staffing can be fine some days and other times not.”

Ongoing recruitment was being undertaken to fill staff vacancies. In the interim, the provider was relying heavily on the use of agency staff, though the same group of agency staff were being used, to try and ensure continuity of care.

Staff had been recruited safely, with all required employment checks in place. A detailed induction process was in place for new staff, to ensure they understood the role and felt confident to safely provide care to people. Staff had completed training in topics necessary to provide safe and effective care and meet people’s needs. Completion rates for the majority of topics were 90% or above. Staff received supervision and appraisals in line with the providers policy.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were protected as much as possible from the risk of infection because premises and equipment were kept clean and hygienic, with no lingering offensive odours noted. Bathrooms and toilets all contained hand hygiene guidance, liquid soap and paper towels. Domestic staff were observed throughout the home, completing daily and weekly tasks. Infection risks were identified and addressed through internal audits.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were stored safely and securely, and stock levels checked on the day of inspection were correct. Controlled drugs, which require extra storage and documentation due to their potential for misuse and abuse, were stored appropriately.People that were prescribed medicines for Parkinson’s disease were given these on time which is vital for best health outcomes.

For people prescribed ‘as and when required’ (PRN) medicines, protocols were in place to ensure staff would know how and when to give these appropriately. Body maps were in place for people who were prescribed medicine in a patch form, which is stuck to the skin. However, one person’s records showed their patch had been applied to the same site on two consecutive applications, meaning there is a higher risk of skin irritation and the medicine not being consistently absorbed.

People that were prescribed creams had body maps in place, so staff knew where to apply these correctly. Some electronic care records did not always show all creams prescribed for people, which could lead to confusion when documenting which creams have been applied by carers.

Care plans had up-to-date information on people’s needs, for example: diabetes insulin and blood glucose monitoring regimes, and percutaneous endoscopic gastronomy (PEG) feeding and care regimes.Regular medicines audits were completed by management and staff training, and competencies were up to date. There was evidence of appropriate actions being taken in the event of a medicine error or incident taking place.