Background to this inspection
Updated
26 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was prompted in part by notification of a safeguarding incident. This incident is subject to a criminal investigation and, as a result, this inspection did not examine the circumstances of the incident.
This inspection took place on 16 and 24 October 2017 and was unannounced. The inspection was conducted by one inspector.
As part of the inspection, we reviewed the information we held about the service, such as statutory notifications we had received from the provider. Statutory notifications are about important events which the provider is required to send us by law. We asked the local authority and Healthwatch if they had information to share about the service. We used this information to plan the inspection.
During the inspection, we spoke with two people who lived at the home. We spoke with three staff which included the provider, the deputy head of home and one care staff member. We viewed two records which related to the assessment of people’s needs and risk. We also viewed other records which related to the management of the service such as medicine records and accident reports. We spent time observing how staff supported people and how they interacted with them.
Updated
26 January 2018
The inspection was carried out on 16 and 24 October 2017 and was unannounced.
Ashgrove Care Home is registered to provide accommodation with personal care for up to a maximum of 10 older people. There were two people living at the home during our inspection, visit however shortly following this the provider confirmed that both people had moved out of the home.
The provider is registered as an individual and therefore is not required by law to have a separate registered manager. 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.
At our last inspection on 5 and 6 June 2017, we found the provider was in breach of the Regulations of the Health and Social Care 2008 (Regulated Activities) 2014. We gave the service an overall rating of requires improvement. The breach related to the provider’s failure to ensure good governance. We asked the provider to send us an action plan to tell us how they would make these improvements by the 7 September 2017. Despite several contacts with the provider requesting their action plan we did not receive it prior to this inspection.
The service was not well-led. The provider lacked knowledge and understanding of the care regulations and their requirement to comply with them. There was a lack of effective systems to monitor the quality and safety of the service and to drive improvements.
There was a reduction in staff employed at the home and the provider was considering extending their service user band to include people living with dementia. We were not confident that staffing arrangements in place would support changes in people’s needs or the needs of new people who may wish to live in the home.
The provider was unable to demonstrate what, if any, learning they took from accidents to prevent them from happening again.
There was a lack of effective systems in place to identify and monitor staff training needs. Not all staff had received training that was relevant to their roles and responsibilities.
The provider had not sought advice on person-centred care planning as recommended. We found that people’s care records did not record their involvement in care planning and reviews. However, people felt staff knew them and their preferences well.
The provider had not conspicuously displayed their ratings from the latest inspection at the home as they are required to do by law.
People were satisfied with the choice and quality of food available to them. Staff were aware of people’s dietary needs and monitored what people ate and drank to ensure people’s nutritional needs were met.
People were supported to take their medicines when they needed to. Staff monitored people’s health and arranged healthcare appointments as necessary.
Staff sought people’s consent before supporting them and enabled them to make their own decisions.
People found staff to be kind and patient and enjoyed positive working relationships with them. People were given choice and felt listened to. Staff treated people with dignity and respect and encouraged them to maintain their independence.
People had not had cause to complain but felt confident and able to raise concerns should the need arise.
Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.