7 March 2016
During a routine inspection
Ashley Gardens care centre is a privately owned nursing home supporting up to 89 older people who have nursing needs and who may be living with dementia. The premises are purpose built and made up of three units over three floors. There were 84 people living at Ashley Gardens care centre when we inspected.
A registered manager was in post and assisted with our inspection. 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. The registered manager was supported by a deputy manager and unit managers and they all knew people well. They had a good understanding of people’s needs and led by example. Staff told us they felt supported and one staff said that the registered manager was the ‘best manager they had ever worked for.’
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. At the time of the inspection, the registered manager had applied for DoLS authorisations for people living at the service, with the support and advice of the local authority DoLS team. The registered manager and the management team understood their responsibilities under the Mental Capacity Act 2005. Mental capacity assessments and decisions made in people’s best interest were recorded.
The registered manager provided leadership to the staff and had oversight of all areas of the service. There was a culture of continuous improvement, so that people would feel increasingly well cared for. Staff were motivated and felt supported by the registered manager and senior staff. The deputy manager said his aim was to support and coach staff so that all staff felt ‘proud’ that they worked at Ashley Gardens.
The staff understood the vision and values of the service, such as person centred care, treating people with respect and maintaining their privacy and dignity. Staff told us the registered manager was approachable and that they trusted the registered manager to provide good leadership. There was a feeling of unconditional positive regard for people by the staff. People were respected and treated with kindness and consideration. One relative told us “I cannot praise the staff enough, when I know that (staff member) is on duty, I feel lifted. I really trust her to look after my loved one.”
Staff had completed safeguarding training and they knew what action to take if they suspected abuse, and who to report to, such as the local authority safeguarding team. Staff knew about the whistle blowing policy, and were confident they could raise any concerns with the registered manager, who would take appropriate action.
There were sufficient numbers of staff on duty with extra staff made available if people needed them. Staff were checked before they started to work at the service and regularly received training to ensure they had the skills and competencies to provide safe care. New staff received induction training and shadowed established staff before they started to work on their own. Staff met regularly with a senior staff member to discuss their role and practice, and to discuss their training and development needs.
Medicines were stored and administered safely. People had the support they needed to attend health appointments and to remain as well as possible. Staff responded to any changes in people’s health needs; people told us that staff always called their doctor if they felt unwell. People made positive comments about the food, there were daily choices and people took part in choosing the menu. If people were not eating enough their food was monitored. If required a referral was made to a dietician or their doctor, and supplements were provided as necessary so that they maintained a healthy diet.
Potential risks to people were identified and there was guidance in place for staff on how to care for people effectively and safely and keep risks to a minimum without restricting their activities or their life styles and promoting their independence, privacy and dignity.
The care and support needs of each person were different and each person’s care plan was personal to them. Parts of the care plans recorded the information needed to make sure staff had guidance and information to care and support people in the safest way that suited them.
The complaints procedure was available and was displayed around the service. People told us they felt comfortable in complaining and when they did complain they were taken seriously and their complaints were looked into and action was taken to resolve them. People had opportunities to provide feedback about the service provided both informally and formally. Feedback received had been very positive and any issues raised were acted on and taken as an opportunity to improve the service.
People had an allocated keyworker who was involved in their assessments and reviews. A key worker was a member of staff who takes a key role in co-ordinating a person’s care and support and promoted continuity. Staff were attentive and the atmosphere in the service was calm, and people were comfortable in their surroundings. Staff encouraged and involved people in conversations as they went about their duties.
People were given individual support to carry out their preferred hobbies and interests. Staff were familiar with people’s likes and dislikes, such as how they liked their food and drinks and what activities they enjoyed. People were supported to make choices and decisions and staff followed the principles of the Mental Capacity Act 2005.