10 November 2022
During an inspection looking at part of the service
Ashley Gardens Care Centre is a residential nursing home providing personal and nursing care and treatment of disease, disorder or injury to up to 89 people. The service provides support to older and younger adults with dementia needs and nursing needs. At the time of our inspection there were 76 people using the service.
Ashley Gardens Care Centre is a purpose-built care home, with accommodation across three separate floors Each floor has separate adapted facilities, such as dining room, kitchen area and lounge. People had their own bedrooms and toilets.
People’s experience of using this service and what we found
Risks to people had not been fully mitigated since our previous inspection. Some people with constipation or other health conditions such as diabetes did not always receive their assessed care.
We observed there were times when there was not enough staff, and people, staff and relatives confirmed this. Some people did not receive medicines when they should, meaning they were at risk of experienced discomfort or distress. Accidents and incidents were not always reported to managers which meant that lessons may not have been learned and shared, and improvements made.
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.
Quality audits had not always highlighted where improvements were needed in service delivery and some concerns had not been shared with managers. Some incidents of bruising to people had not been reviewed to ensure risks were mitigated.
Risks to people from falls and complex eating and drinking needs had been addressed by the provider and care plans were improved. A new management team had been driving improvements and a new manager had started and was in the process of registering with CQC.
People told us they liked their staff and we observed caring interactions. One person commented, “The staff are kind and caring; you can’t fault anything to do with that.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was Inadequate (published 14 October 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made and the provider was no longer in breach of regulations relating to safeguarding. However, despite some improvements the provider was still in breach of regulations relating to safe care, good governance and staffing.
Why we inspected
The inspection was prompted in part due to concerns received about diabetes care and staffing. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
Following our last inspection we imposed conditions on the location meaning the provider must send reports of audits completed every month. The provider has been complying with this condition and updating CQC on the improvements they are making in the service.
We have identified continued breaches in relation to safe care, staffing and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.