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Inspection carried out on 27 June 2019

During a routine inspection

About the service

Ashlea Mews is a care home providing personal care to 40 people aged 65 and over. Nursing care is not provided. The service can support up to 40 people.

The home was divided into two separate units, one provided general residential care and one provided support to people who lived with dementia.

People’s experience of using this service and what we found

People said they were safe and there were sufficient staff although they were busy. One relative commented, “The staff are good here, although they could do with more staff and more activities.”

People received limited opportunities for activities and engagement when staff were busy.

Improvements were required to cleanliness in some areas of the home.

We have made a recommendation staffing levels are kept under review and to ensure an adequate standard of cleanliness around the building.

People enjoyed a very positive dining experience with the support of staff. Improvements were required to menus and the timings of meals.

We have made a recommendation nutritional guidance is followed to ensure people received a varied and balanced diet.

Improvements were required to manage and respond to complaints and concerns.

The environment was well-maintained and it promoted the engagement of people who lived with dementia.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed.

Communication was effective to ensure staff and relatives were kept up-to-date about any changes in people's care and support needs and the running of the service.

Records provided guidance to staff to ensure people received safe, person-centred, appropriate care and support. Information was accessible to involve people in decision making about their lives.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks.

Appropriate training was provided and staff were supervised and supported. Staff had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.

There were opportunities for people, relatives and staff to give their views about the service. The provider undertook a range of audits to check on the quality of care provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 30 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received about standards of care, staffing levels, lack of activities and lack of responsiveness to complaints. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective, Caring and Responsive domains of this full report.

We have found evidence that the provider needs to make some other improvements. Please see the Safe, Effective and Responsive sections of this full report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 22 March 2017

During a routine inspection

This inspection took place on 22 and 23 March 2017. The first day of the inspection was unannounced. This meant the staff and registered manager did not know we would be visiting.

Ashlea Mews Residential Home provides personal care and accommodation for 40 older people. The service was supporting 39 people at the time of this inspection.

The service had a registered manager. 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.

Food and fluid charts were not fully completed, target amount of fluids were not recorded. Where people had refused meals, there were no records to suggest staff had returned at a later time to offer food again.

We have made a recommendation about maintaining records regarding people’s nutritional needs.

There were robust recruitment processes in place with all necessary checks completed before staff commenced employment.

There were systems in place to keep people safe. We found staff were aware of safeguarding processes and knew how to raise concerns if they felt people were at risk of abuse or poor practice. Accidents and incidents were recorded and monitored as part of the registered manager’s audit process.

The registered provider used a dependency tool to ascertain staffing levels. We found staffing levels to be appropriate to meet needs of people who used the service. These were reviewed regularly to ensure safe levels. Call buzzers were answered in a timely manner and staff were visible throughout the building.

Medicines were administered by trained staff who had their competencies to administer medicines checked regularly. Medicine administration records (MAR) were completed with no gaps, medicine audits were completed regularly. Policies and procedures were in place for safe handling of medicines for staff to refer to for information and guidance.

Staff training was up to date. Staff received regular supervision and an annual appraisal. Opportunities were available for staff to discuss their performance and development.

People were supported by kind and attentive staff, in a respectful and dignified manner. Staff discussed interventions with people before providing support. Advocacy services were advertised in the foyer of the service accessible to people and visitors. Staff knew people's abilities and preferences, and were knowledgeable about how to communicate with people.

People’s nutritional needs were assessed and we observed people enjoying a varied diet, with choices offered and alternatives available. Staff supported people with eating and drinking in a safe, dignified manner.

Care plans were individualised and person centred focussing on people's assessed needs. Plans were reviewed and evaluated regularly to ensure planned care was current and up to date.

People were supported to maintain good health and had access to healthcare professionals when necessary and were supported with health and well-being appointments.

The registered provider had an activity planner with a range of different activities and leisure opportunities available for people.

The registered provider had a quality assurance process in place to ensure the quality of the care provided was monitored. People and relative’s views and opinions were sought and used in the monitoring of the service. Processes and systems were in place to manage complaints.

The service adhered to the principles of the Mental Capacity Act and had made applications to the appropriate agencies to deprive people of their liberty and keep them safe.

The registered provider ensured appropriate health and safety checks were completed. We found up to date certificates to reflect fire inspections, gas safety checks, and electrical wiring test had