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Ashleigh House Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 17 July 2019

About the service: Ashleigh House is a residential care home that is registered to provide accommodation for up to 30 people. It provides care to people living with mental health problems. At the time of the inspection 25 people used the service.

People’s experience of using this service: During our inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to ensuring the safe care of people, need for consent principles were followed and staff were trained.

The provider had not fully completed matters raised at the last inspection. Half of the bathrooms and toilets remained out of commission, windows needed replacing and the façade at the back of the home had not been renewed. They had not met all the fire authority requirements, which were outlined in a letter dated 25 January 2019. Plans were in place to deal with these matters and work had commenced to refurbish the bathrooms.

Since the last inspection the occupancy had significantly increased but at the time of the inspection care staff hours had remained the same. A deputy manager, cook covering weekdays and activity coordinator had been employed but the provider could not show us how they ensured there were enough staff to deliver rehabilitative work, personal care, safely manage situations where people were distressed and cook the meals on a weekend. Two staff on duty overnight, which was insufficient to ensure people’s safety could be maintained.

Staff were completing mandatory training, supervision and appraisals. The staff lack of training around working with people who live with mental health needs was significantly impacting how staff responded to people, planned their care, identify risks, assessed individual's needs and worked in line with best practice.

Staff were not following principles round obtaining consent and care records suggested they imposed restrictions on people even when they deemed them to have capacity. The registered manager and staff had worked hard to improve the assessment of people’s needs but the lack of training meant they were not accurate.

Nutritional assessment tools were in place and staff encouraged people to eat a balanced diet. However, when people lost weight or had a low body mass index (BMI) staff did not always act in timely manner to refer them to the GP and dieticians. Staff did the cooking at the weekend and it was not clear why. Staff had not received the food hygiene training.

The provider had a system in place for overseeing the service and had identified gaps in practice plus put action plans in place. However, the timescales they gave for completing action was unrealistic and lead to areas that needed urgent attention being left for months and in some cases years before being addressed. The regional manager and registered manager were clearly aware of gaps and had acted to make improvements where they could.

People spoke extremely positively about the staff at the service, describing them as kind and caring. One person told us the staff had restored their faith in mental health services. Staff treated people with dignity and respect. Staff were extremely empathetic and non-judgemental when working with people.

Staff told us that the registered manager and deputy were approachable and closely listened to their views. They felt positive about how the service was being operated. Incident monitoring records were used, and each event was thoroughly reviewed with lessons to be learnt and put into action. People felt that this registered manager would listen and act on complaints. Medicine management was effective.

Staff tried to be proactive and support people to enjoy a range of activities. Staff had supported some people to gain paid employment.

The registered manager and deputy manager had formed excellent working relationships with local care co-ordinators and this had led to them having the confidence to place more people at the service.

For more d

Inspection areas

Safe

Requires improvement

Updated 17 July 2019

The service was not always safe

Details are in our Safe findings below.

Effective

Requires improvement

Updated 17 July 2019

The service was not always effective.

Details are in our Effective findings below.

Caring

Good

Updated 17 July 2019

The service was caring.

Details are in our Caring findings below.

Responsive

Good

Updated 17 July 2019

The service was responsive.

Details are in our Responsive findings below.

Well-led

Requires improvement

Updated 17 July 2019

The service was not always well-led

Details are in our Well-Led findings below.