The Care Quality Commission
  • Care Home
  • Care home

Archived: Ashmead Care Centre

Overall: Inadequate read more about inspection ratings

201 Cortis Road, Putney, London, SW15 3AX (020) 8246 6430

Provided and run by:
Life Style Care (2011) plc

Important: The provider of this service changed. See new profile
Important: The provider of this service changed. See old profile

All Inspections

20 and 21 November 2014

During a routine inspection

This inspection took place on 20 and 21 November 2014 and was unannounced. At our last visit in March 2014 the service was meeting the regulations inspected.

Ashmead Care Centre provides accommodation for people requiring nursing and personal care. The service can accommodate up to 110 people. At the time of our inspection 93 people were using the service.

The home was divided into six units. Three units were allocated to people living with dementia and two units were for people requiring general nursing. One unit which was to become a private 20 bedded unit was closed and undergoing refurbishment at the time of our visit. There did not appear to be any distinguishing features to any of the units and we saw that people with very different needs were placed across all six units. These arrangements may have made it difficult to provide specialist care to people identified as having very high support needs.

The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. A newly appointed home manager was responsible for the day to day management of the service and was being supported in her role by a peripatetic manager, a deputy manager and a clinical nurse lead. The home manager told us she would be applying to become the registered manager in the near future.

People’s needs were assessed and care plans were developed to identify what care and support people required. We saw that reviews of people’s health and safety had been completed and updated in line with the provider’s policies and procedures.

Staffing levels were based on the dependency levels of people using the service. People using the service, relatives and friends and members of staff expressed concern that staffing levels were not always adequate to consistently meet people’s needs.

The home was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. We found that staff had received training and understood when a DoLS application should be made and how to submit one. However, this had not happened when applications were needed in relation to people being able to independently access different parts of the building and/or leave the premises if and when they wished to.

Staff had qualifications in health and social care, previous experience of working in care settings and received regular training. Most of the staff had completed training in dementia awareness.

We saw evidence that the home worked collaboratively with other health and social care professionals to ensure people received specialist care and treatment. Palliative care nurses visited the home on a regular basis and the home had gained accreditation in the Gold Standards Framework (GSF) in September 2014. GSF is an evidence based approach to optimising care for people approaching the end of their lives.

Staff demonstrated that they understood how to recognise the signs of abuse. Staff told us they would report any concerns to senior members of staff who would then assess the situation and report to the local authority’s safeguarding team and the Care Quality Commission (CQC) as required.

Activities were limited as the service did not have an activities co-ordinator. People using the service told us they had little opportunity to access the local community and take part in everyday activities such as going to the local shops, going out for a coffee or going to church.

We observed staff supporting people to make choices about the food they wanted. However, we noted that staff did not always ensure people were able to reach their food when it was served to them in their rooms. Some people who required prompting and/or support to eat their meal did not always receive this assistance. People’s opinions as to the quantity, quality and choice of food on offer, were mostly negative.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

5 March 2014

During an inspection looking at part of the service

Our inspection of the 12th September 2013 found that suitable arrangements were not in place for ensuring people's privacy and dignity was maintained. The provider told us that improvements had been made to staff training and monitoring systems in place. We saw improvements in the interactions between staff and people who use the service. We saw staff spoke with individuals and explained what they were doing and why. Staff sat with people and talked about the afternoons activities, visitors that may be expected, the meal they had eaten and offered people drinks.

We spoke with seven people who use the service, five relatives, twelve members of staff, the relief manager and operations director during this inspection. We observed the care and support being provided in five of the units during our visit.

People told us that they were "looked after very well" and said "staff treat me properly", "staff call me by my name" and "they respect my privacy". Relatives said that they saw staff speaking to people respectfully and did not have concerns regarding people's privacy and dignity being maintained.

Staff told us that their induction included how to maintain privacy and dignity while supporting people. Nurses we spoke with were aware of their responsibility to observe staff and ensure that they maintained people's privacy and spoke with people appropriately.

12 September 2013

During a routine inspection

We spoke with ten people who use the service, four visitors, ten members of staff, the deputy manager and the operations director during this unannounced inspection.

People we spoke with told us that staff respected their privacy and dignity and said they had choices in the food they ate and activities they participated in. Although during our observations we saw mixed interactions with some staff maintaining people's dignity while other staff moved people without telling them what they were doing.

Comments people made about living at Ashmead included: "they give me the help I need"; "they listen and help"; "staff are accommodating", "staff are always available" and "staff know people and how to meet their needs". "The food is very good" and "we get plenty to eat" were just a few of the comments about the food. People told us that staff kept their room clean.

Visitors were happy with the care and support provided and said they felt there were enough staff working at the home to meet people's needs. They said they were made welcome and kept informed of any changes as required. They also said the home was always clean and fresh.

Staff said they received the training and support they needed to carry out their role and said they did their best to provide good care and support to people.

During a check to make sure that the improvements required had been made

The provider identified appropriate actions to take in order to address areas where non-compliance was identified during the last scheduled inspection.

Improvements were made to the security of the premises. Additionally, staff had received all mandatory training and non-mandatory training programme had started, and a system was set up to ensure regular supervisory meetings took place between management and staff. A complaints system had also been put in place, which included monthly reviews to ensure complaints were properly recorded and followed up.

13 February 2013

During a routine inspection

People were invited to the home to have a look around before moving in. People were able to bring in personal items into their bedrooms. One person told us 'I have some of my own things'. A key worker was assigned to each person using the service prior to them coming to live at the home.

We looked at twelve files for people using the service. Care plans and risk assessments were reviewed every month. Nutritional risk assessments were carried out and people's weight, diet and hydration were recorded. Details of visits from health professionals were recorded in care plans.

The provider had taken appropriate steps in response to safeguarding concerns. We saw evidence that where the provider had identified a lack of training as the cause, staff had attended relevant training to ensure they were sufficiently competent in these areas.

There were a number of processes in place to risk assess health and safety issues around the home. We were told the security cameras around the outside of the building had not been working since 2008.

We looked at ten staff files. Although there was evidence that staff had attended mandatory training in the past year, there was a lack of supervision carried out by the provider.

There was a complaints procedure in place but it was not clear if people's complaints were fully investigated and resolved to their satisfaction. Although people had their comments and complaints listened to, these were not acted on by the provider.

17 January 2012

During a routine inspection

The people we spoke with and their relatives said they liked the home, were happy with the care they received, and found the staff helpful and friendly. People said that they were offered a choice of food and drink. People and their relatives said that when they had raised concerns or complaints these had been addressed. People told us that their visitors were allowed to see them at any time.

However, the home could not demonstrate that all its staff receive adequate training and supervision.