Archived: Ash Cottage

Updated 26 August 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The unannounced inspection of Ash Cottage took place on 22 July 2015. The inspection was carried out by one adult social care inspector.

Before the inspection we reviewed the information we held about the service such as notifications, complaint and safeguarding information. We contacted the local authority contract monitoring team for information.

We used a number of different methods to help us understand the experiences of people who used the service. We spoke with four people living in the home and one visitor. We spoke with the registered manager/owner, the deputy manager and three staff. We also spoke with two relatives following the inspection visit. The registered manager was not available for the duration of our inspection so we discussed our feedback with them following the inspection. Following the inspection visit we spoke with two health and social care professionals who regularly visited the home.

We observed care and support being delivered by staff. We looked at a sample of records including two people’s care plans and other associated documentation, one staff recruitment record, induction, training and supervision records, minutes from meetings, complaints records, medication records, policies and procedures and audits. We also looked at the results from the most recent customer satisfaction survey completed by people living in the home and their visitors.

Updated 26 August 2015

We carried out an unannounced inspection of Ash Cottage on 22 July 2015. Ash Cottage is registered to provide accommodation and personal care for up to 20 older people. The service does not provide nursing care. At the time of the inspection there were 11 people accommodated in the home.

Ash Cottage is located on a quiet lane in Edenfield, Rossendale. It is an older type property providing accommodation on four floors. There is a passenger lift and a number of stair lifts. Six bedrooms have en-suite facilities with suitably equipped bathroom and toilet facilities on all floors. There are three shared rooms available. The gardens are well maintained with a small car park for visitors at the front of the house.

There was a registered manager in day to day charge of the home who was also the owner. 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.

At the previous inspection on 7 May 2014 we found the service was not meeting all the regulations. We asked the registered provider to take action to make improvements in respect of maintaining accurate and appropriate records and having an effective system to identify, assess and manage risks to the health, safety and welfare of people.

During this inspection visit we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, relating to management of people’s medicines, policies and procedures and the training and development of staff. You can see what action we told the registered provider to take at the back of the full version of the report.

We found staff who administered medicines had not received appropriate training and regular checks on their practice had not been undertaken to ensure they were competent to manage people’s medicines.

We noted staff had not been provided with ongoing safety training which would give them the skills and knowledge to care for people safely. One to one staff supervision sessions had recently commenced and would help to identify the need for any additional training and support. However staff were not provided with a number of policies and procedures that they needed to support them with their work.

Staff had an understanding of abuse but had not received training about the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS). The MCA 2005 and DoLS provide legal safeguards for people who may be unable to make decisions about their care. This meant staff may not recognise when people were being deprived of their liberty and may not make appropriate referrals to ensure people were safe and to ensure their best interests considered.

People told us they were happy with the home and with the approach taken by staff. They said, “I’ve known the staff a lot of years; they are like my family. I’m very comfortable here”, “It’s a lovely place to live” and “I feel safe here; I am treated very kindly.” Visitors told us, “I have no worries about my relative at all” and “It’s very relaxed here; staff are friendly and approachable”. A healthcare professional said, “People are looked after very well.”

We observed good relationships between people living in the home and staff. Throughout the day we heard laughter and friendly banter. We noted staff spending time to sit and chat with people in a relaxed and friendly way. People were supported to take part in a range of suitable activities of their choice.

People told us they were happy with the staff team and there were sufficient numbers of staff to look after them properly. One person said, “Staff are very good; there is always someone around if I need them.” A visitor said, “There seems to be enough staff; people get lots of attention.” A member of staff told us, “I love working here; we are like a big family.”

Each person had a care plan that was personal to them which included information about the care and support they needed. The care plans included information about people’s preferred routines and preferences which helped ensure they received the care and support they wanted and needed. People had been involved in decisions about care and support.

People told us they enjoyed the meals. They told us, “The meals are good; if you don’t like what is on the menu you can ask for something different” and “I enjoy my meals and they will make me something else if I ask.” A visitor said, “The meals always look very appetising.”

People told us they had no complaints about the service and said they could raise any concerns during day to day discussions with staff and also as part of the annual survey. One person said, “We all know each other really well and chat about all sorts of things; I suppose that’s how we deal with things.”

We found the home was clean and odour free. A visiting healthcare professional said, “The cleaner works really hard; the place is always lovely and clean.” We found some areas were well maintained, bright and comfortable whilst other were in need of refurbishment. People told us they were happy with their bedrooms and most had created a homely environment with personal effects such as furniture, photographs, pictures and ornaments.

Checks on systems and practices had been completed which would help the registered manager to identify matters needing attention.