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Archived: Ash Cottage Requires improvement

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Inspection Summary


Overall summary & rating

Requires improvement

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.

Inspection areas

Safe

Requires improvement

Updated 26 August 2015

The service was not consistently safe

Staff were able to describe the action they would take if they witnessed or suspected any abusive or neglectful practice. People told us they did not have any concerns about the way they were cared for.

People’s medicines were not always managed safely and checks on staff practice had not been undertaken to ensure they were competent.

People told us they were happy with the staff team and there were sufficient numbers of staff to look after them properly. Safe and robust recruitment processes had not been followed.

Effective

Requires improvement

Updated 26 August 2015

The service was not consistently effective

Staff had not received a range of appropriate training which would give them the necessary skills and knowledge to help them look after people properly.

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.

Staff did not have access to training or to policies and procedures to underpin an appropriate response to the MCA 2005 and DoLS.

People told us they enjoyed the meals and we observed them being given appropriate support and encouragement.

Caring

Good

Updated 26 August 2015

The service was caring

People told us they were happy with the home and with the approach taken by staff. Staff responded to people in a friendly, caring and considerate manner.

We observed good relationships between people living in the home and staff. Staff took time to chat with and listen to people

People and their relatives had been involved in ongoing decisions about care and support and information about preferred routines had been recorded.

Responsive

Good

Updated 26 August 2015

The service was responsive

People were encouraged to discuss any concerns during day to day discussions and also as part of the annual survey. They were confident their concerns would be listened to and acted upon.

Each person had a care plan that was personal to them which included information about the care and support they needed. Some people were aware of their care plan and they, or their relatives, had been involved in the review of their care.

People were supported to take part in a range of suitable activities of their choice. People were able to keep in contact with families and friends.

Well-led

Requires improvement

Updated 26 August 2015

The service was not consistently well led.

Quality assurance and auditing processes had been improved and checks on systems and practices had been completed.

Policies and procedures were under review. However, staff did not have access to clear guidance to support them in their work.

There were systems in place to seek people’s views and opinions about the running of the home. People’s views were taken into consideration.