Background to this inspection
Updated
24 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by an inspector, assistant inspector and a specialist nurse advisor.
Service and service type
Heathcotes (Ashbrook House) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The first day of the inspection was unannounced. We carried out an announced visit on the second day.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. This included statutory notifications that the provider had sent us. A statutory notification is information about important events which the provider is required to send us by law. We also contacted health and social care commissioners who monitor the care and support that people receive. We used all this information to plan our inspection.
During the inspection
We spoke with three people who used the service, two relatives, three staff, the manager who was responsible for the day to day running of the service, the registered manager and area manager. We reviewed a range of records that included three people’s care records, three staff recruitment files, records relating to staff training and supervision and the management of the service, including policies and procedures quality assurance processes.
Updated
24 September 2019
Heathcotes (Ashbrook House) is a care home service without nursing. The home provides accommodation for persons who require nursing or personal care. The home can accommodate up to six older adults with learning disabilities in one adapted building. At the time of the inspection three people were receiving care at the home.
The home has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Quality assurance processes undertaken by the provider were not robust and failed to ensure that the required standards of quality and safety were being met consistently. Feedback from people and staff was not acted on to drive continual improvements in the service.
Documents relating to the use of physical restraint were not robust and provided poor oversight into the physical intervention.
People’s care plans included assessments of risks associated with their care. Staff had not always followed the risk assessments to ensure people received safe care. Staff knew how to respond to and report any concerns about people’s safety and well-being.
People were supported by staff that knew how to keep them safe and knew how to raise any concerns regarding people’s safety with the provider and the relevant safeguarding body and the Care Quality Commission (CQC).
People were supported to stay healthy. Staff encouraged people to live healthier lives, encouraged healthy eating and supported people to attend all medical appointments. Staff were committed to enabling people to socialise and develop and maintain relationships.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
People were supported by sufficient numbers of staff that were safely recruited to meet their needs. Staff supported people to take their prescribed medicines safely. Staff followed good practice infection control guidelines to help prevent the spread of infection.
People were supported by staff who had the right skills and knowledge to provide care that met people’s assessed needs. Staff were alert and responsive to changes in people's needs. They liaised with relatives and health professionals in a timely manner which helped to support people's health and well-being.
Policies, procedures and other relevant information was made available to people in formats that met their communication needs, such as easy read and picture styles.
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 13/03/2018).
Why we inspected
The inspection was prompted in part by notification of a specific incident. Following which a person using the service died. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.
The information CQC received about the incident indicated concerns about the management of choking and risk assessments. This inspection examined those risks.
We have found evidence that the provider needs to make improvements.
You can see what action we have asked the provider to take at the end 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.