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Reports


Inspection carried out on 6 August 2019

During a routine inspection

Ashmead Nursing Home is a residential care home providing personal and nursing care for up to 110 people. At the time of the inspection 104 people were receiving a service at the home.

Ashmead is a purpose built home accommodating people on three floors; each floor is divided into two units with accommodation and related facilities. The two ground floor units, known as Primrose and Bluebell, specialise in supporting older people with nursing care needs; the two first floor units, known as Lavender and Buttercup and the third floor unit called Rose support older people living with dementia. The second floor unit called Daffodil is a specialist step-down unit that provides intermediate short-stay support to people. A step-down unit is traditionally used to provide people with the short-term care and support they need to enable them to return home.

People’s experience of using this service and what we found

At the last inspection we found people were not always kept safe at the home because some staff did not always follow risk management plans properly. At this inspection we found the provider had improved people’s risk management plans through regular assessments and reviews and staff were aware of these and were putting them into practice.

We also found at the last inspection staff did not always have all the right knowledge and skills to effectively carry out their roles and responsibilities. At this inspection we found the provider had improved the specialist training offered to staff so they could effectively meet people’s needs.

Also at the last inspection the service did not always support people to take part in social activities relevant to their social interests. At this inspection we found the provider had recruited a new activities team who were developing activities based on people’s preferences. However, we found the staff required further support to be able to provide meaningful activities for older people, those bedfast and people with disabilities.

We have recommended to the provider that activities staff receive training in this area and we will check progress at our next inspection.

People we spoke with were happy with the care they received and with the staff who assisted them. People were protected from avoidable harm, discrimination and abuse. Appropriate staff recruitment checks were made. Procedures were in place to reduce the risk of the spread of infection. Medicines were administered, stored and disposed of safely. Risks in the environment were very well managed, which helped to ensure the premises were safe.

Staff were suitably trained and supported. 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. People were supported to maintain a healthy balanced diet and to stay healthy, with access to health care services as and when required.

People received support from staff who were kind and compassionate. Staff treated people with dignity and respect and ensured people's privacy was always maintained. People were supported to do as much as they could and wanted to do for themselves to retain control and independence over their lives.

The provider was exploring ways of ensuring they were meeting the Accessible Information Standard for communication. The provider had effective systems in place to deal with concerns and complaints and to assess and monitor the quality of the service people received.

The service had a registered manager who we found to be open and transparent. They were working in partnership with other health and social care professionals and agencies to plan and deliver an effective service that met the needs of the people they supported.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service

Inspection carried out on 24 July 2018

During a routine inspection

People living at Ashmead Care Centre receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate up to 110 people across six self-contained units located over three floors, each with their own separate adapted facilities. The two ground floor units, known as Primrose and Bluebell, specialise in supporting older people with nursing care needs; the three units known as Lavender, Buttercup and Rose support older people living with dementia; and Daffodil is a specialist step-down unit that provides intermediate short-stay support to younger and older adults with a range of personal and health care needs, including physical disabilities, mental ill health and behaviours that might be considered challenging. A step-down unit is traditionally used to provide people with the short-term care and support they need to enable them to return home. At the time of our inspection 109 people resided at the home.

The service has not had a registered manager in post for the past 2 months. In the interim the deputy manager has been in operational day-to-day charge of the service. At the time of our inspection a regional peripatetic manager was appointed as the service's new manager. They have submitted their registered manager application to us. A registered manager is a person who has registered with the CQC. Registered managers like registered providers 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.

In August 2017 the home was re-registered by the CQC after the service was taken over as a going concern by a new provider known as MMCG (Maria Mallaband Care Group). At the last comprehensive inspection of this home in June 2017 when they were owned and managed by Lifestyle Care Management, we rated them 'Requires Improvement' overall. This was because staff record keeping, governance systems and risks associated with people’s nutritional needs were not managed well.

At this comprehensive inspection, we found after 12 months in charge the new provider had begun to improve the standard of care and support people living in the home received, but they acknowledge further improvements are required. We have therefore rated Ashmead Care Centre ‘Good’ for the one key question, ‘Is the service caring?’ and ‘Requires Improvement’ overall and for the other four key questions ‘Is the service safe, effective, responsive and well-led?’

This was because some staff failed to always correctly follow risk management plans that were in place to keep people safe. Three significant incidents involving people living in the home had occurred in the last 12 months which resulted in people sustaining injuries that could have been avoided if staff had followed their risk management plans.

In addition, staff did not have all the right knowledge and skills to effectively carry out their roles and responsibilities. Although the new provider had a well-established training programme in place, it did not cover the needs of everyone who lived at the home. For example, staff had not received any training in learning disability or autistic spectrum disorder, mental ill-health or sensory impairment.

Both these shortfalls represent breaches of the Health and Social Care (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Furthermore, people did not always have sufficient opportunities to participate in meaningful activities that reflected their social interests. We discussed this issue with the new managers who acknowledged the range of fulfilling activities people could choose to engage in was limited. We also recommended the provider seek a