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Review carried out on 8 July 2021

During a monthly review of our data

We carried out a review of the data available to us about Ashton Court Care Home on 8 July 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Ashton Court Care Home, you can give feedback on this service.

Inspection carried out on 8 December 2020

During an inspection looking at part of the service

About the service

Ashton Court Care Home is a 'care home'. Ashton Court provides nursing and personal care for to up to 42 older people, some of whom live with dementia, across four floors in one purpose-built home. There were 37 people living at the service at the time of inspection.

We found the following examples of good practice:

• Staffing levels were safe. Staff worked on separate floors and did not mix to ensure risks were minimised; there were two lifts and three stairwells to accommodate this.

• All visitors had to undergo a temperature check and sign to agree to a range of entrance criteria. There was ample PPE and handwashing facilities available at the entrance.

• The premises had been adapted where practicable to enable better social distancing for people and staff. The provider had installed a visiting pod in the dining room, with an external entrance, so families could visit their relatives, when guidance allowed.

• The provider was responsive to feedback given regarding specific areas of good practice.

Further information is in the detailed findings below.

Inspection carried out on 2 September 2019

During a routine inspection

About the service

Ashton Court Care Home is a residential care home providing personal and nursing care to 36 people aged 65 and over at the time of the inspection. The service can support up to 42 people. Ashton Court Care Home accommodates people in a purpose-built building across three floors. One of the floors specialises in providing care to people living with dementia.

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

People and relatives told us the care provided at Ashton Court Care Home was good. They described staff as kind and caring.

People said they felt safe living at the home. Staff showed a good understanding of safeguarding and whistle blowing; they were confident to raise concerns if needed. Previous safeguarding concerns had been reported and fully investigated.

There were enough staff on duty to meet people’s needs. New staff were recruited safely.

Medicines were managed safely. Incidents and accidents were monitored to help prevent a further occurrence and learn lessons. Health and safety checks and risk assessments were completed to help maintain a safe environment.

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.

Staff were well supported and received the training they needed. Staff supported people to have enough to eat and drink and to access healthcare services when needed.

People's needs had been fully assessed; this was used to develop care plans. People were supported to participate in a range of activities.

People, relatives and staff gave positive feedback about the management of the home. Quality assurance was effective in identifying areas for improvement. There were regular opportunities for people and staff to share their views about the home. Residents were actively involved in many aspects of the home.

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 was requires improvement (published 6 September 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 31 July 2018

During a routine inspection

Ashton Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing or 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. Ashton Court Care Home accommodates 42 people in one adapted building, across four floors. There were 34 people using the service at the time of our inspection, including some people living with dementia.

This unannounced comprehensive inspection took place on 31 July and 1 and 2 August 2018. This meant that neither the provider nor the staff knew we would be visiting the home.

This was the first inspection since the provider registered with the CQC.

The previous registered manager of the service had formally de-registered with CQC in June 2018. A new manager had been employed and supported the inspection process.

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.

People who used the service and relatives told us staffing was not adequate to run the service safely, particularly the first floor and other floors during certain times of the day. During the inspection we confirmed this to be the case. However, the regional manager confirmed they had increased staffing levels in the 1st floor of the service and provided a ‘floating’ (additional) member of staff to cover during break times and other busy times.

Medicines management had areas which needed to be improved, including timing of administration, disposal and recording. Staff had received training in medicines and competencies had been completed.

We could not always confirm if people were supported to have maximum choice and control of their lives and that staff supported them in the least restrictive way possible. Although documents showed consent was gained. Other issues demonstrated that people were at risk of receiving care and treatment which was not lawfully consented to, for example, lasting power of attorney documentation was not always in place to show those authorised to act on people’s behalf’s. Applications had been made for Deprivation of Liberty Safeguards (DoLS), where it was considered that people would be unable to keep themselves safe if they were to leave the home unaccompanied, however, the service was not clear on the number of people who had been authorised until they liaised with the local authority after our inspection.

Whilst there was evidence that some of the shortfalls we identified had been highlighted through audits and checks, we noted the issues were still on-going in some cases.

Staff were knowledgeable about the safeguarding process. Accidents and incidents were recorded and monitored to determine if any trends were occurring.

Risks to keep people and staff safe were managed, although we did find some gaps. Health and safety checks on the building and equipment were regularly carried out and we were told that in a recent visit from the fire service they were happy with fire safety. We noted that personal emergency evacuation plans needed to be updated, but the manager was going to address this.

Recruitment processes were undertaken, including pre-employment checks. However, we have made a recommendation in this area as the provider had not always followed best practice in reference requests.

Staff training was mostly up to date. Staff received regular supervision and the manager was working to ensure that annual appraisals were completed. New staff completed an induction and had opportunities to shadow more experienced staff.

Feedback about the food on offer was positive. Where required, people were not always provided with a visual choice so t