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Ashchurch View Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 15 January 2019

We inspected Ashchurch View on the 15, 19 and 21 November 2018. Ashchurch View provides accommodation, nursing and personal care to 60 older people and people living with dementia. It also provides short term respite for people. At the time of our visit 55 people were using the service. Ashchurch View is located in Ashchurch near to the town of Tewkesbury. This was an unannounced inspection.

We last inspected the home on 6 and 8 September 2017. At the September 2017 inspection we rated the service as “Requires Improvement”. We found the provider was meeting all of the requirements of the regulations at that time, however due to changes in the staffing and management teams this had had an impact on the level of engagement people received. At this inspection, we found similar concerns in relation to staffing and the support and stimulation people received. The provider was aware of these concerns and had a long term management plan in place to improve the quality of care people received.

A registered manager was in post at the service, however they had recently started maternity leave. The provider had employed a peripatetic manager to provide day to day management support at Ashchurch View. This manager had just started their employment with the provider. 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 did not always receive person centred care or meaningful engagement from care and nursing staff. People went long periods of time without stimulation or support. Care staff did not always feel they had the time to support people with their emotional needs. When people were anxious they did not always receive effective and timely support. People’s life histories and interests did not always inform their care plans and the activities they would enjoy.

People, their relatives and staff raised a number of concerns in relation to staffing levels at Ashchurch View. The provider was taking action to address staffing concerns, including staff sickness and staff turnover. During our inspection the provider and manager took effective action in response to concerns raised in relation to the deployment of staff to ensure people were kept safe, this included the implementation of a short term action plan.

Care and nursing staff did not always feel supported and did not feel their professional development needs were met. The provider had plans to implement effective training and supervision support. Staff did not always feel they had the communication they needed to ensure people’s day to day needs were being met.

People were cared for in a clean, safe and well-maintained home. The provider and manager carried out effective checks to ensure the service was appropriate for people’s needs. Nursing and care staff followed recognised infection control procedures.

People were protected from the risks associated with their care. Care and nursing staff knew how to assist people with their needs and ensure their health was maintained. People’s prescribed medicines were mostly managed well, however some nursing staff (including agency staff) did not work to the provider’s expectations.

Staff understood their responsibilities to protect people from harm and to report any safeguarding concerns. Staff provided people with choice and worked to protect and maintain their legal rights.

People had access to a good variety of food and drink. Care and nursing staff treated people with dignity and ensured they had their nutritional support and their prescribed medicines. Catering and care staff were aware of and met people’s individual dietary needs.

People’s relatives felt their concerns and views had not always been listened to and acted upon due to changes wi

Inspection areas

Safe

Requires improvement

Updated 15 January 2019

The service was not always safe.

There had not always been enough skilled staff deployed to meet people’s needs, this had impacted on the level of engagement people received.

The risks associated with people’s care were managed. People’s prescribed medicines were mainly managed well, however some staff did not always work to the providers policies.

The risks associated with people’s care were managed. People felt safe living at the home and staff understood their responsibilities to report abuse.

Effective

Requires improvement

Updated 15 January 2019

The service was not always effective.

Care staff did not have access to all the training and support they needed to meet people’s needs. Care staff did not always benefit from an effective supervision and appraisal system. The service was addressing these concerns.

People were supported to make day to day decisions around their care. People received the nutritional support they needed. People were supported with their on-going healthcare needs, including rehabilitation to return to their own homes.

Caring

Good

Updated 15 January 2019

The service was caring.

Care staff treated people with kindness and compassion when assisting them with their personal care.

People’s dignity was promoted and care staff assisted them to ensure they were kept comfortable. People’s independence and individuality were respected.

Responsive

Requires improvement

Updated 15 January 2019

The service was not always responsive.

People did not always have access to appropriate activities and stimulation appropriate to their needs.

Where people were at the end of their life they received support to keep them comfortable, in line with their wishes.

People and their relatives told us they had not always felt involved and their concerns and complaints had not always been effectively listened to and acted upon due to changes the management of the service.

Well-led

Requires improvement

Updated 15 January 2019

The service was not continually well led.

The manager and provider had a comprehensive leadership and management plan to address concerns they had identified. These concerns reflected those found at this inspection. Time was needed to assess the effectiveness of these actions.

Care and nursing staff told us they did not always have the communication they required to meet people’s needs.

People and their relative’s felt there needed to be more management presence in the home.