Archived: Three Ashes Residential Care Home

Updated 23 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 13 and 16 April 2018. The inspection was unannounced and was carried out by one inspector.

Before the inspection, we reviewed information we held about the service including notifications. A notification is a report about important events which the service is required to send us by law. We reviewed information the previous registered manager had sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also spoke with commissioners about the service.

Throughout the inspection we observed the support being provided to people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with three people who use the service and two relatives. We spoke with a representative of the provider, the team leader and four other members of the care staff team, the chef, maintenance person, a health professional and a visiting hairdresser. We checked six people’s care records which included pre-admission assessments, care plans, risk assessments and documents relating to assessment of mental capacity and Deprivation of Liberty Safeguards (DoLS).

We sought the views of a further seven health and social care professionals and received feedback from five of those we approached. We checked medicines records for three people and observed two staff members administering medicines. We reviewed the processes in place for managing medicines, including the use of 'as required' medicines and medicines with additional storage and recording requirements. We looked at recruitment records for four staff, staff training records, complaints, accident and incident records, maintenance records and reviewed provider policies and quality assurance systems.

Updated 23 May 2018

This unannounced inspection took place on 13 and 16 April 2018.

Three Ashes Residential Care Home is a ‘care home’ for up to 11 older people, some of whom were living with a physical or sensory disability. 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. Three Ashes is registered for older people living with dementia, physical disability and/or sensory impairment. At the time of this inspection 9 people were living there.

Accommodation at Three Ashes is provided over two floors with bedrooms located on the ground and first floors. The ground floor was wheelchair accessible. A stair lift was fitted to assist people with limited mobility to access the first floor. Most bedrooms had en-suite facilities with a shower and a communal bathroom was located on the first floor. Two lounge areas, one in a large conservatory overlooking the extensive gardens, were located on the ground floor and a dining area was situated, open plan, between the two lounges.

Three Ashes has changed ownership twice since our last inspection in November 2015 but the legal entity remained the same. At our last inspection in 2015 the service was rated Good. The home has been under the current ownership since August 2017. Staff working at Three Ashes at the time of the sale transferred across to the new owner, remaining in post at the home.

There had been no registered manager in post at Three Ashes since February 2018. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The service was being managed by the provider’s representative until a new registered manager was appointed.

During this inspection we identified two breaches of the Health and Social Care Act 2005 (Regulated Activities) Regulations 2014. The service has been rated ‘Requires Improvement’ overall.

People were not always supported by staff who had received the training and support they needed to carry out their duties effectively. The systems and processes in place to monitor the safety and quality of the services provided to people were not always effective in identifying and addressing shortfalls. Complete records of the care and treatment provided to people had not always been kept. We recommend that the service review good practice guidance for managing medicines in care homes and take action to update their practice accordingly.

Risks to people were managed with the support and guidance of health professionals to ensure people remained safe. There were enough suitable staff to meet people's needs. Staff worked openly with other agencies to safeguard people from harm. The building and equipment were appropriately maintained and people were protected from risks associated with cross infection.

People benefitted from a stable and caring staff team who knew them well. They were supported to access appropriate health care. Staff took a personalised approach to meeting people’s needs and outcomes for people were good. People’s preferences were taken into account by staff when providing care and people were offered choices in their day to day lives. People’s privacy was respected and they were treated with dignity and kindness. People were supported to maintain relationships with others who were important to them. People received good end of life care.

People's views about the service they received were sought and these were used to improve the service. People were able to raise complaints and these were responded to promptly. The culture at the home was open and transparent. Staff and managers worked together to provide a friendly service where people told us they felt at home.

This is the first time the service has been rated Requires Improvement. You can see what action we told the provider to take at the back of the full version of the report.