Ashurst Park Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good.

This meant people were safe and protected from avoidable harm. Although some improvements were needed in the medicines systems and processes, people received safe care and staff were aware of the individual risks to people. There were a sufficient number of staff providing care to people and staff had been recruited through robust processes. People lived in an environment that was safe and kept clean.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The registered manager regularly reviewed accidents and incidents, taking appropriate actions in response to help keep people safe. For example, people who experienced frequent falls were referred to the falls team or provided with equipment such as mobility aids. One person who had an increased number of falls was supported to use their wheelchair more often, particularly for longer distances.

Staff were aware of their responsibilities in maintaining people’s safety. One staff member told us, “If someone falls, we don’t move the resident. Instead, we use the emergency bell so that the nursing staff can attend.” A second said in the event of an incident such as a fall they would carry out an analysis of the cause of the fall and a lesson’s learnt exercise to see if the care plan was being followed. They would also look to understand if other measures may be beneficial.

The registered manager worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Prior to people moving into the service, senior staff carried out a face to face assessment. This helped to ensure that moving to Ashurst Park Care Home was a suitable place for people to live. Relatives told us, “They (management) came and visited him there (in hospital). I was impressed with them” and, “They were willing to take him with his 55-page care plan needs.”

Staff outlined the importance of conducting thorough pre-assessments. One senior staff member explained, “We assess the individual with input from the GP, family members, and the home manager. We then hold pre-admission assessment meetings involving the care coordinator, nurses, and manager. It’s essential that we understand each person’s needs and preferences.”

Although effective systems and processes were in place prior to people moving in, we found that people with a learning disability had not always had all of their needs assessed or considered.. The registered manager told us, “They have complex health needs. That comes before their learning disability.” Whilst it was true that these people had complex healthcare needs, senior staff had not considered the person as a whole and as such incorporated relevant statutory guidance when assessing the service’s suitability. As a result, these 4 people may not have been fully supported in accordance with the principles of the Right support, right care, right culture (RSRCRC) statutory guidance which aims to ensure people with learning disabilities live fulfilling lives.

The registered manager worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The provider shared concerns quickly and appropriately.

People and relatives felt Ashurst Park Care Home was a safe place to live. A person told us, “Staff are very, very helpful. I have never met one that is horrible.” One relative said, “I feel he is very safe here. It’s all very secure. He is on a 1:1, I know he won’t fall, if he stumbles someone is close.” A second told us, “100% he is safe. The staff are wonderful.”

Any incidents that raised concerns about potential abuse were reported to the relevant authorities, including CQC, in line with registration requirements. The registered manager conducted thorough investigations into safeguarding concerns and worked with the local safeguarding team. One professional had noted, “She (the registered manager) is particularly proactive in highlighting and preventing safeguarding issues.”

Staff received appropriate training in safeguarding and were able to clearly explain the actions they would take if they suspected abuse. One staff member said, “Abuse can be physical or verbal.” Another added, “Usually, the manager leads on safeguarding. If she’s not available, we have the regional support number and escalate concerns to Kent County Council, who may investigate.”

The registered manager worked with people to understand and manage risks. Staff provided care to meet people’s needs that was safe and supportive.

At our last inspection we identified concerns relating to people’s individual risks. The registered manager told us, “After that inspection, Kent County Council came in and worked with me. I felt our residents needed a better and safe place to live.”

Several people had been allocated 1:1 staffing due to behaviours that may indicate distress, health-related needs, or a high risk of falls and this had contributed to a reduction in incidents and accidents. Staff reported that there were no altercations between people, as staff were consistently present and vigilant.

Staff demonstrated a good understanding of potential risks to people. One staff member said, “If a person has reduced urine output and dry skin, they may be dehydrated. We offer drinks every hour.” We saw this was recorded in people’s daily care notes. During the day however, we observed a staff member not always use the most appropriate moving and handling techniques. We raised this immediately with the registered manager who organised refresher training for all staff on the day following our visit.

We found clear and detailed information about people in care plans and risk assessments which included where people had epilepsy. This included guidance on recognising potential seizures and how staff should respond to these. Yet, we read and were given contradictory information on how one person would be evacuated. It was recorded that the person would be evacuated in their wheelchair. However, the registered manager told us they would be evacuated using a slide sheet and with the assistance of the fire crew. The registered manager told us they would correct the records immediately to help ensure staff who may not know this person so well would know what to do.

We also reviewed the use of pressure-relieving equipment and found all mattresses were correctly set according to people’s current weight and for people requiring insulin to manage diabetes, staff were regularly monitoring blood glucose levels. Furthermore, where people could not be weighed using conventional scales, arm circumference measurements were being used to track any potential weight loss.

Staff were mindful of conditions specific to individual people. For example, people with a learning disability are at greater risk of constipation. We read staff were providing regular medication, including PRN medication when required, to support their bowel health. One person preferred several smaller meals throughout the day instead of three set meals, which supported their digestion and bowel health.

The registered manager detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were living in an environment that had been adapted to meet their individual needs. Some people had specialist beds or moulded chairs to support their safety and comfort. Throughout the day, we observed people moving around the home using wheelchairs or mobility aids such as Zimmer frames. These were regularly checked to ensure they remained safe and appropriate for each person. One person told us, “I have my walker. I can use it easily around the home. There’s plenty of space.”

At our previous inspection, staff were not able to clearly describe the actions they should take in the event of a fire alarm. However, at this inspection, we found staff had a better knowledge of fire safety procedures. One staff member said, “If we hear the alarm, we go straight to the assembly area. There are allocated staff who stay with the residents.” Another added, “We have one person assigned as fire marshal and another as fire warden. The panel shows us which zone the alarm is coming from.”

The service had wide corridors with handrails to support people to move around safely. The garden was well maintained and easily accessible and in the dining area, tables were spaced appropriately to ensure people could sit comfortably and safely in chairs or their wheelchair. Doors to cupboards that contained equipment or products which may harm people were locked and there was keypad access to the stairs and the lift.

The registered manager told us, “We have a regular health and safety meeting. We have 2 maintenance colleagues working here and they check water safety, gas safety, electricity, fire safety and so much more. All staff are health and safety trained and to date the training is at 99%.”

The registered manager made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

At our last inspection we found there were insufficient staff deployed. We had no such concerns at this inspection. The registered manager told us several people were on 1:1 staffing. This was due to their distressed behaviours or for safety reasons, such as they were at high risk of falls. Throughout the day we saw plenty of staff around, either in the lounge area with people, or going in and out of people’s rooms. We did not see anyone waiting to be supported by staff and call bells only rang for a short time. A relative told us, “He has 1:1 in place and staff are always vigilant and attentive. He walks extremely quick, and staff always keep an eye on him.”

People felt they were provided with prompt care. Comments received included, “I praise staff 100%. There are always so many around” and, “I have a bell and the staff come quickly.” Relatives were equally as positive, telling us, “He has the consistent 4 staff members who know him and really love him” and, “There are always plenty of staff around. There is a sea of orange (uniform colour). Today is not for your benefit.”

Our observations on the day of inspection were that staff worked well together. They supported each other when people needed slightly more input and checked in with each other when tasks needed completing.

Staff were supported in their role through training and supervision. Staff said they received induction when first starting at the service. One staff member told us, “I had fire training and I went through the department, call bells and how to use the hoist. I observed care first on a shadow shift for one week.” Another told us, “The online training is good, and my supervisions are done by the compliance lead. They are useful to air things.”

Staff were recruited through a robust recruitment process. Prospective staff had to provide a full employment history, evidence of performance in their previous role, evidence of their right to work in the UK and confirmation of their fitness for the job. Each new staff member underwent a Disclosure Barring Service checklist prior to commencing in the role.

The registered manager assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The registered manager conducted regular infection control audits around the service. These helped to identify any shortfalls in order that they could take appropriate action. The registered manager told us, “I have no concerns about infection control. We don’t have outbreaks here.”

We observed housekeeping staff around the service throughout the day and when there was a spillage in the lounge area, housekeeping staff were there within minutes clearing up and putting up appropriate signage around the spillage.

People felt they lived in a clean environment. One person told us, “They wash my bedding.” A relative said, “Her room is immaculate. It’s not smelly here anymore” and another told us, “His room is always beautifully clean. It’s immaculate.”

The sluice room, where soiled items are cleaned, was clean, well-maintained, and stocked with gloves, aprons, and hand sanitiser. The laundry room was also well organised, and people's clothing was well laundered and properly cared for.

The registered manager made sure that medicines met people’s needs, although we found some improvement was required to ensure medicines systems were consistently safe.

At our previous inspection we identified concerns regarding medicines management. The registered manager told us, “After that inspection, I called the CHC (continuing healthcare) pharmacist to do a full audit.”

During this inspection, we noted improvements had been made. However, we found prescribed creams stored in unlocked cabinets in 2 people’s rooms. After raising this with the registered manager we were informed clinical staff had had problems locking the cabinets and as such people’s creams had been taken to the clinical room. However, staff had overlooked these 2 tubes of cream and they were moved immediately.

We noted medicines were stored in blister packs rather than their original packaging, which, although not an unsafe practice, was not in line with current best practice. While no medicine errors had occurred, the registered manager told us this was an historical practice and said they would review this and look to move over to original packaging.

People told us they received their medicines as needed. One person said, “I take tablets. Staff give them to me. I can ask for pain relief at any time, even during the night.” A relative said, “Staff support him in using inhalers/medication to control his asthma if needed.”

We inspected the clinical room where medicines were stored. Although small, the room was clean and well-organised. Staff were monitoring and recording the temperature of the room daily to ensure medicines were stored according to manufacturers’ guidelines. Additional stock was stored securely in cupboards, and medicines due for disposal were kept separately in a designated collection box.

Each person had a medication administration record (MAR) with no gaps, indicating that medicines were administered as required. Only trained staff, whose competency was assessed annually, administered medicines.