Ashlands Care Home

Updated 17 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector and 1 expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Ashlands Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ashlands Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, the local clinical commissioning group, and from Healthwatch about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 8 people who used the service and observed how care and support was given generally. We spoke with 4 relatives and 5 staff. We spoke with the deputy manager, registered manager, and the provider. We also spoke with the manager from the provider’s other service, who was working with the registered manager at Ashlands Care Home to improve the service. We looked at a range of records including 3 people's care records, how medicines were managed for people, and staff records. During the inspection visit we asked the provider to give us additional evidence about how the service was managed, including records relating to governance and staff training. All the information we requested was provided.

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.

Updated 17 May 2023

About the service

Ashlands Care Home is a residential care home providing personal care to up to 30 people. The service provides support to older people and people living with dementia in one adapted building. At the time of our inspection there were 19 people using the service.

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

Risks to people in relation to their personal care were not always managed safely. The provider had not ensured there was an up-to-date fire risk assessment and evacuation plan in place. Staff did not feel confident that they could safely evacuate people at night, which put people at risk. The registered manager and provider took immediate action to address this issue during the inspection visit. The service was not consistently well-led. Although the provider had a range of checks and audits in place, these were not always effective at identifying areas which needed improvement.

People were protected from the risk of abuse. Staff understood how to recognise and report concerns or abuse and felt confident to speak up about concerns. People received their prescribed medicines safely. The service was clean and well-maintained in most areas.

Staff knew how to support people safely. Accidents and incidents were documented and analysed regularly to assess trends and patterns. During the day, there were enough staff to keep people safe. Staff were recruited safely. People's needs and choices were assessed in line with current legislation and guidance in a way that helped to prevent discrimination.

People and relatives felt staff had the right training to meet their needs. Staff were able to demonstrate they had the right skills and knowledge to support people safely. People were supported and encouraged to have a varied diet that gave them enough to eat and drink. People were supported by staff to access healthcare services when required.

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.

Since our last inspection, the provider had taken steps to ensure all staff were consistently kind, caring and respectful to people. People and relatives spoke positively about how this had improved. The provider and registered manager had worked with the staff team to ensure that people were involved in developing and reviewing their care plans. People’s confidential personal information was stored securely.

Since the last inspection the provider had regularly shared their improvement plans with CQC. From reviewing these and looking at the evidence found on this inspection, we could see progress in all areas of care. The provider now had systems in place to identify when things went wrong. This meant they had information to improve the service and were working to encourage a culture of continuous improvement. The provider had a refurbishment plan in place for the care home. We could see where improvements had been made, and where work still needed to be done to ensure the environment met people’s needs.

Staff spoke positively about the improvements since the last inspection and felt there had been a positive culture change in the whole staff and management team. The provider had started to get feedback from people, relatives, and staff to help drive improvements in the quality of care. This was still a work in progress, and the provider had not had time to fully embed regular and meaningful consultations with everyone.

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 inadequate (published 31 December 2022) and there were multiple breaches of regulations. At this inspection we found the provider was still in breach of regulations.

This service has been in Special Measures since 8 December 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Inadequate to Requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashlands Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to managing risks safely and ensuring robust governance procedures were in place at this inspection.

Please see the action we have told the provider to take at the end of this report.

We recommend the provider consider current guidance and best practice on developing their assessment of staffing levels to meet people’s needs.

We recommend the provider consults with people, relatives, and the staff team to try to identify ways to reduce the overall noise level in communal areas.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.