Background to this inspection
Updated
24 September 2022
Inspection team
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.
Inspection team
The inspection was carried out by one inspector and an inspector from the medicines team.
Service and service type
Asheborough 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 we looked at both during this inspection.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. 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
Before the inspection, we reviewed information we held about the service and the provider which included any statutory notifications sent to the CQC. A notification is information about important events which the service is required to send us by law. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all of this information to plan our inspection.
During the inspection
We reviewed three people's care plans and risk assessments in detail and two further were partially reviewed. We looked at two staff files in relation to recruitment. We reviewed staff training and supervision. We checked 10 people's medicines records. We also reviewed other records relating to the management of the service, including complaints and compliments received. We spoke with two people, seven staff including the registered manager and the nurse.
We spoke on the phone with three relatives of people living at Asheborough, about their experience of the care provided.
Updated
24 September 2022
About the service
Asheborough House Care Centre - Saltash is a residential care home providing personal and nursing care to up to 31 people. The service provides support to older people and people with physical disabilities. At the time of our inspection there were 20 people using the service.
People’s experience of using this service and what we found
At our last inspection the service had experienced low staffing levels. The registered manager had been required to work many shifts, including night shifts, to cover the rota. This meant they had less time to spend on management tasks. This had led to lapsed staff training and supervision. The service had been at a tipping point with all contingency plans exhausted.
At this inspection we found some improvements had taken place. There were sufficient staff on shift to support people at the time of this inspection. Recruitment had been successful. However, the service was still using some regular agency staff to support some shifts.
Staff support, such as supervision and training provision, had improved. Some staff remained overdue for some training; however, we were assured that the registered manager was closely monitoring the situation and supporting specific staff to update training. Staff had not yet received an annual appraisal but this was planned as staffing stabilised.
Oversight and governance by the registered manager was improved. They did spot checks on the service along with a regular programme of audits. The registered manager told us, “No one knows when I might appear. I arrived here at 3.30am this morning just to support the night staff and do some checks.”
At this inspection staff morale was good. Staff told us, “I like it here, it’s a good place to work” and “The registered manager really looks after us all.”
People's care and support needs were assessed before they started using the service. People received support to maintain good health and were supported to maintain a balanced diet. When needed, people were having their food and drink intake recorded and were regularly weighed.
People received their medicines in a safe way as prescribed for them. However, there were improvements needed to some aspects of the way medicines were managed.
Some care plans did not contain specific guidance for staff to guide them on how to support some people. However, we saw and were told by staff that appropriate care was being provided and this was recorded in the daily notes. The registered manager addressed this during the inspection.
Mental capacity assessments had been carried out where it was indicated. Deprivation of Liberty Safeguards (DoLS) authorisations had been applied for appropriately. Six authorisations for restrictive care plans, were in place at the time of this inspection. We confirmed this with the local authority.
Recruitment procedures were robust.
People told us they felt safe with staff. There were systems to help protect people from abuse. Staff had received training on how to recognise abuse.
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. People’s preferences and choices had been recorded.
At our last inspection the service was noted to be in need of renovation. At this inspection we found the broken windows, seen at the last inspection, had been replaced. However, the service was still in need of re-decoration and updating in places.
Staff understood the importance of respecting people's diverse needs and promoting independence. People told us they liked living at Asheborough and that the staff were caring and responded when they called. One person told us, “It is a good place to live and the staff are lovely.”
People and staff were asked for their views by the registered manager through a survey and responses had been audited. Relatives told us, “They (Asheborough care staff) are very responsive and communicative. They share information with us and have been very amenable around timing of our visits. They seem genuinely concerned for (Person’s name) well-being. (Person’s name) is very happy there and he always seems to have something to do” and “The staff are lovely and they look after (Person’s name) well.”
Staff meetings had been held to seek the views of staff and share information.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was requires improvement (published 23 December 2021).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.