Archived: Ashford Nursing Home

Updated 9 July 2016

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 16 and 17 May 2016 and was unannounced. The inspection was carried out by two inspectors and one specialist nurse advisor. Before our inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the PIR and other information we held about the home, including previous inspection reports. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, looked at any safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

We met with ten of the people who lived at Ashford Nursing Home. Not everyone was able to verbally share with us their experiences of life in the service. We therefore spent time observing their support. We spoke with five people’s relatives. We inspected the home, including the bathrooms and some people’s bedrooms. We spoke with six of the care workers, the cook and the registered manager.

We ‘pathway tracked’ eight of the people living at the service. This is when we looked at people’s care documentation in depth, obtained their views on how they found living at the home where possible and made observations of the support they were given. This allowed us to capture information about a sample of people receiving care.

During the inspection we reviewed other records. These included three staff training and supervision records, three staff recruitment records, medicines records, risk assessments, accidents and incident records, quality audits and policies and procedures.

Updated 9 July 2016

This inspection took place on 16 and 17 May 2016 and was unannounced.

Ashford Nursing Home is registered to provide nursing; personal care and accommodation for up to 22 people .There were 16 people using the service during our inspection; who were living with a range of health and support needs. These included; diabetes, catheter care and people who needed to be nursed in bed.

Ashford Nursing Home is a large detached house situated in a residential area just outside Ashford. The service had a communal lounge available with comfortable seating and a TV for people. There was an enclosed garden to the sides and rear of the premises.

A registered manager was in post. A registered manager is a person who has registered with the care Quality Commission to manage the service. 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.

Ashford Nursing Home was last inspected in May 2015. They were rated as ‘Requires Improvement’ at that time and we asked the provider to send us an action plan about the changes they would make to improve the service. At this inspection we found that actions had been taken in some areas, but work was still needed in others.

Risks to people had generally been assessed and minimised but medicines had not always been recorded or stored appropriately. Fire safety had been addressed through training, drills and alarm testing. Maintenance had been carried out promptly when repairs were needed.

There were enough staff on duty but the registered manager was contracted to carry out management duties for only 12 hours per week. This had led to a lack of oversight in some areas of the service. Recruitment processes were not sufficiently robust to make sure that applicants were suitable for their roles and some refresher training was overdue. Staff had received regular supervision to measure their competency.

Assessments and decisions had not consistently been carried out within the principles of the Mental Capacity Act (MCA) 2005. People’s health care needs were supported and documented. Assistance to eat and drink was provided when needed and people enjoyed their meals.

Staff were caring and considerate and people and relatives praised them throughout the inspection and in telephone conversations following it. People were offered hand massages, hairdressing and one-to-one chats with staff to help prevent them becoming isolated. Care plans were person-centred and staff knew people’s personalities and preferences well.

Complaints had been properly documented, and recorded whether complainants were satisfied with the responses given. People and relatives said they knew how to complain if necessary and that the registered manager was very approachable.

Records had not been maintained appropriately and it was often difficult to find information about people’s care quickly or in one place. Audits had not always been effective in highlighting shortfalls which meant there was a risk that safety issues would not be addressed promptly.

Staff felt appreciated and involved and said they were supported by the registered manager.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.