Ashfields Care Home

Updated 8 September 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 undertaken by 1 inspector and an 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

Ashfields 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. Ashfields 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 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 sought feedback from professionals at the local authority and Healthwatch. 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 all this information to plan our inspection.

During the inspection

We spoke with 11 people and 2 relatives about their experience of the care provided. We spoke with 8 staff members, including the registered manager, deputy manager, a senior carer, healthcare assistants and the activities coordinator. We reviewed 3 staff files in relation to recruitment and 3 people’s care plans. We looked at 9 people’s medicines records and reviewed records relating to the management of the service, such as meetings, audits, health and safety checks and policies and procedures.

Updated 8 September 2023

About the service

Ashfields Care Home is a residential care home providing accommodation and personal care to 36 people at the time of the inspection. The service provides support to older people and those living with dementia or physical disabilities. The service can support up to 39 people. Ashfields Care Home is a detached, adapted building with 2 floors accessible by lift. There are 5 self-contained flats adjacent to the home and a large garden area.

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

The management of medicines was not always effective or robust. Records relating to medicines were incomplete or inaccurate. Recruitment checks for new staff were being completed, but these did not always include checks of employment history. We made a recommendation about this. Risks relating to people and the environment were assessed and monitored, and people told us there were enough staff to meet their needs.

Quality systems were not always effective in identifying issues relating to the management of medicines, recruitment practices or health and safety. Staff and people told us there was a positive culture in the home, and people spoke positively of the registered manager. People and staff were engaged in the running of the home, and people benefited from the home’s partnership working with external agencies.

People’s needs were assessed and used to develop person centred care plans. 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 received support personalised to them, from a staff team who felt supported by the registered manager.

Staff treated people with respect and understood the needs of people well. Staff understood the importance of providing care which promoted dignity, privacy and independence, and people spoke positively of the staff approach to providing care. People and their relatives were engaged in reviewing their care plans in accordance with their changing needs.

People received care tailored to their needs and were engaged in a range of meaningful activities both in the home and the local community. People were supported to maintain relationships with their loved ones, and relatives spoke positively about the service their loved ones received. Complaints and concerns were managed effectively, and people’s communication needs were met.

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 good (published 14 May 2019). At this inspection, we found the overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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.

Enforcement and Recommendations

We have identified breaches in relation to medicines management and good governance at this inspection. We have made a recommendation regarding staff recruitment.

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

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.