Ashbourne Care Home

Updated 8 March 2024

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 3 inspectors, and an Expert by Experience on day 1, and 2 inspectors on day 2. 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

Ashbourne 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. Ashbourne 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 on day 1 and announced for day 2.

What we did before the inspection

We reviewed information we had received about the service since their registration with a new provider. We sought feedback from the local authority and professionals who work with the service. 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.

During the inspection

We spoke with 8 people and 7 relatives about their experience of the care provided. We also spoke with 15 staff which included care and senior staff, domestic, and catering staff. We also spoke with the Deputy and registered manager and a regional manager.

We reviewed a range of documents and records including the care records for 9 people, 8 medicine records, 3 staff recruitment files. We also looked at records that related to the management and quality assurance of the service.

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 8 March 2024

About the service

Ashbourne Care home is a residential care home providing personal care and accommodation for up to 38 people some of whom live with Dementia. The service was supporting 36 people at the time of the inspection. The service has 2 units a residential unit and a unit for people who live with Dementia.

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

Systems to monitor the quality and safety of the home were not always effective in identifying shortfalls and to drive improvements. Timely action was not always taken to address health, safety, and dignity issues within the service. Records were not always detailed and kept up to date to provide effective guidance to staff.

People were not always supported with their mobility in a safe way. Systems did not provide assurances people had received their medicines as required. Not all staff had completed core training for their role and staff competency was not always assessed to ensure they put their training into practice. Not all staff felt supported in their role.

People living on the dementia unit did not have the same opportunities and positive dining experiences as those living on the residential unit. People’s dignity and privacy was not always maintained. We have made a recommendation about the environment on the dementia unit.

Systems were in place to review incident and accidents, and action was taken to learn lessons from these. However staff working practices did not always reflect this. People were supported by staff who had been recruited safely and understood how to protect people from abuse. People had access to healthcare professionals to ensure their healthcare needs were monitored and met.

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 and those important to them, were involved in the initial pre- assessment process and were supported to provide feedback about the way the service was managed. People and their loved ones were happy with the service provided and felt able to approach staff and the registered manager.

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 the service under the previous provider was Good published March 2019.

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, safeguarding concerns, moving and handling concerns, infection control, and the management of the home. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

Enforcement and Recommendations

We have identified a breach in relation to the management of medicines and risk and the overall governance of the service. We have also made a recommendation in relation to the environment on the dementia unit. Please see the action we have told the provider to take in relation to the breaches 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.