The last inspection of this service took place on 05 January 2016. The service was awarded a rating of 'Requires Improvement.' The service was found to be in breach of the regulations relating to need for consent, safe care and treatment and safeguarding service users from abuse and improper treatment. We were provided with an action plan following the inspection carried out in January 2016.Ashleigh Rest Home accommodates older people who are living with dementia. The home had 11 single bedrooms, four of which had en-suite facilities.
The service is registered to provide accommodation for persons who require nursing or personal care. There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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.
People who lived at Ashleigh Rest Home told us they felt safe and supported by staff and the management team.
During our last inspection, we found issues with the reporting of safeguarding incidents. We found not all safeguarding incidents had been appropriately reported to the relevant authorities. We looked at how reporting of safeguarding incidents were being managed during this inspection. We found people were protected from the risk of abuse because staff understood how to identify and report it.
During our last inspection, we found evidence risk assessments were not always updated following a change in needs. We looked at how risks to people were being managed during this inspection. We found people were protected from risks associated with their care because the registered manager had completed risk assessments, which provided updated guidance for staff in order to keep people safe.
During our last inspection we found no additional checks were documented following an accident. This put people at risk of harm. In addition there was no evidence available to show that accident and incident records had been reviewed, in order to identify and analyse any trends or patterns. We looked at how accidents and incidents were being managed during this inspection. There was a central record for accident and incidents to monitor for trends and patterns and the management had oversight of these.
During our last inspection, we made a recommendation that the provider follows best practice guidelines around infection prevention and control in care homes. We looked at infection control processes at this inspection and found improvements had been made.
During our last inspection, we made a recommendation around keeping Personal Emergency Evacuation Plan [PEEPs] up to date. We looked at PEEPs during this inspection and found people had up to date PEEPs in their files to aid safe evacuation.
During the last inspection, we found in some care files, consent forms had not been completed. We also found some examples where consent had been provided by people's family members, but there was no confirmation that people who had provided consent had legal authority to do so.
We found mental capacity had been considered and written consent to various aspects of care and treatment was observed on people's files.
We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. We viewed records for two people documenting evidence conditions for DoLs authorisations were being followed.
During our last inspection visit, we made a recommendation around reviewing care files and the systems in place to ensure these were kept up to date. At this inspection we saw care records were written in a person centred way. Staff took note of the records and provided person centred care.
During our last inspection at the service, we found concerns around good governance. There were systems in place designed to monitor quality and safety across the service but we found these had not been used effectively at times; we made a recommendation around this. We looked at the improvements that had been made during this inspection. We found there were quality monitoring systems in place to help drive up improvements in the service. This helped to ensure people were living in a safe environment.
People were protected by suitable procedures for the recruitment of staff. We saw records which showed the provider had undertaken checks. This was done to ensure staff had the required knowledge and skills, and were of good character before they were employed at the service.
We found the service was pro-active in supporting people to have sufficient nutrition and hydration. People said the quality of the food was good. One person said, “I enjoy the meals, I do like my food.” Care plans showed where appropriate, the staff had made referrals to health care professionals such as the community nursing team and GP's.
People received care which was relevant to their needs and effective because they were supported by an established staff team. The staff had received appropriate training such as moving and handling and had a good understanding of people’s needs.
We received consistent positive feedback about the care provided at Ashleigh Rest Home from people who lived at the home and their relatives. We observed staff as they went about their duties and provided care and support during this inspection visit. Staff appeared to understand the needs of people they supported and it was apparent trusting relationships had been created. One relative told us, “The staff understand that they cannot bring the residents into their world so they try to get into the residents world, and they do it very well.”
The registered manager and staff told us they fully involved people and their families in their care planning. People we saw were well presented and staff sought to maintain people's dignity throughout the day.
People told us, “I like to do crosswords and the staff will provide the things I want.”. And, “The staff would support me if I wanted to do something.”.
We saw people engaging in activities positively with staff. People were supported and encouraged to take part in activities, these were provided by the care staff and included one to one time and singing. People were encouraged to raise any concerns or complaints. The service had a complaints procedure. People we spoke with said they felt comfortable raising concerns if they were unhappy about any aspect of their care.
The registered manager kept up to date with current good practice guidelines by attending meetings at which they shared learning and discussed new developments in care. We found the management team receptive to feedback and keen to improve the service. The registered manager worked with us in a positive manner and provided all the information we requested.