Archived: Ashlee Residential Care Home

The home had a manager in place who was in the process of registering with us. 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.

Our last inspection took place in August 2014 and at that time we found that there were three breaches to the regulations.

The provider sent us an action plan in April 2015 stating what actions they were putting in place to ensure these standards would be met in the future. We were told how they would make improvements in how people’s medicines were managed; how they would ensure sufficient staff were in place to meet needs and keep people safe; and how they would plan care to meet individual’s needs. During this inspection, we found that the provider had made improvements in all these areas.

We found that people were supported in a way that protected their welfare and they told us they felt safe. People’s medicines were kept and administered in a safe manner and staff showed they had a good understanding about medicines. There was sufficient staff available to meet people’s needs. Staff had a good understanding and knowledge of safeguarding people and understood what constituted abuse or poor practice. The staff knew how to report or respond if they had any concerns.

People were supported in the way that they chose and staff knew each person well and understood their support needs. They were supported to make choices and decisions. When they were not able to, decisions were made in their best interests involving people who were important to them. Where restrictions had been placed upon people these had been assessed, and applications made to ensure any restrictions were lawful.

We found that people were supported to eat and drink to maintain a balanced diet. Specialist diets were catered for and people were given choices and encouraged to be independent. People received support from health care professionals when needed and staff enabled people to attend appointments.

People were treated with kindness and compassion. Their dignity and privacy was respected and they were supported to express views about their care. They received care that was individual to them and responsive to their needs. Staff were aware of people’s changing needs and individual’s preferences. People were given choices about the activities they wanted to participate in. People and their relatives knew how to raise any concerns or complaints. Issues were dealt with in a timely manner.

Staff felt supported by the manager and provider. They told us they were approachable and responsive. Staff received a range of training to develop their skills and they showed how they put this knowledge into practice. Systems were in place to assess and monitor the quality of the service and they were keen to continue to make improvements.

We observed people sitting in the communal areas. Other people chose to remain in their rooms. Staff interacted with people in between their tasks. A member of staff was seen to spend time with people in the lounge area providing a group activity for people. Another staff member was seen doing hair dressing for one person. However, we also observed care that lacked attention to detail. For example, one person was given a drink that they could not manage as they could not lift the mug safely. In the dining room there were no visible prompts to remind people of the menu for each meal. This was important because it would show they were part of the planning and management of their social circumstances.

People using the service did not raise concerns about the staffing levels. However, because some staff had left the provider's employment, remaining staff were being asked to cover the extra shifts. The staffing rota was not accurate as the work planned was different from what was actually worked. Staff told us that any short falls were covered by them as agency staff were not often used.

We saw people had contributed to the new care plans and care workers were using the information from them more effectively.

We found medicines were handled appropriately as observed and people received their medicines in a timely manner.

We did not speak with people directly at this visit but observed and listened to the interactions staff had with them instead. Many of the people at this home had memory problems that limited the ability of the inspector to converse directly with them about their experiences at the home. We observed people being attended to by staff. Staff asked for their permission in different situations or offered an alternative as required. People were seen being treated kindly and their needs were being met.

People were provided with their medicines when they needed them. Although, the system in place for checking medicines was not always adhered to. Staff at the home told us they worked long days we saw this was verified by the duty rota.

We observed people during the inspection. They looked comfortable in their surroundings. We found issues that had been dealt with at the last inspection were revisited. Some areas were not being met.

We spoke with eight relative's about their opinion of the care provided and about staff at the home. Their comments included,

'I was contacted for information about my parent staff were interested in knowing about my parent's background and explained this would be useful when putting together a memory book. I am invited to take part in any reviews being held'.

'I am kept involved in my parent's life. I am asked my opinion about the care of my parent. I was sent a survey to complete in June 2012. I am invited to review meetings about my parent's care. I am advised of incidents and accident when they occur. I feel the staff at the home make a genuine effort to communicate with me'.

We observed a senior care worker administering medication during the lunch time and there were no concerns.

Three relative's told us staff always have plenty to do yet despite this they had never found the home to have mal odours. They told us the care workers and domestic staff worked hard together to keep the home clean and tidy. One relative told us, 'I can visit at any time of the day or night. It is a very friendly place'.

Relative's told us they were kept informed of changes to their relative's and were invited to attend meetings. They told us they were listened to.