Ashford House Care Home

Updated 24 January 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 carried out by 2 inspectors.

Service and service type

Ashford House 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. Ashford House 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

The inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 4 relatives about their experience of the care provided. We spoke with 5 members of staff including the registered manager, 3 care staff and the cook. We observed staff providing care to people. We reviewed a range of records. This included 4 people's care records and 10 medicines administration records. We looked at 3 staff files in relation to recruitment and training. A variety of records relating to the management of the service, were reviewed.

Updated 24 January 2023

About the service

Ashford House is a residential care home providing accommodation and personal care. The service is registered to support up to 27 older people with a physical disability, dementia and mental health needs. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, 15 people were suing the service, 1 person did not receive a regulated activity.

Accommodation was split across two floors accessed by a lift and two stairwells.

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

Following the last inspection, quality assurance systems and processes to monitor the quality and safety of the service had improved. However, many of the improvements required to the premises identified at the last inspection had not taken place.

The registered manager was accessible, open and inclusive. People, relatives and staff told us they were supported by and had confidence in the registered manager.

People felt safe and risks were mostly assessed and managed. Some improvements were required to ensure all risks were identified, the registered manager agreed to take this action. There were enough staff with the right skills and experience. Some people had complex needs and at times staff were very busy attending to people’s needs in different areas of the service. This meant at times people had to wait for staff to attend to them and on one occasion there were no staff available to support people in the communal lounge.

People received their medicines in a safe way. When things went wrong, the registered manager used this as an opportunity to learn. Systems and processes were changed to reduce any further risks.

Staff were kind and caring and had developed positive relationships with people. People were involved and included in decision making about their care and support. People were supported to maintain relationships with people important to them. Social activities were provided. However, opportunities for people to follow their interests and hobbies were limited.

People liked the meals provided and were mostly supported to eat and drink sufficient amounts. Staff identified when people’s health deteriorated. They consulted with health care professionals and followed their advice and guidance.

Staff had the training and support they required to carry out their role.

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 had appropriate authorisations in place for deprivation of liberty (DoLS) where this was required. Staff did not always follow the DoLS conditions. This meant important information to support least restrictive practices was not always available. For example staff were required to record the action taken when the person became distresses or were resistant to care but they did not always do this.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was Inadequate (published 6 May 2022).

This service has been in Special Measures since 26 November 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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

Enforcement and Recommendations

We have identified a continuing breach in relation to leadership and quality monitoring at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.