Ash Court Care Centre - Camden

Updated 13 April 2021

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 Care Act 2014.

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

This inspection was carried out by two inspectors a pharmacy 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

Ash Court Care Centre is a 'care home'. People in care homes receive accommodation and nursing or

personal care as single package under one contractual agreement. CQC regulates both the premises and the

care provided, and both were looked at during this inspection.

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. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one relative about their experience of the care provided. We spoke with 10 members of staff including the chief executive (CEO) who was conducting a planned, routine visit of the home, the registered manager, the deputy manager, the home administrator, two nurses, three health care assistances and the maintenance operative.

We reviewed a range of records. This included 16 people's care records including care plans and medicines records. We looked at two new staff files in relation to recruitment. A variety of records relating to the

management of the service, including staff training, policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate the evidence found. We looked at training data and quality assurance records. We received feedback from one professional. Our Expert by Experience spoke with seven family members.

Updated 13 April 2021

About the service

Ash Court Care Centre – Camden is a care home providing personal and nursing care for up to 62 people aged 65 and over. The accommodation is on three floors, with communal areas located on each floor and a patio garden on the ground floor. There were 58 people living in the home at the time of our visit.

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

Since our last inspection, the management team at the home had taken effective action on improvement. Newly introduced monitoring systems and processes led to an improved managerial overview of the service delivery. This led to meeting a warning notice about medicines management and meeting breaches in relation to protecting people from abuse, staff training, reporting on notifiable events and appropriate maintenance of equipment.

Further improvements were still needed to fully meet the requirements of the Regulations. This related to aspects of the management of medicines and their monitoring.

People were protected from harm and abuse from others. Overall, risks to people’s health and wellbeing had been assessed. There were appropriate infection prevention and control measures in place. Recruitment procedures were safe, and people were supported by suitably selected staff. There were enough staff on each shift to support people safely. Staff and the managers followed the procedures related to the effective management of accidents, incidents and safeguarding concerns at the home.

Staff received training to help to support people effectively and safely. Formal staff one to one supervisions during the last 12 months have been reduced due to demands related to the Coronavirus pandemic. Nevertheless, staff said they felt supported as they received emotional and practical help from the managers, colleagues and when appropriate the local authority.

People’s care plans were personalised and included information about their cultural background, religion, disability, age, end of life wishes, important relationships and personal preferences. This helped staff to understand people’s specific needs and provide effective care. End of life care plans needed further development to ensure they specified when the end of life care pathway would be implemented. The managers assured us this would be looked into.

Overall the managers at the home received positive feedback from staff, people, their relatives and external professionals. They all said the managers were kind, attentive and willing to take improvement action when gaps in the service delivery were identified. Some family members told us, they were not always updated on the outcomes of the actions agreed.

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 requires improvement (published 05 November 2019) and there were multiple breaches of regulation. A warning notice was issued in relation to the management of medicines. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found improvements had been made however more improvements were needed and the provider was still in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 11 and 12 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the safe care and treatment and governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led domain and additional checks on breaches and recommendations from the effective and responsive domain.

The ratings from the previous comprehensive inspection for those key questions we did not fully look at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement. This is based on the findings of this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ash Court Care Centre Camden on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the management of medicines and governance of the service at this inspection. We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

Follow up

We will continue to monitor the information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.