Background to this inspection
Updated
16 July 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
The inspection was carried out by two inspectors on day one and one inspector on day two which was conducted remotely. An Expert by Experience contacted people and relatives to gain their feedback about the service.
Service and service type
Ascot Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. This included feedback we had gained from people and relatives using the service as part of our monitoring activity in February 2021. We sought feedback from the local authority and healthcare professionals who work with the service. 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. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with 12 people who used the service and two relatives about their experience of the care provided. We spoke with 13 members of staff including care workers, restaurant and housekeeping staff, a nurse, a supervisor, the clinical manager, the registered manager and the provider. We observed staff provide care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at documentation about people’s support needs and staff levels. We sent questionnaires to the 82 members of the staff team and received 17 written responses. We spoke with one local authority professional who had regular input with the service.
Updated
16 July 2021
About the service
Ascot Grange is a residential care home providing personal and nursing care to 43 people aged 65 and over at the time of the inspection. The home is purpose-built and can support up to 106 people across four adapted floors, each of which has separate adapted facilities. One of the floors specialises in providing care to people living with dementia.
This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this single location. The providers are WR Operations 1 Limited and Signature Senior Lifestyle Operations. This means the service is subject to one inspection visit however the report is published on our website twice, under each provider.
People’s experience of using this service and what we found
Some people and staff told us the service was sometimes short staffed. Most people and staff felt there were enough staff to respond to people’s needs quickly. We found documentation was not readily available to evidence regular reviews and summaries of people’s needs and agreed support hours. We have made a recommendation about this.
People said they received safe and caring support, with comments such as, “I feel safe here there is no reason to not feel safe”, “Oh yes definitely safe here. I am well cared for with no worries” and “I was well protected during COVID”.
The registered manager had taken appropriate action in relation to previous concerns about the management of falls and inconsistent reporting of events to the local safeguarding authority and CQC. We found systems were in place to review and escalate incidents of falls with a multidisciplinary team of healthcare and local authority professionals to reduce the risk of future occurrences and avoidable harm.
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.
The environment was comfortable and adapted to meet people's physical and sensory needs. Healthcare and local authority professionals told us the service was open to partnership working and responsive to suggestions, which benefitted people's health and quality of life.
The service fostered an open culture. People told us the service sought and listened to their views, with comments such as, “I go to the resident’s meetings and they do act on things" and "I think so that it is well run and organised. The manager is approachable".
Management understood regulatory requirements and notified CQC of specific events. We saw this had been sustained since March 2021 after we had initially identified concerns about this with the registered manager and provider.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 22 January 2018).
Why we inspected
The inspection was prompted in part due to concerns about the management of people’s falls and inconsistent reporting of events to the local safeguarding authority and CQC where required. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this 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 remained Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ascot Grange on our website at www.cqc.org.uk.
Follow up
We will continue to monitor 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.