Ashmore Nursing Home

Updated 25 October 2022

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 two Inspectors and an Expert by Experience who made telephone calls to relatives.

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

Ashmore Nursing Home 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. Ashmore Nursing Home is a care home with 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

This inspection was unannounced.

Inspection activity started on 29 September 2022 and ended on 12 October 2022 when we gave feedback.

What we did before the inspection

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 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

During the inspection we spoke with four people who used the service, 14 staff, including the registered manager. We also spoke to 14 family members of people receiving support.

We reviewed ten care records, medicines administration records (MAR) and four staff records. We also reviewed other records, including policies and procedures, and records relating to the quality and safety monitoring of the service.

Updated 25 October 2022

About the service

Ashmore Nursing Home is a care home providing personal and nursing care for up to 42 older people in one adapted building. At the time of our inspection there were 27 people living in the service.

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

We found shortfalls in the management of risks to people’s safety and welfare including, oversight of environmental risks, catheter care, wound care and medicines management. Audits in place had failed to identify the shortfalls we found at this inspection. These concerns had not been identified or resolved through any governance process.

Not everyone had a care and risk management plan in place. This meant staff had not been provided with formal guidance as to the care support needed and identify any risk to people’s health, welfare and safety.

People were at risk of being supported by unsuitable staff as safe recruitment procedures were not always followed.

We have made a recommendation for guidance to be reviewed to ensure staff wear the correct Personal Protective Equipment (PPE) at all times.

We observed positive relationships between people and staff. There was mostly positive feedback from people and their relatives about staff approachability and good communication. Further work was needed to ensure people isolated in their rooms had sufficient staff to meet their social and emotional needs and planned activities to protect them from the risk of social isolation.

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.

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 good (published 19 March 2020).

Why we inspected

We received concerns in relation to staffing, a lack of training, and people left isolated in their rooms leading to a lack of social stimulation. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the list relevant key question sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashmore Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management, risk management and staffing.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.