Ashburton House

Updated 13 July 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 conducted by two inspectors and two Experts 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

Ashburton 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. Ashburton 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

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed information we had received about the service since the service was registered.

We spoke with health and social care professionals who are either in contact with the service or regularly visit the service.

We used all this information to plan our inspection.

During the inspection

Two Experts by Experience spoke with 6 people living at the home and 15 relatives on 22 and 24 March 2023 to gain their feedback on the service.

We also used the Short Observational Framework for inspection (SOFI) on 24 March 2023. SOFI is a way of observing care to help us understand the experience of people who were not able to comment specifically on the service.

On the first and second day of inspection, we gave verbal feedback during the day to the registered manager and the nominated individual. The inspection concluded on 29 March 2023 when verbal feedback was provided to the registered manager, the nominated individual and the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

During the inspection, we spoke with 12 staff and an additional 4 people living at the home. We reviewed a range of records. This included 6 people’s care records and people’s medication records. We looked at 3 staff files in relation to recruitment and looked at records relating to staff supervision. We reviewed a variety of records relating to the management of the service, including minutes from staff meetings, handover notes, rotas and audits. We completed a tour of the building, the laundry and the grounds with the registered manager.

Updated 13 July 2023

About the service

Ashburton House is a residential care home providing accommodation and personal care to up to 24 people. The service provides support to older people, including people who are living with dementia. At the time of our inspection there were 23 people living at the care home.

Accommodation is provided over the ground floor and first floor, including a recently adapted annexe. There were four separate staircases in the home and a passenger lift, which enabled people to access some areas of the first floor. The first floor could be accessed by stairlifts

Communal rooms included an open plan area, with two lounges and a dining room and interconnected by a gradual slope with handrails. There was also a separate lounge, which provided a quiet space for people and their families, as well as a space for religious worship or spiritual practice. Outside of the dining room was a patio and a large lawn.

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

Since our last inspection, the provider had reflected on their role and how the service was run and staffed. Consequently, there had been significant changes to the staff team, resulting in a positive impact on the quality of care and the running of the care home.

The new registered manager was popular with the staff group and relatives. People living at the home also responded well to the registered manager who knew them well. Staff said, “The registered manager is amazing… Staffing has totally changed, we work as a team, the new starters come together. Best job I have ever had.” A relative said, “The home now has a manager who is working extremely hard to put good/safe practice in place, gaining the trust and respect of staff, residents and their families.”

There was an improved approach to managing risks both to people and linked to the environment with improved recording in most areas. During and following the inspection, actions were completed to address other issues linked to potential risk, such as the layout of the laundry and the fencing around the garden.

There was improved oversight in place to ensure accidents, incidents or near misses were reviewed by the management team and remedial action was taken to reduce any identified or emerging risk. Since the last inspection, there have been no further safeguarding concerns. The service provided safe care to people. People looked at ease and comfortable in the company of staff. For example, they said, “I like it here, it’s a nice space and they’re always kind.” Relatives said they would recommend the service to other families. For example, they said “Atmosphere is lovely, friendly and homely, staff always talking to residents, certainly I would recommend.”

Changes were being made to how staff were recruited, including a new staff member to oversee the process. The staff team met people’s care needs. For example, we saw staff were attentive, checking on people’s well-being and taking time to listen to them. People told us staff were friendly and kind. Relatives were positive about the skills and approach of the staff group. One noted there had been a number of staff changes but said all were caring.

Medicine records showed people received their medicines in the way prescribed for them. Staff support including training and induction had significantly improved since our last inspection. Most of the staff working at the home were new in post but we saw they worked well as a team to benefit the people living at the home. Staff looked calm, cheerful and relaxed during the inspection.

Improvements had been made to the environment. The large lawn had a perimeter fence and security had improved. The registered manager told the inspector there were further plans to enhance the area for people living with dementia.

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.

Staff spoke respectfully and with compassion about the people they supported at the home. Throughout our inspection, we saw gentle shows of affection by staff, both through their actions and their conversation and tone of voice. Staff showed a genuine interest in the well-being of each person. They recognised how the new registered manager had established an improved ethos at the home, which included celebrating people’s difference. A staff member said, “I would just like to say how much the home has improved and is still improving. Staff are coming together as a good functioning team ensuring care comes first.”

Care records information had improved, which was personal to each individual. This had been noted by a visiting health professional. We saw personalised information in care plans which gave important information to staff in how to work alongside people and maintain their dignity and trust. A health professional said the registered manager and staff went the “extra mile” to meet people’s individual care needs and worked closely with families. There had been improvement to people's end of life care wishes. This meant people could receive the care and support they needed to reassure them, for example, the last rites or to listen to a piece of music which gave them comfort.

Social events were now delivered by a skilled staff member who treated people as equals. There was a good range of social opportunities for people, including visiting musicians, quizzes, trips to the pub and cafes.

The management of complaints was improving. For example, how they were recorded and the tone of the response. The registered manager was supported by the new operations manager which worked well. This meant there was increased oversight of concerns and provided an extra layer of response if complainants were not satisfied with the initial response.

Care staff recognised how important it was to understand and get to know each person so they could provide individualised care. Throughout the inspection, staff checked with people to ensure they had understood their wishes and had their consent. A person told us, “Nothing is too much trouble. They treat me with dignity and respect.”

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 inadequate (published 25 October 2022).

At this inspection we found improvements had been made and the provider was no longer in breach of 8 regulations. This service has been in Special Measures since 25 October 2022. 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 prompted by a review of the information we held about this service.

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.

You can see what action we have asked the provider to take at the end of this full report.

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

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

Follow up

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