- Care home
Ashview
Report from 11 July 2024 assessment
Contents
On this page
- Overview
- Learning culture
- Safe systems, pathways and transitions
- Safeguarding
- Involving people to manage risks
- Safe environments
- Safe and effective staffing
- Infection prevention and control
- Medicines optimisation
Safe
At the last inspection, the provider was in breach of the regulations because they had failed to ensure people were safeguarded from harm, appropriate and safe staffing was in place, the environment was not safe, people were not involved in risks to their wellbeing and medicines management was not safe. At this assessment, staffing levels, recruitment checks, the premises and management oversight had improved so people’s experience of care overall had improved significantly. Improvements had been made and the provider was no longer in breach of the regulations relating to the question of Safe. People received safe care from staff who understood their personal and health care needs and followed healthcare guidance from professionals. Staff knew how to safely support people around their individual risks. The provider ensured people were safe and received care which met their individual needs, protected their rights, and safeguarded them from abuse and neglect. Medicines administration was managed safely by competent and trained staff.
This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Learning culture
People told us the service had changed for the better as they felt listened to and involved. People told us they could make complaints and would be listened to. They were now involved in developing the service and together with the manager and staff had created new values for all who lived at Ashview. These included, listening to one another, challenging bad practice, being respectful and emphasising abilities not limitations.
The registered manager analysed incidents, accidents and complaints to identify any common themes, patterns and lessons learnt. Action was taken to learn from and address lessons learnt, this included reviewing people’s care needs and staff knowledge and training.
There were clear processes to record incidents, complaints, and compliments. Clear processes were in place to investigate, analyse and learn from incidents. The manager had created a learning culture where staff could raise and discuss issues and concerns during supervision and staff meetings, enabling staff to reflect and share ideas of how to improve things further.
Safe systems, pathways and transitions
People and their relatives told us staff supported them to access different health and social care services when needed and their care was well coordinated. The service provided short term and respite stays for people. These were coordinated so that there was continuity of care for people from hospital or their home.
The manager communicated with other services, assessed, and reviewed people’s needs and ensured smooth transitions between healthcare services.
People’s changing needs and new admissions were discussed within the staff team during regular meetings, care was well-organised and monitored daily. Referrals for professional support were made such as GP, district nurse teams, speech and language therapy or social services for additional help and advice when needed
Safeguarding
People and relatives told us they were safe at Ashview. A person said, “The staff know me well now and I feel safe with them supporting me.”
Staff undertook training in safeguarding people from abuse. We saw that knowledge was shared and reflective learning sessions enabled staff to discuss safeguarding and preventing harm to people. Staff told us how they kept people safe. A staff member said, “We keep an eye out always for seeing if people are treated well and I would go to the manager if I thought someone wasn’t being respected.”
We saw that people were safe from harm and being treated respectfully. The new values at the service were being demonstrated.
The system for managing and recording of safeguarding concerns had been improved and was now detailed and robust. The manager demonstrated how they learnt from incidents which affected people's safety. They shared concerns quickly and worked well with relevant local authorities to be open and transparent in any investigation. They had learnt from incidents which affected people's safety and had implemented a process of thorough investigation, actions and outcomes and lesson learnt to prevent them from happening again.
Involving people to manage risks
People and their relatives were fully involved in discussing risks to their health and safety. People’s care plans recorded discussions about risks, ways to mitigate them and making choices and decisions about their day to day lives. A person told us, “We now have staff asking us about how we want to do things, when and where. Decisions are not made for us anymore but with us and my views are listened to and respected. I feel treated like the adult that I am.”
Staff supported people to remain safe and well and were aware of potential risks to their health and wellbeing. They were responsible as ‘key workers’ to ensure people’s information was up to date and their programme of activities and tasks around the house worked effectively. A staff member told us, “We always thought [name of person] couldn’t do certain things, then together we took positive risks and now their world has opened up.”
We observed staff involving people in conversation and listening to their views and body language. Care plans contained well written information to provide staff with the knowledge in how to support people with choice, control and autonomy.
Systems to involve, discuss and assess risks with people had improved significantly. Risks were appropriately assessed and documented. People’s capacity to make decisions was also considered and any barriers to involvement were removed through effective communication and engagement.
Safe environments
All the refurbishment work being undertaken at the last inspection had been completed. The corridors, lounge area and people’s bedrooms had all been decorated. People had chosen the colours for their walls, curtains and bedroom furniture. New wardrobes were in the process of being secured to walls. The garden was well maintained, and people were involved in looking after it. A person told us, “I chose these curtains to go with the colour of my walls, before I just had old ones. It was nice when they said, you can choose what you want and I didn’t have to pay for them.”
Staff told us the service was much more homely and they felt proud to work at Ashview.
The service was free from obstacles and barriers and had been made as accessible as possible, such as an adjustable sink and hob which could be adjusted for wheelchair users to use. The alarm code for the front door entrance had also been moved so that wheelchair users could reach it to open and close the door independently.
There was a system to monitor health and safety. Daily, weekly, monthly and quarterly checks were undertaken to ensure all aspects of the service were safe. This included equipment, maintenance, medicines administration, cleaning, finance and care plans. Personal emergency evacuation plans, and fire safety measures were in place. The provider had a business continuity plan which provided guidance on contingency plans in case of various emergencies and untoward events that could affect the service. Accidents and incidents reports were completed and detailed about what had happened and how risks were being mitigated to keep people safe. Lessons were learnt as a result.
Safe and effective staffing
People said they liked the staff who looked after them. They were respectful and friendly. A person said, “Before, we had agency staff, who didn’t really know me. Now we have the same staff, so it is so much better as they know the way I like to do things.” A family member told us, “The staff are wonderful and [relative] is so happy”.
There was enough staff to meet people’s needs. Staff told us staffing in the service had improved since the last inspection and had the time and the skills to meet people’s needs and promote independence. Agency staff were no longer used. One staff member said, “We are a really good team now and have worked hard to make things better for everyone.” Another told us, “The manager has made such a difference. Morale is good and my role and responsibility is clear. I know how to support people to reach their goals.”
We saw staff used people’s names when addressing them, were polite, encouraging and responded to their individual personalities.
Staff induction was thorough, and a process was in place to complete the Care Certificate (a set of standards expected of staff working in social care settings). Staff training was reviewed to ensure they had the knowledge and skills to meet people's needs. Staff were up to date with their required training. Knowledge checks and information sharing sessions had been introduced for managers and staff to discuss and share their understanding of the regulations and their competency to carry out their role and responsibilities. Staff received regular supervision which recorded discussions and performance. Team meetings were inclusive and there was a clear action plan and follow up from the meetings to ensure continued improvement. New staff were recruited following a robust recruitment process. Disclosure and Barring Service (DBS) checks were undertaken. DBS provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.
Infection prevention and control
People were protected as much as possible from the risk of infection. People were involved in maintaining cleanliness through undertaking household tasks such as putting out rubbish and keeping their bedrooms clean and tidy.
Staff were aware of their responsibilities to keep the service clean and infection free in order to keep people safe.
The premises and equipment were kept clean and hygienic.
The programme of refurbishment had been completed. Cleaning rotas and responsibilities had been improved and these were audited to ensure the service continued to prevent people from being at risk of infection.
Medicines optimisation
People were given their medicines as prescribed. Their choices about how they liked to be given their medicines and their capacity to manage them was recorded. Staff were aware of people’s rights to decline medicine and the process to follow should this occur. Plans were being discussed for one person to administer and manage their own medicines to increase their independence and control.
Staff were able to explain practises to manage peoples’ medicines and reduce the risk of errors. Body maps had been implemented to show where topical creams should be used. Information was available to staff about the fire safety risks of using paraffin-based emollients.
Medicines were stored safely. Staff completed appropriate records when supporting people with their medicines and there were regular audits in place. Medicines used ‘as and when required’ and controlled drugs were managed in a safe way. Protocols for providing covert medicines had the necessary medical approval in place. The provider had a medicines management policy and staff members’ competency was assessed.