Ballards Ash

Updated 2 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

One inspector attended the service visit.

Two inspectors made phone calls to seek feedback from staff and health and social care professionals following this site visit.

Service and service type

Ballards Ash 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

We gave a short period of notice to the provider of this inspection.

What we did before the inspection

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. 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. We used all of this information to plan our inspection.

During the inspection

We spent time observing people in their home environment as some people had limited speech or communicated through signing, expressions or tone. We spoke with 11 members of staff and three members of the management team, which included the registered manager, assistant regional director and member of the in-house behaviour team. We reviewed a range of records. This included three people's care records and medication records. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with six professionals who regularly visit or have regular contact with the service.

Updated 2 April 2021

About the service

Ballards Ash is a residential care home which is registered to provide a service for up to 10 people. People living at Ballards Ash had diagnosed needs including a learning disability, mental health disorders and some people were on the autistic spectrum. At the time of our inspection seven people were living in the home and one person was in hospital.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This was a focused inspection and did not cover all areas of the Right support, right care, right culture during this inspection. People had limited access to external activities and reduced social contact due to the current government guidelines around the pandemic.

Improvements had been made in documenting and reviewing incidents within the service. Care plans had detailed information around identified risks. Medicines were being managed safely and staff had received appropriate training. Improvements had been made to infection control measures to ensure the service followed safe practices.

Staff feedback was mixed around the support they received and how the management team dealt with raised concerns. Staff felt the morale continued to need work and that some documentation was more of a tick box exercise than an actual review of practice. During this inspection we received two whistle-blowing concerns which have been safeguarded and raised with the management to investigate.

Quality systems were in place and actions set where improvements were identified. Additional management support was in place to oversee and drive improvements. Staff felt mixed on changes within the service, some felt good improvements had been made and others felt that the high staff turnover impacted negatively on the skill mix in the service and wasn’t being considered by the management team.

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 8 July 2020).

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 and the provider was no longer in breach of regulations. We have made one recommendation for the provider around reviewing the management of raised concerns.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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 which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service is Requires Improvement. 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 Ballards Ash on our website at www.cqc.org.uk.

Follow up

We will continue to engage with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.