Ashgrove House Care Limited

We found the following examples of good practice.

The home appeared clean and uncluttered and rooms were being regularly sanitised. The service had designated staff that only worked at this service, this was to minimise the chance of cross infection.

The home was allowing visitors in line with government guidance. All visitors’ temperatures were taken to help screen people for COVID-19. Appropriate personal protective equipment (PPE) was being used, and staff, residents and visitors also took part in routine COVID-19 testing. People were supported to maintain regular contact with loved ones through video calls, telephone calls and visits at the window.

Staff spoke positively about the service and management. One staff member told us, “Her [Registered manager’s] door is always open, and she is always on the floor, she mucks in, which is nice and so does the owner.”

Ashgrove House is a residential care home providing accommodation and support for up to 33 older people, some of whom live with dementia. At the time of the inspection the home was fully occupied.

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

People spoke positively about the care and support provided and felt staff had a good understanding of their individual needs, wishes and preferences. People’s relatives were confident their family members were safely and effectively cared for. A range of activities were provided both in and away from the home providing variety to people’s daily routine.

There was evidence to show on-going compliance with the regulations in relation to staff training and support, infection control, safeguarding and complaints, health care & nutrition, health and safety and maintenance checks.

People received their medication as prescribed. Additional locks to cupboards were provided to ensure stocks of medicines were kept secure and documentation to record the use of thickeners and creams were to be implemented.

Electronic care records were seen exploring all areas of care and support including people’s goals, aspiration, preferences and wishes. Where risks to people’s health and wellbeing had been identified, these were assessed and planned for.

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.

People had access to a range of healthcare support so that their health and well-being was maintained. Suitable arrangements were in place to meet people’s nutritional needs. The kitchen was clean, well-organised and the dietary needs of people were understood by kitchen staff.

A review of records, feedback received and our observations showed sufficient numbers of staff, who had been safely recruited, were available to respond to people’s requests for help.

An on-going programme of training and support was provided to help ensure staff had the knowledge and skills needed to support people safely and effective. Staff spoken with felt the service was well run, there was good team work and felt supported in their role.

Ashgrove provided a good standard of accommodation that was clean and well-maintained. Suitable aids and adaptations were available to aid people’s mobility and promote their safety.

There was evidence of on-going management and oversight of the service. Opportunities were provided for people, their relatives, professionals and staff to share their views about the service. Regular audits and checks were completed to monitor and review the standards of care. Any themes or patterns were explored, such as accidents or incidents, and an action plan was put in place to evidence improvement to be made.

Systems were in place for recording and responding to complaints.

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 December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

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.

The inspection took place over two days on 8 and 9 November 2016. The first day was unannounced. The home was last inspected in November 2014. At the last inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service did not always check the suitability of newly recruited staff to work with vulnerable adults. There was a breach of Care Quality Commission (Registration) Regulations (2009) as the service did not notify us of how they responded to certain specified situations, such as injuries, illness or safeguarding concerns. During this inspection we saw that the service was now compliant in these areas.

Ashgrove House is a large Victorian house, which has been extended and refurbished to provide 32 single rooms, 28 with en-suite facilities. It is situated in a residential area of Chadderton, and is close to local amenities such as shops, churches and schools. Bedroom accommodation is provided on the ground and first floor. There is a passenger lift to the first floor. The service is registered to provide accommodation for persons who require nursing or personal care. At the time of our inspection there were 31 people living at Ashgrove House.

The home had a manager registered with the Care Quality Commission (CQC), but this person was not present when we inspected. However there was an interim manager in place who was available throughout the time we were at the home. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

Ashgrove had a warm and friendly atmosphere and people told us they felt safe there. When we spoke with staff they were able explain how they ensured people were protected from abuse or harm.

People were supported by a long-standing, stable staff team. Staff were knowledgeable and knew the needs of the people who used the service. Procedures for recruiting new staff were sufficiently robust to help ensure that people were protected from the risk of unsuitable staff being employed, and the level of staff was sufficient to meet the needs of the people who used the service.

We saw from looking at the training records that staff received appropriate training to meet the identified needs of people who lived at Ashgrove, such as dementia training, capacity and consent, and end of life care. We saw that where specialist equipment was required, staff had received instruction on its use, and the property and all equipment was well maintained.

Care records gave a good indication of people’s abilities and provided a good description of their individual likes and dislikes. Where risk was identified, plans were in place to minimise the risk of harm occurring. Senior staff were trained to administer medicines and we saw procedures were in place to ensure the safe management of medicines.

When people were being deprived of their liberty, the correct processes had been followed to ensure that this was done within the current legislation. Staff understood issues around capacity and consent, and offered people choices to support their independence. People who did not have family or representatives and were unable to speak for themselves had access to advocates who gave independent advice and acted in the person’s best interest.

Staff communicated well with each other and we saw that information was exchanged between staff informally throughout the working day, and a detailed handover meeting took place at the start and finish of every shift to ensure that care and support was provided in accordance with people’s changing needs.

People enjoyed the food provided. One person commented, “All the food is good; the cook is very fussy about food and it always looks and tastes nice”.

We saw that staff monitored people’s physical and mental health needs, and ensured they had good access to healthcare staff. We saw in care plans that people had regular access to other treatment such as dentist, optician and chiropody appointments.

People were treated in a caring and compassionate manner, by cheerful staff. One person who used the service told us, “This is a happy home. Staff are always smiling. A relative who was visiting Ashgrove during our inspection told us, “When I came here, I got a good feeling. The staff were friendly and pleasant and I saw how well they cared for residents. Nothing has changed my opinion; I can’t find fault”. Care was person centred and delivered by cheerful staff who understood how to interact with the people who used the service. We saw people were comfortable and looked well cared for. Staff were vigilant to people’s needs and were able to respond in a timely way to people’s requests for assistance. They respected people’s need for privacy, but understood the risk of social isolation and did not leave people unattended. Staff spent time talking with people on a one to one basis or in small groups so that people felt like they were included. We saw that people’s belongs were treated with respect, and personal information held about individuals was securely stored.

Staff provided care for people at the end of their lives in a sensitive, manner and recognised the need to treat people with dignity and compassion. The home achieved accreditation from Pennine Care NHS Foundation Trust in the Six Steps to Success Programme. We saw that that people’s wishes for care at the end of their lives were respected.

Information contained in care plans gave a good outline of the individual, actions to take to support the person to maintain their independence, recognition of personal preferences, and actions to take to minimise risk. We saw care records were thorough and gave a good chronology of interventions with individuals, which indicated any changes in the person’s presentation or needs. People’s preferences and wishes were taken into consideration in the day-to-day delivery of care and support.

The service was well led by an experienced management team committed to service improvement and providing a high quality of care. Regular checks were made by the entire management team to measure and improve the delivery of good quality care to the people who lived at Ashgrove.

We spoke to two people living at the home and using services and one visiting family member. Due to presenting conditions, the service users we spoke to were not able to describe their experiences in detail. All the people we spoke to were positive about their experiences and said they or their relative were happy there. They said their choices and dignity were respected, they felt independent and free to do as they pleased. All were complimentary about the staff; comments included 'they are very nice' and 'there when you need them'.

We spoke to three members of staff. All demonstrated commitment to their work and the service users.

In the main, the atmosphere was relaxed and friendly; we saw service users and staff engaged in conversations and activities. There was a noisy period during the morning when the television was on and there was music playing.

We observed and heard staff assisting people. This was done discreetly and efficiently.

Memorabilia was displayed in the home although this was not observed to reflect ethnic diversity and the provider may wish to consider addressing this.

We spoke with three people staying at the home and with visiting relatives for two people. One person told us that living at Ashgrove House was “like home from home”. Another person said “This is my home now”. One visitor described the service their relative received as “Excellent”. Another visitor said “On the whole they were happy with the service”.

People told us that they were involved in their care. Both visitors we spoke with, told us that they were kept informed about their relative’s health and wellbeing. Both said that any issues or concerns they had raised were responded to immediately.

The sample of care records we looked at showed that people’s needs were assessed and reviewed regularly.

We saw that people lived in a home that was well maintained, clean and comfortable.

The staff employed at the home were subject to thorough vetting before they started employment.