Ashgrange House

Updated 27 May 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

The inspection was carried out by one inspector.

Service and service type

Ashgrange House 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 did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 with five people who used the service and used various communication methods and observations to understand their experience of the care they received. We spoke to five members of staff including the manager, acting deputy manager and support staff. We reviewed a range of records. This included two people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service including audits and action plans.

After the inspection

In order to minimise time spent at the service, we requested some policies and procedures, staffing rota and training matrix after the inspection. We continued to seek clarification from the provider to validate evidence found. We spoke with two relatives and six members of staff.

Updated 27 May 2021

About the service

Ashgrange House is a residential care home providing accommodation and support to up to eight people. At the time of our inspection six people were living at the home. People had a range of support needs, some people lived with a learning disability and may also have mental health needs.

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

People had recently experienced a difficult period through the COVID-19 pandemic. There had been recent changes in management and the staff team. Staff and relatives told us that previously there had been concerns around the culture of the home. This was being addressed under the new management and staff team.

Staff were wearing personal protective equipment correctly and infection control procedures were being followed. Relatives had been informed of the visiting procedures during the COVID-19 pandemic. There were correct visiting procedures in place should relatives wish to visit.

Relatives told us communication with the home over the last year had been poor. Improvements were being made by the manager, but more consistency was needed to keep relatives up to date with information. Quality assurance systems had been recently implemented and action plans were being worked on by staff, however more time was needed to embed this into practice to ensure that areas to address were consistently identified.

Risks to people were assessed and managed by staff. Staff understood how to support each person individually and understood the risks associated with each person. Staff were recruited safely and received appropriate training. The home was clean and tidy and cleaning schedules had recently been implemented and completed by staff.

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.

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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• People living at the home had been supported to personalise their bedrooms and communal areas with items from home. People were supported to move freely around the home and choices about how to spend their day were respected by staff. The home did not have anything that identified it as a care home and had many homely touches such as ornaments and photographs of people around the home.

Right care:

• We saw that people were treated as individuals and that staff knew people well. External activities had recently been re-instated at the home and were based on people’s individual choices and interests. One person told us they were, “very happy,” and told us “They (staff) do very good”. We saw that staff spoke to people kindly and with affection.

Right culture:

• Poor practice had recently been identified and addressed by the provider. Changes brought in by management and staff had improved the experience of living at the home for people. Staff and relatives both spoke of the improvements that had been made recently. Staff focused on the needs and wishes of people living at the home. We observed that people and their choices were at the centre of the care they received from staff.

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 23 October 2019).

Why we inspected

We received concerns in relation to people not being supported to lead active lives with meaningful activities and the practices and attitude of staff towards people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 remained the same. 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 Ashgrange House on our website at www.cqc.org.uk.

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.