Ashton Cross

Updated 25 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection that was unannounced on 14 March 2018 and announced on 23 March 2018. The inspection was undertaken by one adult social care inspector on the first day and two adult social care inspectors on the second day.

We checked the information that we held about the service and the service provider. This included statutory notifications sent to us by the registered manager about incidents and events that occurred at the service. A notification is information about important events which the service is required to send us by law.

During the inspection we spoke with two people supported by the service to live in their own homes and two people in each of the residential homes. We also spoke to two relatives of people supported by the service. We spoke to 5 support workers, the deputy manager and a healthcare professional.

We also spent time looking at records, including two care plans for people supported by the service to live in their own homes, two care plans for people living in the residential homes, seven staff recruitment and training records, medication administration records (MARs), complaints and other records relating to the management of the service. We spent time observing staff interactions with people living in each of the residential homes.

We contacted the local authority safeguarding teams who told us they did not have any immediate concerns about the service.

Updated 25 May 2018

The inspection took place on 14 and 23 March 2018. The first day was unannounced and the second day was announced.

Ashton Cross 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.

Ashton Cross consists of two residential care homes. The Beeches supports up to nine people and the Woodland supports up to six people. On the day of our inspection eight people were living in the Beeches and four people were living in the Woodland. Ashton Cross also supports people living in their own home within the community through their domiciliary care service. There were eight people receiving support at the time of our inspection.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was absent from the service at the time of our inspection.

At the last inspection in November 2016 we found that some improvements were needed in relation to safe care and treatment. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the last inspection, we asked the registered provider to complete an action plan to show what they would do and by when to improve the key questions of Safe and Well-led to at least Good. The registered provider sent us an action plan that specified how they would meet the requirements of the identified breach. During this inspection we found all required improvements had been made.

This inspection was carried out to check that improvements had been made to meet the legal requirements planned by the registered provider after our comprehensive inspection in November 2016. The team of two inspectors inspected the service against all of the five questions we ask about services: Is the service Safe, Effective, Caring, Responsive and Well-led?

Improvements had been made in relation to people's safety. Window restrictors were now fitted to all required windows to ensure people were not at risk of falling.

Recruitment procedures were safe and robust and sufficient numbers of staff were employed to meet people's individual assessed needs. All staff had completed an induction process and undertaken shadow shifts with experienced members of staff. Mandatory training had been undertaken however, some training required updates.

Staff received regular supervision and support through mentor meetings and also attended team meetings.

The registered provider had comprehensive audit systems in place that had identified areas for development and improvement. The information fed in to quarterly governance meetings.

There were clear safeguarding policies and procedures in place. Staff were knowledgeable and able to describe the process they would follow to raise any concerns. Staff also knew how to raise an alert with the local authority safeguarding team directly.

People's needs had been assessed and this information was used to create comprehensive person centred care plans and risk assessments that were regularly reviewed. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process.

People had access to a variety of activities of their choice. The management team had developed relationships with local community organisations.

People received their medicines in accordance with best practice guidelines. Medicines were ordered, stored, administered and disposed of safely. Staff that administered medicines had all received up to date training and had their competency assessed.

The service operated in accordance with the Mental Capacity Act 2005 (MCA). Records showed that consent was always sought in relation to care and treatment.

The registered provider had a complaints policy and procedure in place. People knew how to raise a concern or complaint.

The residential homes were attractively decorated, well maintained, clean and all equipment was regularly serviced. All required health and safety checks had been undertaken and clear documentation was in place. All Fire safety equipment checks were in place.

The registered provider had a comprehensive range of up to date policies and procedures in place to offer clear guidance to staff as required.