Ashley House - Langport

Updated 7 April 2023

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 Health and Social Care Act 2008.

Inspection team

An inspector undertook the inspection. They were supported by An Expert by Experience who spoke to relatives by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Ashley House - Langport is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Ashley House - Langport is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the beginning of our inspection there was not a registered manager. A new manager was in post and had submitted an application to register. During the inspection the manager's application was assessed and they had been registered.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We observed how staff provided support for people, to help us better understand their experiences of the care they receive. We spoke with 4 people who lived at the home and 8 members of staff including the registered manager, operations manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 1 relative about their experience of the care provided, and a visiting professional.

We reviewed a range of records relating to people’s individual care and records relating to the running of the home. This included 5 people’s care records and a variety of records relating to the management of the service, including policies and procedures. We checked 5 people’s medicines records and looked at arrangements for administering, storing and managing medicines.

An Expert by Experience spoke with 6 relatives by telephone about their experience of the care provided.

The registered manager, operations manager and nominated individual sent us additional documentation following the inspection including training documents, audit checks and recruitment documents. We reviewed these documents, and sought clarification from the registered manager to validate information.

Updated 7 April 2023

About the service

Ashley House- Langport is a residential care home providing personal care to up to 25 people. The service provides support to people aged 65 and over. At the time of our inspection there were 19 people using the service.

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

Since the last inspection there had been changes in the management team and the service had a new registered manager, operations manager and nominated individual. New systems and processes had been introduced to monitor the service; however the new processes were still not fully effective in identifying and addressing shortfalls in a timely way. These new systems also required embedding into practice and sustained to continue to drive improvements.

Some individual risks to people were not always thoroughly assessed and mitigated, and records relating to people's care were not always complete. Although staff in general knew how to support people safely, they did not always have appropriate training and detailed guidance to ensure people received safe care at all times. The registered manager was responsive to our feedback and took action to address the issues identified.

People were supported by a sufficient number of staff who were recruited safely. Staff told us the atmosphere and communication in the home had improved. Staff felt supported by the registered manager and told us they were approachable and felt 'things had improved' at Ashley House.

Throughout the inspection we observed staff interacting with people in a caring and considerate way. People we spoke with were complimentary about the care and support they received. Relatives spoke positively about the current management of the home and changes that are being made.

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 told us they felt safe. Staff spoken with understood how to protect people from poor care and abuse. Action to rectify the concerns identified at the last inspection in relation to the safety of the environment were being addressed.

Medicines were stored and administered safely, and protocols were in place for the administration of 'as required' medicines.

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 5 October 2022) with breaches of regulations identified. At this inspection we found the provider remained in breach of regulations and the service remains rated requires improvement. We took into consideration the limited length of time and changes in management team since the last inspection and the provider's response.

Why we inspected

We carried out an unannounced focused inspection of this service on 11 and 12 August 2022 which was prompted in part by a specific incident. This incident is still subject to an ongoing police investigation and further investigation by CQC as to whether any regulatory action should be taken.

The inspection on 11 and 12 August 2022 identified breaches of legal requirements. The provider completed an action plan after the last inspection to show what they would do and by when to improve consent, safety, staffing and governance.

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, Effective and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remained requires improvement. This is based on the findings 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.

Enforcement

We have identified continued breaches in relation to staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and llocal authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect