Ashton Court Residential Home

Cleaning and hygiene procedures were in place. However, some items of equipment were found to require additional cleaning, and some surface paintwork was damaged and required redecoration. This was raised with the registered manager who told us they would take the necessary action. The inspector also provided guidance on how to zone different areas within care homes, as a way of reducing the potential for the spread of health infections.

We found the following examples of good practice.

¿ Access to the building was controlled, with arrangements in place to reduce the risk of visitors contracting or spreading infections. The care home was not allowing routine visitors on the date of the inspection; but essential health professional visits, and visits from relatives of people who were receiving end of life care, were safely facilitated.

¿ The provider had an ample supply of PPE, and this was reviewed regularly to maintain the required stocks for the home.

¿ The staff used a range of methods to help people maintain contact with family. This was through, mobile phones, skype or zoom meetings, emails and text messaging.

¿ Testing was completed in the home weekly for staff and monthly for people using the service. Daily temperatures, and observations, were also taken to identify any early signs of someone becoming unwell.

¿ The registered manager, and staff team, had followed current Government guidance on infection prevention and control (IPC) and PPE. However, the provider’s IPC policy and procedure documents were not up to date. This was raised with the registered manager who told us they would update their IPC policies and ensure they were regularly reviewed.

Further information is in the detailed findings below.

At our last inspection in April 2015, the service was rated ‘Good’ overall with some improvements required with effective relating to people’s hydration and nutritional needs. At this inspection we found that the service remained ‘Good’ and the required improvements for effective had been made.

People continued to receive a safe service. Staff were aware of their role and responsibility in protecting people from avoidable harm. They had attended appropriate safeguarding training and had policies and procedures available to them. Some issues were identified with the environment and risks associated to people’s needs had not all been risk assessed. The registered manager took immediate action during our inspection to address these issues.

People were supported by appropriate staffing levels to meet their dependency needs. The staffing levels were regularly reviewed and were flexible to respond to people’s changing needs. The provider had safe staff recruitment procedures and these were followed. The storage and management of medicines were found to be safe.

People received an effective service. Improvements had been made to how people’s hydration and nutritional needs were assessed and planned for. Staff had the required information to meet these needs.

Staff received an appropriate induction, ongoing training, support and opportunities to review their work. Staff understood the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards that protected people’s human rights. People were supported to maintain good health and staff worked well with external healthcare professionals.

People continued to receive good care. People were treated with kindness, dignity and respect by the staff. People’s care records included detailed and personalised information which enabled staff to support people in line with their personal preferences. People had access to independent advocacy information should they have required this support.

People continued to receive a responsive service. Assessments were completed and support plans developed. This information supported staff to provide a responsive service based on people’s needs, routines and interests. People had access to the provider’s complaint policy and procedure. Where concerns had been raised they had been responded to appropriately.

The service continued to be well-led. The provider had arrangements in place for monitoring and assessing the quality and safety of the service. These included seeking and acting upon the views for people who used the service and others.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Medicines were not always handled or stored appropriately. This demonstrated that the procedures they used were not always safe and did not follow best practice.

Because some of the people who lived at the home have limited communications, we were unable to ask them about their experiences.

We spoke with two people who use the service about the support with medicines that people received from the staff. One person said “Don’t ask me what it’s for? They ask me every day, they ask me do I want a painkiller. They are very good like that". The other person said “I’m very happy living here and looked after”. Another person’s relative said “Generally speaking they have been very good and very helpful”.

We spoke with six people using the service and the relative of another person, who could not communicate with us. Five people we spoke with were very happy with the care they received at Ashton Court. They told us they felt that staff understood their needs and met them appropriately. People’s comments included, “I’m very happy here. It couldn’t be better for me” and “I have no complaints at all. It’s a good place to be.”

We observed staff having respectful and friendly interactions with the people in the communal areas. The people in these areas appeared relaxed and comfortable with the staff. Staff were chatting to people who were able to communicate and they provided respectful care to people with communication difficulties.

We looked at the records being maintained by staff in relation to three people. We saw they were recording their food and fluid charts appropriately. We did not have concerns about the quality of recording during this visit.