The Ashton Care Home

The Ashton Care Home is a residential care and nursing home providing accommodation to people who require personal and/or nursing care to up to 77 people. The service provides support to older people some of who lived with dementia. At the time of our inspection there were 41 people using the service.

The Ashton Care Home accommodates up to 77 people in one purpose built building. The home accommodates up to 77 people across 3 separate floors, each of which had adapted facilities. The top floor of the building was being used and managed by the University Hospitals of Leicester.

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

Improvements were required in certain areas of the home to comply with required standards of hygiene and promote infection prevention and control. There were minor areas of improvement required in the management of ‘as required’ medicines.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

The provider had effective systems in place for monitoring and improving the quality of care and support people received. Managers were accessible and supportive to staff, people and their relatives. There were robust systems in place for engaging people who used the service, staff and other stakeholders in service planning and delivery.

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 14 April 2022).

Why we inspected

The inspection was prompted in part due to concerns we received in relation to the management of medicines and management of people’s behaviour support needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 remains good based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Ashton Care Home on our website at www.cqc.org.uk.

Recommendations

We have made recommendations about the management of covert medicines and the management and compliance of DoLS authorisations.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Ashton Care Home is a residential and nursing care home providing accommodation to people who require personal and nursing care to up to 77 people. At the time of our inspection there were 29 people using the service.

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

People received safe care and treatment. Changes and improvements had been made to people’s care plans and risk assessments which reflected their needs and provided staff with guidance about how to safely support them.

People received medicines safely.

Staff were observed wearing personal protective equipment (PPE) in accordance with government guidance.

People were supported by caring staff who knew them.

People were supported to engage in activities that were meaningful to them. Staff were provided with information to enable them to safely meet people’s needs in accordance with best practice guidelines.

Significant improvements had been made to systems and processes used to manage the service. The registered manager had worked hard with the team to make improvements required at the service.

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.

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 2 February 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 30 December 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, caring, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Ashton Care Home on our website at www.cqc.org.uk.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

The Ashton Care Home is a purpose-built residential home providing personal and nursing care to 29 people aged 65 and over at the time of the inspection. The service can support up to 72 people.

The Ashton Care Home is currently using two out of the three floors of the service. People living at the service have their own bedroom with ensuite facilities. There are shared dining and lounge areas on each floor. There is also a hair salon and cinema rooms people are able to access.

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

The provider continued to fail to ensure the service was well-led. The management team had undergone further changes but there remained significant shortfalls in governance and oversight at the service. Levels of monitoring such as daily flash meetings, audits and compliance visits were taking place, but had failed to recognise changes needed to be made. Enough improvement had not been made to ensure people received safe care and treatment.

The provider continued to not ensure effective systems were in place to assess and monitor people’s needs. Staff did not always have enough information about people’s assessed care needs to guide them to safely care for people. The provider did not always ensure medicines were managed safely. The provider also failed to ensure all staff were effectively trained in all aspects of care delivery. This meant people continued to be exposed to unnecessary risk of harm.

The provider continued to fail to fulfil their legal responsibilities. We continued to find breaches of regulation at this inspection. We did not find enough lessons were learned to ensure breaches of regulation were met.

People were not always supported to have maximum choice and control of their lives and staff did not always have the guidance to support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People felt staff knew them well and provided care and support to them in a dignified way. We observed caring interactions between staff and people living at the service. People and their relatives spoke highly of the staff and the management team, and felt changes were being made at the service.

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 inadequate (published 10 June 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had still not been made and the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Ashton Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to medicine management, assessment of risks, staff training and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 overall rating for this service is ‘Requires improvement’. The service continues to be placed in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The Ashton Care Home is a purpose-built residential home providing personal and nursing care for up to 72 people. The service supports a range of needs including older and younger adults and people living with dementia across three separate floors. At the time of the inspection the service was supporting 41 people over two separate floors.

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

Staffing levels were not sufficient provide safe care to people. People with dementia were seen being left unsupervised by staff. Staff told us staffing numbers continued to be unsafe at the service. The providers tool used for determining safe staffing levels at the service was inaccurate. This meant people did not receive the care they needed to keep them safe from harm.

Medicines were not managed safely. People did not always receive their medicines as prescribed and medicines had not been ordered prior to running out. Staff continued to make medication errors. The provider had not identified an issue with the service’s electronic medication system. This meant four people did not receive their medicines over a four-day period which meant they were put at risk of harm.

People were at risk of harm due to poorly managed health conditions such as diabetes. A person was at increased risk of developing chronic complications as there was no indication of diabetes for staff on the care plan; a diabetic specific care plan was not completed despite health advice. This increased the risk of chronic complications developing which can lead to serious damage.

The service was not well-led. The management team had undergone changes but still did not have oversight or awareness of concerns, risks and incidents that had taken place. Quality assurances and processes were not always robust or effective at identifying areas of concern, and improvements to the service were not always made.

The provider failed to ensure adequate leadership or oversight. The provider failed to create an open culture, so staff did not feel safe to speak out and report issues or concerns.

The provider failed to operate effective systems to assess, monitor and improve the service. They failed to review audits affecting the safety and quality of the service. Because of this, people were placed at an avoidable risk of harm.

The provider had not fulfilled their legal responsibilities. Breaches of regulations were found at our inspections of December 2020 and our inspection in August 2020. This demonstrated the lack of lessons learned and limited action had been taken to improve the service as further breaches of regulations were found at this inspection.

At the time of inspection, one person was being isolated due to testing positive for COVID-19. Infection prevention and control practices had improved at the service, and staff were using Personal Protective Equipment (PPE) in accordance with national government guidance. The provider ensured staff and people living in the service were tested regularly for COVID-19, in line with government guidelines.

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 inadequate (published 1 March 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Ashton Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to staffing, safe care and treatment and good governance at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss the next steps. We will work with the local authority. If we receive any concerning information we may inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.

The Ashton Care Home is a purpose built residential home providing personal and nursing care for up to 72 people. The service supports a range of needs including older and younger adults and people living with dementia across three separate floors. At the time of the inspection the service was supporting 51 people.

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

There was unsafe assessment, monitoring and management of risk for people with support needs regarding behaviours that may challenge. Staff practice, and reporting systems to safeguard people from abuse, were not always effective to ensure people were safe from harm. Lessons were not always learnt, and actions not taken to investigate safety incidents and prevent them re-occurring. Staff did not always have the required competencies or knowledge to meet people's individual needs safely.

There were insufficient numbers of suitably qualified, competent, skilled and experienced staff to meet people's needs and keep them safe.

Medicines were not always managed safely. People had not always received their medicines as intended when they needed them.

Service management and the provider's wider quality assurance and governance systems had not ensured actions were taken to address any issues and risks in a timely manner. People's care records were not always up to date or accurate.

The provider had failed to act upon known areas of concern, non-compliance and risk to improve the quality of care for people at The Ashton Care Home. This had exposed people to on-going poor care and risk of avoidable harm.

The provider had acted to manage infections during the Covid-19 pandemic. Additional infection prevention and control measures in line with Department of Health and Social care guidelines had been put in place to ensure people's safety. Staff wore personal preventative equipment (PPE) when supporting people. The provider had ensured there were adequate stocks and supplies of PPE available.

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 Inadequate (published 7 November 2020). The service has been rated inadequate for two consecutive inspections. At the last inspection we found multiple breaches of regulations. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection in response to concerns we had received and to confirm the provider now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed. 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 The Ashton Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 regulations 12, 13, 17, 18 in relation to: safe care and treatment, safeguarding people from abuse and improper treatment, good governance and staffing.

We have also identified a breach of Care Quality Commission (Registration) Regulations 2009 in relation to failing to notify CQC of incidents regarding abuse or allegations of abuse in relation to service users.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service until we return to visit. If we receive any concerning information we may inspect sooner.

The overall rating for this service is 'Inadequate' and the service remains in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will act in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The Ashton Care Home is a purpose built residential home providing personal and nursing care for up to 72 people. The service supports a range of needs including older and younger adults and people living with dementia across three separate floors. At the time of the inspection the service was supporting 56 people.

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

People did not always receive a service that ensured their safety.

Risks to people's health and wellbeing had not been effectively assessed, monitored or mitigated. Risk assessments did not provide sufficient information and guidance to enable staff to respond consistently when supporting people. Systems and process to manage control and prevent infections, including COVID-19, were not consistently followed by staff. This exposed people to significant risk of harm.

People were not consistently protected from the risk of poor nutrition and dehydration. Staff recording was not always accurate and therefore an accurate picture of support could not always be determined.

People were not protected from abuse or improper treatment. We observed occasions when people were left unsupervised and unsupported for lengthy periods of time. We also observed staff using improper and unsafe methods when providing care and support.

Analysis of incidents and accidents were not always effective. Timely action was not consistently taken to identify root cause and immediate measures that could reduce the risk of further incidents of harm for people.

The service was not well managed. Systems and processes to assess and monitor the service were not effective or completed accurately. Audits, although completed, were not effective in accurately capturing information or driving improvements. There had been a lack of effective oversight of the service by the provider. The lack of robust, effective quality assurance meant people were at risk of receiving poor quality care.

Following our inspection, the provider took immediate action to make significant improvements in the service and had put in place an interim management team to make this happen. Following the inspection, we were provided with evidence that demonstrated improvements were taking place.

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 17 April 2020).

Why we inspected

We received concerns in relation to the management of people's care needs, how people were protected from the risk of infection, harm and abuse and a lack of leadership at The Ashton Care Home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvements. The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Ashton Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding people from abuse or harm and governance systems. We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Special Measures

The overall rating for this service is 'Inadequate' and the service is in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating. In addition, 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 with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Ashton Care Home is a residential and nursing home providing personal and nursing care to 53 people aged 65 and over at the time of our inspection. The service can support up to 72 people. Accommodation is provided on three floors. Residential care on the ground floor, dementia care on the first floor and nursing care on the second floor.

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

Shortfalls in quality monitoring had not led to an adverse impact on people.

Enough staff were deployed to meet people’s needs in a timely way. Minor concerns over staffing levels on the ground floor had been acted on.

Care and support were delivered in a person-centred way, and planned with the person or their relative, but records did not always reflect this.

People received their medicines when they needed them but not all were stored securely. The environment was well maintained and free from infection and most equipment was appropriately checked.

People were safe and protected from abuse and avoidable harm by staff who had been recruited safely.

People were supported by kind and compassionate staff who usually knew them well. They had time to spend with people and involved them in making decisions about their care and support.

People were provided with a comfortable place to live and there were appropriate spaces to enable them to either spend time with others, or on their own.

People had their needs assessed and staff had the training and support they required to carry out their roles. People had access to the healthcare services they required. Staff worked closely with healthcare professionals and followed their advice and guidance.

People’s nutritional needs were met, and they enjoyed their meals, and were given a choice of what that they liked.

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.

Complaints were taken seriously and used as an opportunity to learn and improve. People and staff were supported by their managers and were engaged and involved in service development.

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 25 January 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Ashton Care Home 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.

The Ashton Care Home is located in the town of Hinckley, Leicestershire. It provides accommodation for up to 72 people who require nursing or personal care. Accommodation is provided on three floors. Residential care on the ground floor, dementia care on the first floor and nursing care on the second floor. On the day of our inspection there were 64 people using the service.

We inspected The Ashton Care Home on 11 and 12 December 2018. The first day of our visit was unannounced. This meant the staff and the provider did not know we would be visiting.

At the last inspection in September 2016, the service was rated Good. At this inspection we found the service Required Improvement.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

Appropriate numbers of staff had not always been suitably deployed to meet people’s needs in a caring, safe or timely manner.

Systems in place to monitor the quality and safety of the service being provided were not always effective.

Care records kept to demonstrate people were being supported in line with their plan of care were not always accurate, up to date or completed.

The providers infection control policy had not always been followed. Protective personal equipment, such as disposable gloves and aprons were readily available, though not always used.

People’s needs had been considered prior to them moving into the service and the risks associated with their care and support had been assessed and managed.

There were arrangements in place to make sure action was taken and lessons learned when things went wrong, to improve safety across the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Appropriate checks had been carried out when new staff members joined the service and relevant training had been provided. Not all of the staff team had received training on how to support people at the end of their life. We have made a recommendation about this.

The staff team supported people to make decisions about their day to day care and support. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people's human rights were protected. Where people lacked the capacity to make their own decisions, these had been made for them in their best interest and in consultation with others.

People's food and drink requirements had been assessed and a balanced diet was being provided. People received on-going healthcare support and had access to the relevant healthcare services.

People told us the staff team were kind and caring and treated them with respect.

The staff team felt supported by the registered manager and the senior team and told us there was always someone available to talk with should they need guidance or support.

People were supported with their medicines in a safe way. Systems were in place to regularly audit the medicines held and the appropriate records were being kept.

People were provided with a clean and comfortable place to live and there were appropriate spaces to enable them to either spend time with others, or on their own.

Relatives and friends were encouraged to visit. People were provided with the opportunity to have a say and to be involved in how the service was run. Regular meetings had been held and surveys used to gain people’s feedback.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.

Further information is in the detailed findings below.

The Ashton Care Home provides accommodation for up to 72 people who require nursing or personal care. Accommodation is provided on three floors. Residential care on the ground floor, dementia care on the first floor and nursing care on the second floor. There were 61 people using the service at the time of our inspection.

The service had 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe living at The Ashton Care Home. Relatives we spoke with agreed. The staff team were aware of their responsibilities for keeping people safe from avoidable harm and knew to report any concerns to the management team.

People’s needs had been considered prior to them moving into the service and the risks associated with their care and support had been assessed and managed.

Plans of care had been developed for each person using the service and the staff team knew the needs of the people they were supporting.

People had received their medicines as prescribed. Systems were in place to regularly audit the medicines held at the service and the appropriate records were being kept.

Checks had been carried out when new members of staff had started working at the service. This was to make sure that they were suitable and safe to work there.

The staff team had received an induction into the service and training on a variety of topics had been provided to enable them to meet people's needs.

The majority of people we spoke with felt that there were enough staff on duty to meet people’s needs; some however thought there were not. The registered manager told us that they would monitor the staffing levels so that appropriate numbers of staff were deployed on each shift.

People told us the meals served at The Ashton Care Home were good. People’s nutritional and dietary requirements had been assessed and a nutritionally balanced diet was being provided.

For people who had been assessed to be at risk of not getting the food and fluids they needed to keep them well, records were kept showing their food and fluid intake.

People were supported to maintain good health, have access to healthcare services and receive on going healthcare support.

People told us that the staff team were kind and caring and they treated them with respect. The relatives we spoke with agreed. Throughout our visit we observed the staff team treating people in a kind and friendly manner.

The staff team supported people to make decisions about their day to day care and support. Where people lacked the capacity to make their own decisions, we saw that decisions had been made for them in their best interest.

There was a formal complaints process which was displayed for people’s information and people we spoke with knew what to do and who to speak with, if they had a concern of any kind.

Relatives and friends were encouraged to visit and were made welcome by the staff team.

Meetings were held and surveys were used to gather people’s views on the service provided.

There were systems in place to regularly check and monitor the quality and safety of the service being provided.