Ashtonleigh

Updated 6 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

The first day of inspection took place on the 7 January 2019 and was unannounced. Two inspectors and one expert by experience were present. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. A second inspection day took place on the 10 January 2019 and was undertaken by two inspectors.

Before the inspection, we checked the information held regarding the service and provider. This included previous inspection reports and any statutory notifications sent to us by the registered manager. A notification is information about important events which the service is required to send to us by law. We also reviewed the Provider Information report. This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make.

During the inspection, we spoke with 15 people and five relatives about the care received at Ashtonleigh. We spoke with 16 staff, including the provider, director, two registered managers, deputy manager, care staff, chef and kitchen assistant. We also spoke with a visiting health professional. We spent time reviewing records, which included 14 care plans, three staff files, five medication administration records, staff rotas and training records. Other documentation that related to the management of the service such as policies and procedures, complaints, compliments, accidents and incidents were viewed. We also 'pathway tracked' the care for 11 people living at the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care.

Updated 6 February 2019

Ashtonleigh 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.

Ashtonleigh provides accommodation and personal care for up to 54 older people with varied care needs. Some people were living with dementia, whilst others required support with physical illness or disability. There were 49 people using the service at the time of inspection. There were single and double occupancy rooms available. Some people had bathrooms attached to their bedrooms and there were communal facilities for those that did not. There were numerous communal areas for people to relax in, including a large, well maintained garden.

At our last inspection in October 2017, the service was rated 'Requires Improvement' with one breach to the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. During this inspection, we found significant improvements had been made and the provider is now meeting the regulations.

The service had two registered managers. 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 and that staff knew them and any risks to their wellbeing. There were risk assessments for people and for the building, with relevant safety checks completed by the management team each month. Staff were recruited safely and there were suitable numbers so people’s needs were consistently met. Staff had a good understanding of how to recognise potential signs of abuse and what actions to take with any concerns. Medicines were given in a safe, consistent way, by staff who were competent to do so. Any accidents or incidents were analysed and actions taken immediately to prevent their reoccurrence.

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 practise.

Staff had the skills and knowledge to support people and meet all their needs. They spoke highly of the training offered. Their induction was in depth and gave them opportunities to get to know people, their routines and preferences. Further support was provided in supervisions, appraisals and team meetings.

People’s nutritional needs were met and they were positive about the quality and choice available of food. People had continuous input from a variety of health and social care professionals to improve their wellbeing. People’s health conditions were managed well and staff valued and followed feedback or guidance given by professionals.

Feedback from people, their relatives and a professional was consistent, in that staff were kind, caring and attentive to people’s needs. People's dignity, independence and privacy was promoted and encouraged. Staff knew people, their preferences and support needs well and celebrated special events with them. They took an interest in people’s wishes and did everything possible to make these happen.

Care plans were tailored to individual's and detailed support needs, preferences, people’s life stories and routines. Staff were knowledgeable of people’s communication support needs and used a variety of tools to support them with this. People told us they always felt listened to. There was a clear complaints process and any concerns received had been responded to promptly and professionally. People had choice and control over the activities they wanted to participate in each day. These were tailor-made to people's likes and dislikes and used to support them to reminisce about their past.

People, their relatives, staff and a professional were complimentary of the management team. They felt that the service was well-led and that an open, transparent and supportive culture was promoted. Quality assurance processes were robust and ensured documentation was up to date and reflective of people. Regular audits carried out by the provider, director, registered managers and deputy managers meant that there was continuous oversight of the service. Management and staff were proud of the home and keen to continuously improve and grow together.

Further information is in the detailed findings below.