Background to this inspection
Updated
17 January 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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was completed by 2 inspectors and an assistant inspector.
Service and service type
Ashley Grange Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ashley Grange Nursing Home is a care home with 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 time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we reviewed the information we held about the service and the service provider. 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 looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law. We used all of this information to plan our inspection.
During the inspection
We spoke with 6 people and 6 relatives to gather their views about the care they received.
We looked at 5 people’s care records. We checked recruitment, training and supervision records for staff and looked at a range of records about how the service was managed. We also spoke with the registered manager, operations manager, peripatetic manager and 10 nursing, care and ancillary staff. We received feedback from 2 professionals who have contact with the service.
Updated
17 January 2023
About the service
Ashley Grange Nursing Home is a residential care home providing personal and nursing care for up to 55 people. The service provides support to people living with dementia. People are accommodated in one building, over two floors. At the time of our inspection there were 28 people using the service.
People’s experience of using this service and what we found
The provider had developed detailed action plans to address the shortfalls identified at the last inspection. The plans included information about who was responsible for completing actions and had been regularly reviewed to ensure they were on track. Progress to complete actions was overseen by the registered manager and operations manager. The provider had taken the immediate action needed to meet the requirements of the warning notice we served following the last inspection. Further action is needed to ensure these improvements are sustained over time and people receive a consistently good service.
People felt safe at Ashley Grange. The provider had systems to manage risks people faced and help keep them safe.
The home was clean and the provider was undertaking renovation and redecoration. Further work was needed to ensure environmental safety checks were completed consistently and all fire fighting equipment was regularly serviced.
There were enough staff available. Staff had a good understanding of people’s needs and how to meet them. New staff were thoroughly checked before starting work in the home and given a good induction.
People were supported to take any medicines they had been prescribed.
Infection prevention and control procedures had been reviewed and updated to reflect the COVID-19 pandemic and changed as government guidance had changed. Systems were in place to prevent visitors catching and spreading infections.
Staff demonstrated a good understanding of people’s individual needs and a commitment to provide the care people needed.
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.
There were effective management systems in place to monitor how the service was operating and plan the improvements that were needed. Relatives and staff told us the management team had consulted with them and made improvements since the last inspection.
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 December 2022). This service has been in Special Measures since 28 October 2022. 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 the warning notice we served on the provider following the last 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.
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 has changed from inadequate to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashley Grange Nursing Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.