Ashgrove Residential Care Home

Ashgrove Residential Home is a residential care home registered to provide accommodation and personal care to 26 older people. The service is a two-floor building. Each floor has separate adapted facilities. At the time of our inspection, the service provided personal care to 20 people.

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

At our previous comprehensive inspection of this service on 12 October 2021, we found robust quality assurance systems were not in place to identify shortfalls we found with risk assessments, infection control, need for consent, staff training and support and good governance. We completed a targeted inspection on 27 July 2022 to check on good governance and found improvements had been made. At this inspection, we found a number of improvements had been made.

Risk assessments for people were robust and detailed to ensure people received safe care. Risks such as those related to people’s health conditions and mobility were monitored and managed so staff could support them safely. Medicines were managed safely. Safeguarding processes were in place to protect people from the risk of abuse. Staff were recruited appropriately and checked they were of suitable character to support people. There were enough staff working in the home. Systems were in place to prevent and control infections.

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 were supported to achieve positive outcomes. People were given choices during meal times and were supported by staff when needed.

Staff were kind and caring towards people and had a good relationship with them. People’s dignity, privacy and human rights were respected at all times. Their equality characteristics were understood and respected.

People received care and support that was personalised for their needs. Systems were in place to manage and respond to complaints. People’s communication needs were met. People took part in activities and were supported to see their family and friends.

The management team had implemented robust governance systems and carried out quality audits to ensure the home was compliant with health and social care regulations and to identify areas for improvement. Feedback was sought from people and relatives to help make continuous improvements to the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The previous rating for this service was Requires Improvement (published 25 November 2021) and there were multiple breaches of regulation. We issued requirement notices for breaches of Regulation 17 (Good Governance), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment) and Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

Why we inspected

We undertook this comprehensive inspection to check if there were improvements regarding the concerns we identified at the last comprehensive inspection. The overall rating for the service has changed from Requires Improvement to Good. 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.

Follow up

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

Ashgrove Residential Home is a residential care home registered to provide accommodation and personal care to 18 older people. The service is a two-floor building. Each floor has separate adapted facilities.

At the time of our inspection, the service provided personal care to 17 people.

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

At our previous inspection of this service on 12 October 2021, we found robust quality assurance systems were not in place to identify shortfalls we found with risk assessments, infection control, need for consent and staff training and support. At this inspection we found improvements had been made and quality assurance systems were in place to identify shortfalls and take prompt actions to ensure people were safe.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The previous rating for this service was requires improvement (published 25 November 2021) and there were multiple breaches of regulation. We issued requirement notices for breaches of. Regulation 17 (Good Governance), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment) and Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

Why we inspected

We undertook this targeted inspection to check if there were improvements regarding the concerns we identified at the last inspection about governance of the service. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

We use targeted inspections to follow up on warning notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

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

Ashgrove Residential Home is a residential care home providing accommodation and personal care to 18 people, at the time of the inspection. The service is a two-floor building. Each floor has separate adapted facilities.

People’s experience of using this service:

Risk assessments were not completed for people with certain health conditions to ensure they were safe at all times. Robust systems were not in place to prevent and minimise the spread of infections.

Staff had not completed essential training to perform their roles effectively. People were not supported to have maximum choice and control of their lives and were not being supported in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Robust oral healthcare plans were not in place. We made a recommendation in this area.

Quality assurance systems were not robust to identify the shortfalls we found during the inspection. There were no systems in place for quality monitoring to ensure feedback was sought from people about the home.

People received person centred care. Care plans had been reviewed regularly to ensure they were accurate. People participated in group activities. However, people’s preferences with activities were not being recorded. Systems were not in place for one to one interaction between people and staff to ensure continued stimulation and social well-being. Some people’s dignity was not being preserved as commodes in some people’s rooms were not being stored away appropriately.

Medicines were being managed safely. Pre-employment checks had been carried out to ensure staff were suitable to support people. People told us they felt safe at the home and staff were aware of how to safeguard people from abuse. There were appropriate numbers of staff to support people when required.

People had choices during mealtimes and had access to healthcare services. Systems were in place to manage complaints and peoples communications needs were being met.

People received care from staff who were caring and had a good relationship with them. People were encouraged to be independent and to carry out tasks without support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 11 November 2020 and this was the first inspection under the provider’s new registration.

The service was rated Require Improvement under the provider’s previous registration (published 12 April 2019) and there were breaches of regulation. We served a Warning Notice to the provider. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We carried out a focused inspection (published 5 November 2019) and found improvements had been made and the previous provider was compliant with the warning notice. However, we did not change their rating.

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, infection control systems and leadership in the service. A decision was made for us to inspect and examine those risks.

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 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 risk assessments, infection control, need for consent, training, staff support and good governance. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.