Askham Place is registered to provide accommodation and care, with nursing, for up to 16 adults. It is part of the Askham Village Community, which comprises of four care homes, each catering for a different client group, built around a central courtyard garden. Askham Place is on one floor, with a large lounge/dining area, which has a kitchenette, and all bedrooms are single rooms with an en suite bathroom. There is a shared café opening onto the courtyard, which is open to the general public.
The inspection took place over two days and was unannounced. There were 15 people in residence. The last full inspection of Askham Place was on 16 October 2013. During this inspection we found that improvements were needed relating to the management of medicines. The provider sent us an action plan detailing the improvements they were going to make. In December 2013 we carried out a review of the evidence sent to us by the provider and found that the required improvements had been made.
There was a registered manager in place. 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. The registered manager is also registered to manage Askham Court, one of the other three care homes on the site.
People were safe living at Askham Place and staff had undergone training to recognise and report abuse. Any potential risks to people were managed so that people were protected from harm.
There were enough staff on duty to keep people safe and pre-employment checks had been carried out to ensure that only staff suitable to work at the home were employed. People were given their medicines safely. Staff were trained and knowledgeable in how to prevent infection but this had not resolved the unpleasant odour we found in the home.
The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had been assessed by staff trained to do so. However, staff’s knowledge was not sufficient to ensure that people’s rights were protected if they did not have capacity to make decisions for themselves.
People were given sufficient amounts of nutritious and appetizing food and special diets were catered for. People’s health was monitored and maintained by staff with the involvement of a range of healthcare professionals.
Relationships between people who lived at Askham Place and the staff were very good and staff showed they cared about the people they were looking after. Staff treated people well and respected their privacy and dignity. People were encouraged to remain as independent as possible.
People and their relatives were not always involved in the planning and reviewing of their care. Care plans did not contain sufficient, up to date information to give staff guidance on how to offer people consistent and personalised care and support. There were not enough activities, outings and entertainment offered to people to keep them occupied.
There was an open culture in the home and people, their relatives and other visitors were encouraged in a number of ways to put forward their views about the service and make suggestions for improvements. Audits carried out were not always effective in driving improvements in the quality of the service provided.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We have made a recommendation about upholding the rights of people who lack the mental capacity to make all their own decisions.