Archived: Ashfield House - Leominister

Updated 1 June 2022

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 carried out by one inspector and a specialist advisor in nursing.

Service and service type

Ashfield House 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. Ashfield House 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We also requested feedback from Healthwatch to obtain their views of the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 used all this information to plan our inspection.

During the inspection

Due to the COVID-19 outbreak restrictions we observed as much as we could staff interactions with people. We spoke with the registered manager and deputy manager. We spoke by telephone with relatives of six people who used the service about their experience of the care provided. We also spoke with five members of staff including senior care staff, care staff and a domestic member of staff. Additionally, we contacted a Nurse Practitioner who regularly visits the service.

We reviewed a range of records. These included three people’s care records, multiple medication records, five staff recruitment files and a variety of records in relation to the management of the service were reviewed.

Updated 1 June 2022

About the service

Ashfield House is a care home providing personal and nursing care to up to 25 people. The service is registered to support older people, people living with dementia, physical disabilities and sensory impairments. At the time of our inspection there were 21 people using the service.

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

Since our last inspection improvements had been made in how safeguarding concerns were reported to the appropriate authorities. Staff understood safeguarding and described how they would identify and report any concerns of possible abuse. Incidents and accidents were recorded and reviewed, and any measures put in place to prevent these from happening again.

On the day of our inspection the home was experiencing their first COVID-19 outbreak. This was being managed safely. Staff were wearing PPE appropriately for the task being carried out. Infection, control and prevention procedures had improved and helped to protect people from the risk of infection.

People’s medicines were managed and administered safely, and regular audits were completed.

People’s needs and choices had been assessed. Care provided was personalised and considered people’s preferences and wishes.

There was enough staff to meet people’s needs. Staff knew what was expected of them. Staff received appropriate training and support to enable them to perform their role safely and effectively.

People were supported to eat and drink enough to maintain a balanced diet. People’s dietary needs were met in accordance with their needs and preferences.

Staff recognised changes in people’s health, and sought professional advice appropriately.

Systems to asses, monitor and mitigate risks to people’s safety and well-being had improved. Improvements of the governance systems ensured better oversight of performance and quality. A range of audits were used to effectively monitor the service. Areas for improvement were identified and responded to so the service was continuously learning and developing.

People and their relatives were encouraged to provide feedback in the form of questionnaires. Information was used to drive through improvements.

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 05 September 2019) and there were breaches of regulations. The provider sent us a monthly 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

The inspection was prompted in part due to concerns received about the quality of care and management of the service. We also wanted assurances the provider had followed their action plan and to confirm they now met legal requirements. As a result, we undertook a focused inspection to review the key questions safe, effective and well-led which contain those requirements.

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 requires improvement to good. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective 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 Ashfield House 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.