Ashcombe

Updated 15 April 2021

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.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 15 February 2021 and was announced.

Updated 15 April 2021

This inspection was unannounced and completed on the 22 and 23 May 2018. At our last inspection in August 2016 we found the service required improvement in the key questions safe and effective. At this inspection the required improvement had been made so the service is rated good.

Ashcombe is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ashcombe accommodates 31 people in one adapted building. At the time of our inspection 26 people were living at the service.

Ashcombe is a two storey building with a lift to access the upper floor. The home has communal areas such as a lounge and small conservatory. There is a small secure garden and a sheltered seating area at the front of the property with garden furniture.

There was a registered manager in post. 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.

Medicines were managed safely. Registered nurses were responsible for medicines management and were assessed and trained by the provider. People had individual medicines administration records that had been completed in full with no unexplained gaps.

Staff had been recruited safely. There were sufficient staff available to people and staff rotas demonstrated consistency. Staff were aware of their responsibility to keep people safe from harm and told us how they would report any concern. Staff were confident that the registered manager would take appropriate action.

The environment was clean and well maintained. All equipment was serviced regularly and safety systems were checked and tested. Fire systems were tested weekly and staff practiced fire drills monthly.

Risks had been identified and assessed. There were safe systems in place which were reviewed on a regular basis. If people required equipment to keep them safe such as hoists or bed rails this had been sourced and were available.

Staff were trained in a variety of topics relevant to their role and all new staff had an induction. Supervision was provided on a regular basis, all staff we spoke with told us they felt well supported in their role. There were daily meetings for the heads of department and monthly team meetings with minutes produced.

People had regular food and drinks. There was support provided for people to eat if needed. The dining experience was relaxed and unhurried. The tables were laid with tablecloths, napkins and flowers to support a positive dining experience. The chef served all meals when possible so they could monitor satisfaction levels.

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 practice. Where people had their liberty restricted, the service had completed the related assessments and requested the authorisation from the local authority.

The environment had been refurbished and improved in many areas. The registered manager had also submitted requests to improve more areas and was waiting for approval from the provider. Some people’s rooms had been updated with decoration and new furniture.

We observed many positive social interactions which demonstrated that staff were kind and caring. People’s privacy and dignity was promoted and respected by all staff. Visitors were welcomed and there was opportunity for them to stay and enjoy a meal with their relatives.

People had individual care plans that were person centred and reviewed regularly. Care plans detailed people’s needs and how the support was to be provided.

Systems were in place to manage complaints. Any received were logged and investigated. The registered manager shared complaints with the staff team so that lessons could be learned. The service had received a number of compliments from people, relatives and other visitors.

Activities were structured and provided daily. Engagement levels were recorded and monitored for effectiveness and enjoyment. There were two dedicated activities workers who planned and organised activities with the involvement of people. The service had good community links in the local area.

End of life care was provided. People were able to record their wishes for this stage of their lives. Nurses worked with local healthcare professionals to make sure people were not in pain and had all they needed at the end of their lives.

Without exception the feedback about the registered manager was very positive. People, relatives, staff and healthcare professionals were happy with their leadership style and thought they managed the service well. There was an open and positive culture at the service, staff told us they worked together as a team and enjoyed coming to work.