This inspection took place on the 17 November and the 09 December 2014 and was unannounced.
Ashley Park Nursing Home provides personal and nursing care, and is registered to accommodate up to 30 people some of whom are living with dementia. The home is a large period building with accommodation arranged over three floors, set in extensive gardens overlooking woodlands.
At the time of our inspection there was no registered manager in post. We were informed by the area manager that the registered manager had left the service two days prior to the inspection. 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 home was clean and welcoming; however we found poor standards of cleanliness in the sluice rooms on all three floors of the home. We looked at infection control audits that had been completed and found that the sluice rooms had not been included.
Staff told us they had received the training they needed to do their jobs well. We found that the home had no records of staff appraisals, one to one sessions or supervision sessions. Some staff told us they had informal supervision which was not documented, and other staff told us they had not received supervision for at least one year. This meant that the provider had not provided opportunities for staff to discuss their personal development needs.
Records we looked at showed that the provider had not provided opportunities and support for staff to discuss their personal development needs and to have these meetings recorded for audit purposes. People and their relatives had opportunities to give their views about the service they received. At the time of the inspection the provider did not have a registered manager in post, however the interim manager promoted an open and inclusive culture.
People told us they felt safe in the home because of the way staff cared for them. We observed that people were supported in a timely manner with their personal care needs. We saw that people were supported at lunch time to have their meal in a relaxed and calm manner.
We looked at the staff rota and saw there was sufficient staff with appropriate skills and experience to meet people’s care needs. Staff we spoke with said they were supported by the management team, and had received the required training to enable them to do their jobs and meet people`s care needs. People were supported to maintain good health and to access healthcare professionals when required. Relatives told us they felt there was generally enough staff to meet their relative’s needs.
People and their relatives told us they were included in reviews in relation to their care needs. People’s reviews and risk assessments were up to date and provided information for staff about how people wanted to receive their care. We saw that people were asked for their consent; before personal care took place. We saw that people received their care how they wanted to receive it and in positive ways that met their individual preferences.
Staff knew the people they were supporting, and provided opportunities for people to make choices about how they spent their day. People were supported and encouraged to maintain their independence, and people told us the staff were caring.
People were treated with kindness and respect. We saw that during meal times in communal areas staff took the time to speak with people they were supporting. We observed positive interactions and people appeared to enjoy speaking to staff. People had a choice of meals, snacks and drinks, and could request an alternative meal if they did not want the meal that had been offered on the menu. People had been included in planning the menu and had the freedom to change their minds if they so wished.
We saw that people`s medicines were managed safely and were administered and stored in a safe and appropriate manner. Staff had received the training that they needed to administer medicines in a safe manner.
We found safe systems in place for recruiting new members of staff, and found staff had relevant documents in place for safe recruitment. We found that staff were aware of the safeguarding procedures and of their responsibility of protecting people from harm, and were confident in reporting abuse to the home manager.
We have made a recommendation about infection control and how staffs are supported to report concerns to the manager about infection control.
We have made a recommendation about staff supervision, and staff are supported to be involved in supervision and appraisals.
We have made a recommendation about further guidance and support for the management team around staff development and maintenance audits.