Archived: Ashlea Court Care Home

Updated 2 June 2015

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 registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 & 9 April 2015 and was unannounced. The inspection was led by an adult social care inspector who was accompanied by a second inspector and an expert-by-experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We received this information within the required timescale. We also received information from North East Lincolnshire clinical commissioning group (CCG) and we contacted the local safeguarding of vulnerable adults team for information.

At the time of our inspection visit there were 42 people living at Ashlea Court .We used a number of different methods to help us understand the experiences of the people who used the service. We used the Short Observational Framework for Inspection (SOFI) in the lounge areas. SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.

During the inspection we observed how staff interacted with people who used the service. We spoke with ten people who used the service and nine relatives. We spoke with the registered manager, the administrator, senior manager, one member of qualified staff, three care workers, the cook, a student on placement and the activity co-ordinator. We also spoke with six visiting health care professionals.

We looked at six people’s care records. We looked at 20 medication administration records (MARs). We looked at how the service used the Mental Capacity Act 2005 to ensure that when people were assessed as lacking capacity to make their own decisions, best interest meetings were held in order to make important decisions on their behalf. We looked at a selection of documents relating to the management and running of the service. These included three staff recruitment files, the training record, the staff rotas, minutes of meetings with staff and people who used the service, quality assurance audits and maintenance of equipment records. We completed a tour of the premises.

Updated 2 June 2015

Ashlea Court Care Home is registered to provide nursing and personal care for up to 48 older people. The home was purpose built and has been extended. Accommodation is provided over two floors with both stairs and lift access to the first floor. Local facilities and amenities are within walking distance.

The service had 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.

This inspection was unannounced and took place over two days. The previous inspection of the service took place on 28 May 2013 and was found to be compliant with all of the regulations inspected.

The registered manager and senior management team completed quality checks on areas such as the environment, medicines and records. We found this had not been effective and had missed areas that required improvement. Also we found people’s care plans were not written in a person centred style, some had not been updated to reflect changes in needs and not everyone who used the service had plans of care to support all their needs. This meant staff may not have guidance in how to meet people’s needs, staff may not support people in the way they preferred and there was a risk important care could be missed.

These issues meant the registered provider was not meeting the requirements of the law regarding monitoring the quality of the service and assessing and planning care for people. You can see what action we told the registered provider to take at the back of the full version of the report.

Staff completed safeguarding training and knew what measures to take to help to protect people from the risk of abuse or harm. Risk assessments were completed, although we found these lacked some important information to guide staff in how to minimise risk which the registered manager confirmed they would address.

People received their medicines as prescribed and they were held securely. The registered manager told us they were reviewing the storage arrangements so medicines were stored at safe temperatures.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider had followed the correct process to submit applications to the local authority for a DoLS where it was identified this was required to keep them safe. At the time of the inspection there were no DoLS authorisations in place and the service was waiting for assessments and approval of the six applications they had submitted.

Staff supported people to make their own decisions and choices where possible about the care they received. When people were unable to make their own decisions staff mostly followed the correct procedures and involved relatives and other professionals when important decisions about care had to be made. Improvements were needed with the assessment and recording of decisions about the use of bed rails and for decisions about resuscitation.

Our observations showed staff were attentive to people’s needs and were always available. People who used the service told us there were enough staff on duty who would respond quickly to their requests or needs. There were recruitment systems in place that would ensure all employment checks were carried out prior to staff starting work at the service.

Staff approach was seen as caring; they took time to speak to people, they respected privacy and dignity and they involved them in day to day decisions. Staff had developed positive relationships with people and their families. We saw people were encouraged to participate in activities, to maintain their independence and to access community facilities.

People felt able to raise concerns and the registered manager was available for people who used the service, their relatives and staff to talk to. People’s views were sought in meetings and via questionnaires about the service.