Archived: Ashwood Care Centre

Updated 13 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the 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 29 November, 1 and 5 December 2016 and the first day was unannounced.

Before the inspection we reviewed the information we held about the service including notifications and information received from the local authority. Notifications are for certain changes, events and incidents affecting their service or the people who use it that providers are required to notify us about. We also viewed the Provider Information Return (PIR) that had been submitted in March 2016. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

The inspection team consisted of four inspectors including a pharmacist inspector, a specialist advisor in dementia care, palliative care and nutrition and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who has used this type of care service. They had experience with older people including those with dementia care needs and of care services for older people.

During the inspection we viewed a variety of records including fifteen care records, some in detail and some to look at specific areas of care, medicines management on all floors and medicines administration record charts for 15 people, four staff recruitment files, three staff training files and the staff training matrix for all staff, risk assessments for safe working practices, servicing and maintenance records for equipment and the premises, complaints records, audit and monitoring reports and policies and procedures.

We used the Short Observational Framework for Inspection (SOFI) on the second floor. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed the mealtime experience for people and interaction between people using the service and staff on all floors.

During the inspection we spoke with sixteen people using the service, seven relatives and other visitors, the manager, two registered nurses, three senior carers, nine carers, the activities coordinator, the chef and two domestic staff including the housekeeper. We spoke with one visiting healthcare professional. Following the inspection we requested feedback from healthcare professionals including members of the Community Adult Rehabilitation Service. We received feedback from the Team Leader of the rehabilitation service with input from four healthcare professionals in the team.

Updated 13 January 2017

The inspection was carried out on 29 November, 1 and 5 December 2016 and the first day was unannounced. This was the first inspection under the current registration with the Care Quality Commission which occurred on 4 November 2015. The service was taken over by the new provider as a going concern and staff transferred over, many of whom had worked at the service for several years.

Ashwood Care Centre is a nursing home providing care for a maximum of 70 people. The service has three floors. The ground floor is for people with general nursing and personal care needs, the first floor is for people with nursing and dementia care needs and the second floor is for people with personal care and dementia care needs. At the time of the inspection there were 62 people using the service.

The service is required to have a registered manager. At the time of inspection there was a new manager in post who had commenced on 24 October 2016 and who was going through the application process to become the registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Risks were not always being assessed to identify the action required to minimise them. People were not always supported in a manner that maintained their safety. Evidence was not available to show the findings of the fire and legionella risk assessments had been addressed.

Staff recruitment procedures were in place but were not always being followed to ensure only suitable staff were employed by the service.

Staff were not always meeting people's social, emotional and leisure needs in a way which reflected their preferences.

Care records were varied with some being comprehensive while others did not identify and reflect people’s individual needs, interests and wishes.

The process for auditing and monitoring had not been effective in identifying shortfalls within the service.

The environment had not been reviewed to encompass the sensory needs of people with dementia. We have made a recommendation in respect of this.

The majority of staff demonstrated a caring attitude towards people, however some of the care was task driven and the manager was working with staff to improve the care people received.

Systems and equipment were being serviced and maintained and incidents and accidents were recorded, investigated and audited to minimise the risk of recurrence.

Procedures were in place to safeguard people against the risk of abuse. Staff understood the importance of keeping people safe and reporting any concerns.

The provider made suitable arrangements to ensure service users were protected against the risks associated with the inappropriate treatment of medicines.

Policies for infection control were in place and were being followed to maintain a clean environment and protect people from the risk of infection.

Staff received training to provide them with the skills and knowledge to care for people effectively.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS are in place to ensure that people’s freedom is not unduly restricted.

People’s dietary needs and preferences were being identified and met.

People’s healthcare needs were identified and they received the input they needed from healthcare professionals.

A complaints procedure was in place and people and relatives said they would express any concerns so they could be addressed.

The manager was approachable and was introducing practices to improve the communication within the service.

We found five breaches 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.