Ashlynn Grange

Updated 9 August 2023

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.

Inspection team

The inspection was carried out by 4 inspectors and 1 operations manager. The inspection team was further supported by 3 Expert by Experience’s. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Ashlynn Grange 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. Ashlynn Grange 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. However, a new manager had been in post for 3 months and had submitted an application to register with the CQC. We are currently assessing this application.

Notice of inspection

This inspection was unannounced and took place over 3 days.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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

We spoke with 15 people who used the service, and 16 of their relatives about their experience of the care provided. We spoke with 24 members of staff including care workers, nurses, catering staff, housekeeping staff, maintenance staff, the new manager, operations director, quality manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received feedback from 2 external healthcare professionals who provide support to people at the service.

We reviewed a range of records at the service. This included recruitment documentation for staff and staff induction records. We also reviewed certain care records, medicine, and supplementary records for 25 people during the inspection. We asked for other records to be sent to us, which we reviewed away from the care home. These records included monitoring documentation, staff rotas and training records, and quality assurance records. Additionally, we requested some policies and other records which related to the management and oversight of the service.

Updated 9 August 2023

About the service

Ashlynn Grange is a ‘care home’ providing personal and nursing care to up to 156 people. On the first day of our inspection there were 82 people living at, and using, the service. The service provides support to adults, some of whom have dementia, in 4 separate buildings, these are called ‘communities’. Each community is on ground floor level and has its own adapted facilities. At the time of our inspection 3 communities were in use.

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

Safeguarding processes were not always robust to help keep people safe, and lessons were not always learnt when things went wrong. Risks to people’s safety were not consistently assessed and considered, and people were at risk of pressure sores and worsening skin health due to ineffective monitoring of pressure relieving equipment. Checks for medical devices were not always being completed in line with the provider’s procedures and manufacturer’s directions. Medicines were not always managed safely.

In the months prior to the inspection, the provider had received support from the local authority to make improvements at the service. We found many actions had been taken, and improvements to service provision was apparent in many areas. However, governance, systems and audit processes still required review, development, and time to embed, which was recognised by the provider’s senior leadership team. The senior leadership team told us they were committed to making and sustaining ongoing improvements and were responsive to our feedback during the inspection process.

We have made a recommendation for the provider to review accessible information signage within the environment.

People told us they felt safe at the service. The environment was clean, and infection control processes were in place. There was enough staff to support people safely, and the provider undertook safe recruitment procedures.

People, and their relatives, gave mixed feedback for their involvement in the care planning process. However, responsive end of life care planning took place, and relatives told us staff did regularly involve them in this process. Activities for people had not always been consistently available and planned. However, a new activities team had been appointed at the service during the inspection time frame.

People, and their relatives, gave us mixed feedback of their experience and knowledge of how to raise a concern or complaint. The provider’s representatives had plans to improve communication information and systems.

People’s needs were assessed prior to them moving into the service. Staff received the required support and training to enable them to meet people’s needs. Trained chefs were employed at the service and staff supported people to receive a balanced diet. People told us they received healthcare reviews and support when it was needed, however, some people’s relatives felt this area could be further improved upon.

Most staff treated people with respect and dignity. People told us they received good care and support from staff.

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

The last rating for this service was good (published 6 July 2018).

Why we inspected

The inspection was prompted in part due to concerns received about safe care and treatment; safeguarding; person-centred care and good governance. A decision was made for us to inspect and examine those risks.

We found evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective, caring, responsive and well-led sections of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashlynn Grange on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding people from abuse, safe care and treatment, and good governance at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

We have made one recommendation for the provider to review the accessible information available for people.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.