Archived: Ashbourne Care Home

• Ashbourne Care Home is a care home providing personal care and accommodation for up to 37 people who are frail or are living with dementia. At this inspection 35 people lived within the service.

People’s experience of using this service:

• People continued to receive safe care. However, people felt while there were enough staff, the deployment of staff was of concern. People were safe and staff knew how to keep them safe. Recruitment systems ensured people were supported by staff who were appropriately employed. People were given their medicines as it was prescribed. Staff had access to personal protective equipment as part of the provider’s procedures for infection control. Accidents and incidents were noted so any trends could be monitored to reduce accidents.

• People continued to receive effective care. Staff had the skills and knowledge required to support people. 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. People made their own choices as to what they had to eat and drink with support from staff. People could access support from health care professionals when needed.

• People continued to receive support from staff that were of a caring and kind nature. People decided how they were supported by staff. Staff were caring and respectful of people’s privacy, dignity and independence.

• People continued to receive support that was responsive to their needs. People’s support needs were assessed and a care plans developed to inform staff how people’s personal needs should be met. The support people received was what they wanted and reviews took place to ensure where there were changes, these could be identified and acted upon. People’s interests and hobbies were considered so people could take part in the things they liked to do. The provider had a complaints process in place and people knew how to complain.

• The service continued to be well managed. The registered manager supported staff to ensure people received the support they wanted. Quality audits and spot checks took place and where improvements were needed, this was fedback to people. Questionnaires were used to engage with people. The environment was welcoming, warm, clean and tidy.

Rating at last inspection:

• Rated Good (Report published 26/01/2016).

Why we inspected:

• This was a planned inspection based on the rating at the last inspection. Whilst the service was rated ‘Requires Improvement’ in safe, it remains rated Good overall.

Follow up:

• We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

At our last inspection in October 2014, we found that the provider was not meeting one of the regulations associated with the Health and Social Care Act 2008 which related to staffing. Following the inspection we asked the provider to take action to make improvements. The provider sent us an action plan outlining the actions they had taken to make the improvements. During this inspection we looked to see if these improvements had been made and found that they had.

Ashbourne Care Home is registered to provide care and treatment for up to 38 older people, some of whom may have dementia. At the time of our inspection there were 34 people living at the home.

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.

People living in the home told us that they felt safe and that they were supported by staff who knew them well. Staff had been trained to recognise different types of abuse and were confident that that if they raised any issues then the appropriate action would be taken.

We found that both the registered manager and the staff group knew the needs of the people living at the home and how to support them.

The provider had a suitable number of staff on duty with the skills, experience and training in order to meet people’s needs. Staff had access to a range of training to provide them with the level of skills and knowledge to deliver care safely and efficiently.

Medicines were stored and secured appropriately. People told us that they received their medicines on time and that staff responded to their needs in a timely manner.

Staff obtained consent from people before they provided care. The registered manager and staff all had an understanding of the Mental Capacity Act (2005) and were able to give a good account of what a Deprivation of Liberties Safeguard (DoLS) meant for people.

People were supported to eat and drink enough to keep them healthy and were offered choices at mealtimes. Staff were aware of people’s individual dietary needs and provided discreet assistance at mealtimes, where required. People were supported to access a variety of healthcare professionals to ensure their health care needs were met and were assisted to see their GP as and when required.

People living at the home and their relatives told us that they felt the staff were very supportive and caring. Relatives told us they found the registered manager and the staff group very welcoming and approachable.

Staff were aware of people’s likes and dislikes and how people preferred to spend their day and what was important to them. There were a number of activities planned during each week and work was ongoing to collect more information about people’s life history in order to develop more person centred care.

People and their relatives told us that they had not had to raise any concerns or complaints but if they did, they knew who to speak to and were confident that they would be dealt with satisfactorily.

People living at the home, their relatives and staff alike, all thought that the home was well-led. They all spoke positively about the registered manager and the staff group. Visitors to the home felt welcomed and always listened to.

People using the service were supported to be involved and make decisions about their care.

People are in receipt of effective and appropriate care that meets their needs. All

staff we spoke with told us they had the information they needed to care for people safely. One visiting healthcare professional said; 'The staff contact us regularly if they have any concerns about the health of the people here'.

All staff we spoke with told us they felt supported by the management team, and had regular training opportunities. One member of staff we spoke to said; 'They have an open door policy here, I feel I can comment to them about anything'.

Complaints were recorded, investigated and resolved to the satisfaction of people using the service. One person we spoke with said; 'If I have a complaint I am happy to take it to the manager in the office'.

There was not an effective system to regularly assess and monitor the quality of service that people receive.

People told us they felt able to express their views and felt involved in making decisions about their care.

People told us that staff had spoken to them about how their needs were to be met and their choices were reflected in the care they received. People told us, 'Don't interfere, staff give a choice of clothing' and, 'Hundred percent support from staff'. A visiting healthcare professional told us that the home provided good care and worked well with them.

People and staff we spoke with told us that they felt able to raise concerns about the service. The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were positive about the staff, and staff told us they were well supported by their managers so that they could deliver care safely and to an appropriate standard.

The provider had effective systems in place that identified, assessed and managed risks to the health, safety and welfare of people who used the service and others.