CQC report explained · a residential care home
What the CQC found at Ascot House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were safely managed, staff recruitment checks were completed and risks such as falls were assessed and reviewed. The building, equipment, fire safety and infection control were also checked.
- Effective?
- Good
- People were assessed before admission to check that rehabilitation was suitable. Health needs, nutrition, therapy and discharge support were provided by a range of staff and professionals.
- Caring?
- Good
- Inspectors observed kind and respectful care. Staff knocked before entering rooms, explained what they were doing and encouraged people to do as much as possible for themselves.
- Responsive?
- Good
- Care plans recorded people's needs, preferences and rehabilitation goals. Discharge planning included home visits, equipment, referrals and a welfare check after people returned home.
- Well-led?
- Good
- Inspectors found a clear team structure, regular meetings and improved audits, including better oversight of medicines. Staff and partner organisations said they worked well together.
What inspectors found, January 2019
Rated Good in all five areas; inspectors found safe, kind rehabilitation care after earlier problems with medicines and staff supervision were improved.
The inspection took place on 7 and 8 January 2019 and was announced. Inspectors spoke with seven people, two relatives and staff. They reviewed care and staff records, watched care and lunch, and checked the building, medicines and quality checks.
The home provides therapy-led rehabilitation for adults after illness, accidents or reduced mobility. It aims to help people regain independence and return home, usually within 21 days. It also has step-down beds for people waiting for longer-term care or support at home.
Inspectors found the home safe, effective, caring, responsive and well-led. Medicines were managed safely, risks were reviewed, staff were trained, and people received support from health and therapy professionals. Care plans supported personal goals, discharge planning and a safe return home.
The home was previously rated Requires Improvement because medicines were not always safely managed and staff supervision was lacking. Inspectors found improvements and rated all five areas Good at this inspection.
Safer medicines
The previous medicines problems had been addressed. Inspectors found records complete, stock correct and regular checks in place.
“Medicines were safely managed.” from the report
Rehabilitation goals
Care plans set agreed goals and exercise plans to help people improve mobility and independence.
“Care plans and assessments contained goals that people had agreed to work towards, these were small but steady steps to enable mobility to improve” from the report
Kind and respectful care
People described staff as polite and helpful. Inspectors saw staff protect privacy, explain care and encourage independence.
“We observed kind and caring interactions between staff and people being supported by the service.” from the report
Planning for discharge
The home worked with health and social care staff to arrange equipment, home safety checks and follow-up support.
“A welfare check was made by therapy staff, 24-hours after discharge.” from the report
Supportive leadership
Staff reported feeling supported. Audits, meetings and shared responsibilities were used to monitor and improve the service.
“There were audits in place to monitor and improve the service.” from the report
Restricted visiting times
minorVisiting was limited to certain times so people could follow their exercise plans. The report says private arrangements could be made when families could not visit at those times.
“Visiting times were restricted to certain times of the day to ensure people engaged in their exercise plans.” from the report
- 01What rehabilitation goals would you set for my relative, and how would you measure their progress?
- 02What happens if my relative cannot complete the planned exercises or is no longer suitable for rehabilitation?
- 03How will you assess whether their home is safe and arrange equipment before discharge?
- 04What follow-up support is available after discharge, and for how long?
- 05What visiting times apply, and how could private arrangements be made if we cannot visit then?
This was an announced inspection of all five key questions, carried out alongside an inspection of the related care at home service to review rehabilitation and follow-up care. This explanation was written from the published report of 31 January 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2018
Rated Requires Improvement; inspectors found kind, responsive rehabilitation care but unsafe medicines management and weaknesses in staff support and oversight.
This was an unannounced inspection on 15 and 20 November 2017. Inspectors observed care, looked at four bedrooms and reviewed care records, medicines records, staffing, training, complaints and other checks. They spoke with people using the service, relatives, staff and health professionals.
People were treated with dignity and respect. Staff supported rehabilitation, encouraged independence and planned discharges carefully. Inspectors found people’s nutrition was monitored, staffing levels were enough and the home was clean. Caring and Responsive were rated Good.
Medicines were not always properly recorded or accounted for. Some records did not match the stock available, and guidance for some medicines was not clear. Staff did not always receive regular supervision or attend recorded team meetings. Safe, Effective and Well-led were rated Requires Improvement.
The overall rating was Requires Improvement. This means the home was not consistently meeting the expected standards, although the report also found several areas of good care. The previous inspection in January 2016 rated the service Good overall, with Responsive rated Requires Improvement.
Kind and respectful care
Staff treated people with dignity, spoke kindly and understood their preferences and needs.
“We saw kind interactions from staff to people throughout the inspection.” from the report
Rehabilitation and independence
People were encouraged to practise skills, work towards agreed goals and regain independence.
“The main ethos of the service was for people to become independent and return to their own home.” from the report
Discharge planning
The home involved people and families in discharge arrangements, checked home safety and arranged equipment and follow-up support.
“This told us that the service worked to ensure that people were involved in their discharge planning and to ensure that people returned home to a safe environment.” from the report
Nutrition and health support
People’s weight, food and fluid intake were monitored. Referrals and special diets were arranged when needed.
“This told us that people's nutrition was closely monitored and managed appropriately.” from the report
Enough staff
Inspectors saw enough staff on duty to meet people’s needs, and people said staff responded quickly to call bells.
“Throughout the inspection, we observed that there were enough staff on duty to meet the needs of people.” from the report
Medicines records and stock
seriousMedicine quantities did not always match the records. Some medicines were not clearly booked in, carried forward or recorded as returned, so inspectors could not be assured that all stock was accounted for.
“Medicines were not managed safely. The provider did not ensure that balances of medicines were accounted for.” from the report
Unclear medicine guidance
needs fixingSome guidance for medicines given when needed did not explain clearly why a person might require them. Directions for some creams were also missing.
“guidance was not in place to clearly inform staff why the person may require this medication.” from the report
Staff supervision and communication
needs fixingSome staff did not receive supervision as often as the organisation’s policy required. Care staff also said they did not have team meetings and communication could be better.
“We saw in one staff file that the staff members had only received four supervisions in a two year period.” from the report
Activities on the step-down unit
minorInspectors did not see activities on the step-down unit, and daily notes did not show activities there. People waiting for longer-term support could benefit from more activities.
“We didn't see any activities on the step down unit.” from the report
Capacity assessments
needs fixingSome people with dementia on the step-down unit did not have capacity assessments available. The home was told to consider whether DoLS referrals were appropriate once assessments were completed.
“Some people within the unit did have a diagnosis of dementia but there were no capacity assessments available.” from the report
- 01How are medicine quantities now recorded when medicines arrive, are given, or are returned?
- 02How do you check that medicine records match the stock held, especially for medicines given when needed and controlled medicines?
- 03How often do staff now receive supervision, and how is this checked against your policy?
- 04What activities are now offered to people staying on the step-down unit while they wait for longer-term care?
- 05How do you complete and record capacity assessments and decide whether a DoLS referral is needed?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. This explanation was written from the published report of 17 February 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ascot House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- January 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 27 April 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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