CQC report explained · a residential care home
What the CQC found at Ash Lea House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Staff understood how to recognise and report abuse, risks were assessed, staffing was sufficient and medicines were stored and given safely.
- Effective?
- Good
- People received support with their health, diet and mobility needs. Staff had training and supported people to make decisions in line with the Mental Capacity Act.
- Caring?
- Good
- People had positive relationships with staff, who treated them with kindness, dignity and respect. People were supported to make choices and develop their independence.
- Responsive?
- Good
- Support plans reflected people's wishes and were updated when needs changed. People could choose activities, maintain relationships, practise their faith and raise concerns.
- Well-led?
- Good
- The home had quality checks covering areas such as care plans, medicines, incidents and infection control. Staff and people said management was approachable and listened to their views.
What inspectors found, July 2018
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
The inspection was unannounced and took place on 17 May 2018. One inspector spoke with four people, staff and a social care professional. They observed care and reviewed four care plans, medicines records, audits and safety checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were supported by staff who understood their needs, treated them respectfully and helped them make choices about daily life, activities, health care and relationships.
The previous inspection, on 3 February 2017, had rated the service Requires Improvement. Inspectors had found problems with safeguarding, health support and quality checks. This inspection found that improvements had been made and that the earlier legal breaches had been addressed.
Enough staff
Inspectors saw enough staff on duty and said staffing was organised around people's support plans and activities.
“We saw there were sufficient staff on duty to meet people's needs.” from the report
Kind, respectful care
Staff built positive relationships with people and supported their privacy, dignity, choices and independence.
“The staff were motivated, kind and compassionate in their approach to care.” from the report
Personalised support
People helped shape their support plans, including their preferences, communication needs, activities and relationships.
“Where people's needs or preferences changed the support plan was updated to reflect this.” from the report
Improved oversight
The home had introduced checks on care plans, medicines, incidents, health and safety and infection control. Inspectors found these checks were effective.
“We saw that these were effective and that there were plans in place to respond to areas highlighted.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you currently check that safeguarding concerns are reported to the local authority when needed?
- 02How are staffing levels reviewed when people's support needs or activities change?
- 03How do you make sure medicines records remain complete and accurate?
- 04How are people's support plans updated when their preferences or health needs change?
- 05How can residents and families raise concerns, and how do you show that their views lead to changes?
This was an unannounced inspection covering all five CQC questions; the inspector spoke with four people, observed care and reviewed four care plans and service records. This explanation was written from the published report of 14 July 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.
What inspectors found, February 2017
Rated Requires Improvement; inspectors found kind care, but identified risks around safeguarding, staffing, health monitoring and records.
Inspectors visited the home without warning on 30 November 2016. They spoke with people, relatives and staff, and reviewed care records, medicines records, training records and management checks.
They found caring staff, safe medicines management, suitable staff training and support with food, drink and choices. People were generally treated with dignity, listened to and supported to enjoy relationships and activities.
However, some safety concerns were not reported or investigated properly. Staffing was not always enough, health conditions were not consistently monitored, care plans contained gaps or conflicting information, and checks by managers did not identify all these problems. The overall rating was Requires Improvement, with the same rating for Safe, Effective, Responsive and Well-led. Caring was rated Good.
Kind and respectful care
Staff generally knew people's preferences and supported them with kindness, privacy and dignity. People appeared relaxed and comfortable with staff.
“People lived in a service where staff listened to them and cared for them in a way they preferred.” from the report
Medicines managed safely
Inspectors found that people received their medicines at the right times. Staff followed stock checks and had medicines training and competency checks.
“People received their medicines as prescribed and medicines were managed safely.” from the report
Trained and knowledgeable staff
Staff had training, supervision and induction. Inspectors found that staff understood how to support people safely and how to respect their decisions.
“People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support.” from the report
Safeguarding information was not always acted on
seriousSome unexplained injuries and other incidents were not fully investigated or shared with the local authority safeguarding team. This placed people at risk of avoidable harm.
“People were placed at risk of abuse and harm because the provider did not have effective systems in place to recognise and respond to allegations or incidents.” from the report
Staffing was sometimes insufficient
needs fixingAt night and at busy times, staff could be occupied supporting people with high needs, leaving too few staff for others. Staffing was increased after inspectors raised their concerns, including a trial of a third night worker.
“People were not always supported by sufficient numbers of staff.” from the report
Health monitoring was not reliable
seriousCare plans did not always give clear instructions for monitoring ongoing health conditions. Records showed occasions when staff did not contact a GP when the guidance said they should.
“People were not always given the appropriate support with their ongoing health conditions.” from the report
Care plans and records were inconsistent
seriousSome care plans were repetitive, unclear or contradictory. Activity and food and fluid records also had gaps, making it harder to check whether planned care had been provided.
“The failure to complete these records meant that people's care and support could not be effectively monitored to ensure this was being provided as intended to meet people's varying needs.” from the report
- 01What changes have been made to staffing levels at night, at weekends and during busy periods since the inspection?
- 02How do you now investigate and report unexplained injuries and other safeguarding incidents?
- 03How are each person's ongoing health conditions monitored, and when would staff contact a GP?
- 04How do you make sure care plans are clear, current and free from conflicting instructions?
- 05How do you check that planned activities and food and fluid records are completed accurately?
This was an unannounced inspection covering all five CQC questions, based on discussions, observations and records reviewed on 30 November 2016. This explanation was written from the published report of 3 February 2017 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 Ash Lea House
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- July 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
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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62 live-in carers within about an hour of Derbyshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,010 to £1,260 a week. 51 can care for a couple. 12 years' experience on average.
“Ernest is an amazing professional carer who delivers care from the heart.”
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
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