CQC report explained · a nursing home
What the CQC found at Ashby House - Milton Keynes
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that people were protected from abuse and avoidable harm. Medicines, risk assessments, infection control and accident reviews were handled safely, although some mental capacity records and daily notes needed improvement.
- Effective?
- Good
- This key question was not given a new rating in this inspection.
- Caring?
- Good
- This key question was not given a new rating in this inspection.
- Responsive?
- Good
- This key question was not given a new rating in this inspection.
- Well-led?
- Good
- Inspectors found effective audits, communication systems and an action plan for improvements. Most feedback about the manager and how the home was run was positive.
What inspectors found, July 2022
Rated Good; inspectors found safe, well-managed care, with some records and staffing concerns being addressed.
This was an unannounced inspection on 4 July 2022. Inspectors spoke with people living in the home, relatives and staff. They also reviewed care records, medicines records, recruitment files and management audits.
The home was rated Good for Safe and Well-led. Inspectors found that people received safe medicines, risks were reviewed, infection controls were followed and safeguarding systems were in place. They also found good oversight from the manager and regular checks on the quality of care.
There were some areas being improved. Mental capacity records and some daily care notes needed updating. Staff gave mixed views about staffing levels, although inspectors saw enough staff to meet people's needs during the visit.
The overall rating remained Good, as it was at the previous inspection published in July 2018. This inspection only gave new ratings for Safe and Well-led.
Safe medicines
People received medicines safely from trained staff. Records were accurate and medicines were regularly audited.
“People received their medicines safely. Medicines were administered by staff who were trained to do so.” from the report
Risk management
People's risks were assessed and reviewed, including risks linked to falls, malnutrition and skin breakdown. Staff had guidance for specialist health needs.
“People's risks were assessed and reviewed regularly, or as their needs changed.” from the report
Infection control
Inspectors were assured that the home had effective arrangements for preventing and managing infections, including COVID-19.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Management oversight
The manager used daily checks, audits and an action plan to identify and follow up improvements. Communication between senior staff was described as effective.
“Systems were embedded to monitor and evaluate all key areas of the service.” from the report
Working with health professionals
Staff worked with dieticians, district nurses, GPs and chiropodists to monitor and meet people's health needs.
“Good partnership working ensured people's health needs were monitored and consistently met.” from the report
Mental capacity records
needs fixingSome mental capacity and best-interest records were missing or had not been meaningfully reviewed. The manager had already identified this and was updating the records.
“Not all MCA and best interest decision making records were in people's care files.” from the report
Mixed views about staffing
needs fixingStaff gave mixed feedback about staffing levels. Some raised concerns about short staffing and possible poor care practice, although inspectors found enough staff during the visit.
“Some staff were concerned about short staffing and two staff shared concerns of poor care practice because of this.” from the report
Daily care records
minorThe manager had identified that daily notes were not always consistently good and that some monitoring charts had gaps. Improvements were underway and inspectors found no impact on people's care.
“The manager had identified some improvements were needed to ensure consistent good quality in daily notes and no gaps in charts.” from the report
- 01Have all mental capacity assessments and best-interest decisions now been reviewed and added to people's care files?
- 02How do you check that staffing levels remain sufficient on every shift, especially when nurses are administering medicines?
- 03What action has been taken in response to staff concerns about short staffing and poor care practice?
- 04How do you make sure daily notes are complete and monitoring charts have no gaps?
- 05What progress has been made on the manager's action plan since the inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the report does not give new ratings for Effective, Caring or Responsive. This explanation was written from the published report of 30 July 2022 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, July 2018
Rated Good; inspectors found safe, kind and person-centred care, with some minor improvements still needed.
This was a comprehensive, unannounced inspection on 22 May 2018. Inspectors spoke with people living at the home, relatives and staff. They observed care, reviewed care plans and staff records, and checked medicines, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found suitable staffing, safe medicines systems, detailed risk assessments and staff who understood people's needs.
People were treated with kindness, dignity and respect. Their care plans reflected their preferences, relatives could be involved in decisions, and people had access to activities, healthcare and end of life support. The home was being refurbished, and inspectors identified that call bell response times were not being monitored or audited.
Individual risk planning
Risk assessments were detailed and kept up to date. Staff understood people's risks and how to support them safely.
“Risk assessments were detailed, individualised and up to date.” from the report
Kind and respectful care
Inspectors found trusting relationships between people and staff. Staff offered comfort, respected personal choices and protected people's dignity.
“People appreciated the respect staff had for them and were happy with the way they were treated.” from the report
Personalised care
Care plans reflected people's preferences and were updated when needs changed. Staff could explain how they supported each person.
“Each person's care plan had been reviewed on a regular basis and accurately reflected their current care needs.” from the report
Activities and social contact
People could join group or one-to-one activities and go out on visits. The home aimed to reduce isolation and loneliness.
“People were supported to join in group activities or spend time on a one to one basis to help prevent isolation and loneliness.” from the report
Call bell monitoring
needs fixingThe home had call bells, but it did not monitor or audit whether responses were efficient. The manager was asked to consider putting this monitoring in place.
“there had been no monitoring or auditing to ensure that call bells were responded to efficiently.” from the report
Regular staff supervision
minorStaff received supervision, but inspectors said it could take place more regularly. Families may want to ask how often this now happens.
“All staff received supervision from their manager although this could be completed on a more regular basis.” from the report
- 01How do you now monitor and audit call bell response times?
- 02How often do staff receive supervision, and how do you record that it has taken place?
- 03What work remains on the large refurbishment, and how are people kept safe while it is being completed?
- 04How will you make sure care plans continue to be updated when people's needs or preferences change?
- 05How are relatives involved in reviewing care and making decisions?
This was a comprehensive inspection covering all five questions, and the report says the Effective rating had improved while the other ratings remained Good. This explanation was written from the published report of 10 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.
Every inspection of Ashby House - Milton Keynes
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- July 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Goodstayed GoodSafe: GoodWell-led: Good
- May 2016Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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