CQC report explained · a residential care home
What the CQC found at Ashdale House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found suitable risk assessments, enough staff and safe recruitment. Medicines were given as prescribed, although only two staff knew how to order medicines and further training was being provided.
- Effective?
- Good
- Staff training had become embedded and mental capacity assessments were individual and decision-specific. People were supported with food, health appointments and ongoing healthcare needs.
- Caring?
- Good
- Staff treated people with kindness, knew their preferences and supported privacy, dignity, independence and personal choices.
- Responsive?
- Good
- Care plans were personalised and regularly reviewed. People were supported with communication, activities, friendships, family contact and complaints.
- Well-led?
- Good
- Inspectors found a positive culture and improved quality checks, records and staff support. The earlier breach of Regulation 17 had been resolved.
What inspectors found, March 2020
Rated Good; inspectors found kind, personalised care and significant improvements since the previous inspection, with a small medicines ordering issue still being addressed.
Inspectors visited without notice on 13 and 14 February 2020. They met everyone living at the home, observed care, spoke with staff, a visitor, relatives and health professionals, and checked care records, medicines, recruitment, training, safety and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough safely recruited staff, safe medicines systems, person-centred care, support with health needs, meaningful activities and kind relationships.
This was a clear improvement from the previous Requires Improvement rating. The provider had addressed problems with staff training, care records, mental capacity decisions, quality checks and staff culture. The previous breach of Regulation 17 had been resolved, and the home was no longer in breach of regulations.
Kind and respectful staff
Staff knew people well and understood their needs, choices and preferred ways of communicating. Inspectors saw people appearing comfortable with staff and enjoying their company.
“People were supported by staff who treated them with kindness and care.” from the report
Personalised support
Care plans reflected individual preferences, communication needs and goals. People were supported to make choices and develop independence.
“People were enabled to make their own decisions and choices about the care and support they received.” from the report
Safe staffing and care
There were enough staff to meet people's assessed support needs, including one-to-one support. Recruitment checks were completed and medicines records showed medicines were given as prescribed.
“There were enough staff, who had been safely recruited, working to provide the support people needed.” from the report
Strong improvement
The provider had acted on the previous inspection findings. Records, training, quality checks and the staff culture had all improved.
“At this inspection we found significant improvements had been made and the provider was no longer in breach of regulations.” from the report
Meaningful activities and relationships
People had daily activity plans shaped around their interests and were supported to maintain family, community and college connections.
“Each person had an activity program of what they wanted to do each day.” from the report
DoLS authorisations pending
needs fixingApplications had been made for people who needed Deprivation of Liberty Safeguards, but the local authority had not yet authorised the assessments when inspectors visited. Ask for an update on this.
“The registered manager had applied for DoLS for people, but these assessments had not yet been authorised by the local authority.” from the report
Limited medicines ordering cover
minorOnly two staff knew how to order medicines. Training was being provided so more senior care staff could do this, reducing the risk of a problem when those staff were unavailable.
“Staff had identified that only two of them knew how to order medicines.” from the report
- 01Have all relevant Deprivation of Liberty Safeguards applications now been authorised, and what happens while authorisation is pending?
- 02How many senior staff can now order medicines, and what cover is available if those staff are off sick or on holiday?
- 03How would you support my relative's preferred way of communicating, including any use of Makaton, signs or symbols?
- 04What activities and opportunities for independence would be planned around my relative's interests and goals?
- 05How would you keep me informed if there were concerns, accidents, safeguarding issues or changes in my relative's health?
This was an unannounced planned inspection based on the previous rating and covered all five CQC questions, including the care provided and the premises. This explanation was written from the published report of 4 March 2020 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 2019
Rated Requires Improvement; inspectors found safe, kind and responsive care, but problems with decision-making, records and quality checks remained.
This was an unannounced comprehensive inspection on 17 and 20 December 2018. Three inspectors visited on each day because concerns had been raised. They reviewed care plans, risk assessments, medicines, staff files, training, complaints, incidents, audits and the home’s premises. They also spoke with people, a visitor, staff and health and social care professionals.
The home was rated Good for safe, caring and responsive care. Inspectors found enough staff, safe medicines systems, kind support and activities suited to people’s interests. People were supported with food, healthcare, communication and personal choices.
The home was rated Requires Improvement for effective and well-led care. Mental capacity assessments did not record decisions properly, and some relatives may not have had legal authority to give consent. Training improvements had started but were not fully embedded. Quality checks had failed to find problems with records, staff checks and decision-making.
The overall rating changed from Good at the January 2017 inspection to Requires Improvement. The report says the provider breached Regulation 17 on good governance. CQC required the provider to send an action report and said it would check that action was taken.
Kind and respectful support
Staff treated people with kindness and patience. Inspectors saw a calm atmosphere and respectful interactions.
“People were supported by staff who were kind and caring. They treated them with kindness, understanding and patience.” from the report
Personalised activities
Activities reflected individual interests and included trips, walks, shopping, college classes, swimming and holidays.
“Each person had their own activity plan which detailed what they done each day.” from the report
Safe staffing and medicines
There were enough staff on each shift, including extra management support when needed. Medicines were ordered, stored, given and disposed of safely.
“At the inspection we found there were enough staff working each shift to meet people's needs.” from the report
Communication and health support
Staff used communication passports, easy-read information and adapted Makaton where needed. People were supported to attend healthcare appointments.
“Each person had a communication passport which included details of how each person communicated.” from the report
Weak quality checks and records
seriousThe home’s quality checks did not find or prevent repeated problems with records and decision-making. This was a breach of Regulation 17.
“There was not an adequate process for assessing and monitoring the quality of the services provided, to ensure that records were accurate and complete and to ensure changes made were embedded and sustained.” from the report
Mental capacity decisions
needs fixingAssessments were not linked to particular decisions. Records did not show people’s views or how best-interest decisions had been reached.
“Mental capacity assessments had been completed but these were not individual or decision specific.” from the report
Training not fully embedded
needs fixingTraining had improved after safeguarding concerns, but inspectors said more time and commitment were needed to make sure staff consistently applied what they had learned.
“Although these improvements had been made further time was needed to ensure these changes were embedded into practice and continued for new staff who join the service.” from the report
Agency staff checks
needs fixingInformation about three agency staff, including their identity, skills and background checks, was not available at first. The manager addressed this during the inspection.
“There was no evidence that DBS checks or other checks had been completed.” from the report
- 01How are you now recording decision-specific mental capacity assessments and best-interest decisions?
- 02How do you check who has legal authority to give consent for a person?
- 03What changes have been made to the quality assurance system since this inspection, and how do you know they are lasting?
- 04How are new and agency staff checked, trained and assessed before supporting people with complex needs?
- 05Did the planned pause on new admissions happen, and what improvements were achieved during that period?
This was an unannounced comprehensive inspection covering all five key questions, following concerns raised about the home. This explanation was written from the published report of 16 February 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.
Every inspection of Ashdale House
5 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- November 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2015
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 17 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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19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.