CQC report explained · a residential care home
What the CQC found at Ashfield Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found premises were maintained, medicines were generally managed safely and infection control measures were effective, but they were not fully assured about staffing levels at night.
- Effective?
- Good
- People had assessments and personalised care plans, and staff had relevant training and support. Food and drink were adapted to people's needs, although the evening menu did not clearly show a suitable non-pork option on the day of inspection.
- Caring?
- Good
- Staff treated people with kindness and respect. They supported people's choices, privacy, dignity and independence, and involved people in decisions about their care.
- Responsive?
- Good
- Care plans reflected people's individual needs, preferences, communication and life histories. People were supported with activities, relationships and religious interests, and complaints were recorded and acted on.
- Well-led?
- Good
- The management team had improved systems for checking quality and reducing risks. People, relatives and staff were able to give feedback, and inspectors found an open and inclusive culture.
What inspectors found, July 2023
Rated Good; inspectors found safe, kind care, but night staffing and some medicines guidance needed attention.
This was an unannounced follow-up inspection on 18 May 2023. Inspectors observed care, activities and mealtimes, spoke with people, relatives, staff and a healthcare professional, and reviewed care, medicines, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse and avoidable harm, received their medicines safely, had personalised care and were treated with kindness and respect.
The home had improved since the previous inspection, which was rated Requires Improvement and found breaches of regulation. The provider had completed an action plan, and inspectors found it was no longer in breach. They did identify some issues, including pressure on night staff and medicines protocols that were not always personalised.
Improvement since the last inspection
The provider acted on the previous inspection findings. Inspectors found improvements to the building, equipment and management systems, and the previous breaches were resolved.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 15.” from the report
Safe and effective care
Inspectors found that staff understood people's risks and needs. Staff were trained, medicines were generally managed safely and people were supported to access healthcare.
“People received safe and effective care from a qualified and competent staff team.” from the report
Personalised activities and relationships
People were offered group and one-to-one activities, support to practise their religion and help to maintain friendships within the home.
“Staff encouraged and supported people to participate in a range of activities to make sure people remained stimulated, socially engaged and to support their wellbeing.” from the report
Stronger management oversight
Managers used audits, meetings and feedback to monitor the service and make improvements. Inspectors found a clear management structure and better governance than at the previous inspection.
“Managers carried out regular audits of the service to monitor, assess and improve the quality of service, while reducing risks to people.” from the report
Menu information
minorThe evening menu shown on the inspection day listed two pork-based meals, although a vegetarian option was available. The manager updated the menus so all options were clearly shown.
“We noticed the menu for the evening meal on the day of inspection consisted of 2 pork-based meals.” from the report
- 01How many staff are normally on duty overnight, and what changes have been made to the night rotas since the inspection?
- 02How do you record personalised instructions for medicines given when required?
- 03How will you make sure menus clearly show suitable choices for people who do not eat pork or who need a vegetarian diet?
- 04How do you assess and review my relative's risks, health needs, preferences and communication needs?
- 05What activities and support would be available if my relative did not want to join group activities?
This was an unannounced follow-up inspection covering all five key questions, with infection prevention and control also checked under Safe; it followed breaches and a Requires Improvement rating at the previous inspection. This explanation was written from the published report of 12 July 2023 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, May 2022
Ashfield Care Home was rated Requires Improvement; inspectors found caring staff and enough staff on duty, but safety, maintenance, medicines and management checks needed improvement.
This was an unannounced focused inspection on 04 April 2022. Inspectors and an Expert by Experience spoke with people, relatives and staff. They reviewed care, medicines, recruitment, training, accidents, incidents and management records.
People and relatives were mostly positive about the care. Inspectors found people felt safe, staffing levels were suitable, recruitment checks were completed and infection control measures were in place. Staff were described as kind, caring and committed.
However, some parts of the building and equipment were not clean or well maintained. Medicines were not always stored securely, some records for as-needed medicines were missing, and not all relevant staff had completed competency checks. The home's monitoring systems had not identified or dealt with these problems early enough.
The overall rating changed from Good to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The report does not give ratings for Effective, Caring or Responsive because this was a focused inspection.
Caring staff
People and relatives gave positive feedback about staff being kind, respectful and understanding. Inspectors also saw positive interactions and teamwork.
“People and their families told us staff at Ashfield were caring and they were treated with compassion and respect.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's care needs. The recruitment records reviewed showed that required pre-employment checks had been completed.
“There were enough staff to ensure people's care needs were met.” from the report
Infection precautions
The home was using masks correctly, arranging testing and following the visiting guidance in place at the time. Inspectors were assured about several infection control arrangements, although premises hygiene remained a concern.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Building and cleanliness
seriousInspectors found unpleasant odours, damaged or worn bedding, broken bathroom tiles, loose radiator covers, broken plug sockets and bulbs needing replacement. These matters led to a breach of Regulation 15.
“The provider had failed to ensure that aspects of the premises and equipment used in delivering care to people was fit for purpose and maintained to a safe standard.” from the report
Medicines arrangements
seriousThe medicines trolley could be opened without a key. Some as-needed medicines did not have the required protocols, and night staff had not had their medicine administration competency assessed.
“We found that the medicines trolley had a broken lock and could be opened without needing a key.” from the report
Weak management checks
seriousAudits did not consistently identify problems or make sure they were fixed. This included issues with the environment, medicines and oral care, and led to a breach of Regulation 17.
“We found no evidence that people had been harmed however, governance systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
Oral care
needs fixingSome people did not have suitable toothbrushes or toothpaste available. Inspectors found items that were dry, brittle or hard, suggesting people may not have been supported to use them.
“People were not always supported to maintain their oral health care and hygiene.” from the report
- 01What repairs have been completed for the bathroom tiles, radiator covers, plug sockets, bulbs and flooring?
- 02Have all stained or damaged mattresses, duvets and bedding been replaced?
- 03How are medicines now kept securely, and have all relevant staff had their competency assessed?
- 04How do you now check that as-needed medicine protocols are complete and up to date?
- 05What changes have been made to audits so that cleanliness, oral care and other risks are found and fixed promptly?
This was a focused inspection looking mainly at Safe and Well-led, including infection prevention and control; Effective, Caring and Responsive were not rated and their previous ratings were not reassessed. This explanation was written from the published report of 24 May 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.
Every inspection of Ashfield Care Home
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2021Goodstayed GoodSafe: GoodEffective: GoodResponsive: GoodWell-led: Good
- September 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- March 2022
Registered with the Care Quality Commission on 10 March 2022.
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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