CQC report explained · a nursing home
What the CQC found at Ashfield Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2022
Rated Requires Improvement; inspectors found unsafe cleanliness and maintenance, with weak checks to make sure problems were fixed.
This was an unannounced focused inspection on 24 November 2021. It followed concerns from the local authority about infection control. Inspectors observed the home, spoke with people, relatives and staff, and checked care, medicines, staffing and management records.
The home was not always clean or well maintained. Inspectors found dirty carpets, stained chairs, peeling wallpaper, damaged fixtures and furniture that was not fixed to walls. The home was also cold when inspectors arrived, although the heating settings were changed during the inspection.
There were also important strengths. Risks were assessed in detail, medicines were managed safely, staffing levels were sufficient and staff understood people's needs. However, checks by managers did not identify all the problems, and the home did not act quickly enough on concerns already raised by the local authority.
The overall rating fell from Good at the previous inspection, published in June 2019, to Requires Improvement. This inspection only assessed Safe and Well-led. The other ratings were carried over from the previous comprehensive inspection.
Detailed risk assessments
Risks such as falls and special diets were assessed in detail, with steps for staff to reduce them.
“Individual risk assessments were detailed and specifically addressed each person's risk.” from the report
Safe medicines
Medicines were stored and given safely. An electronic system helped reduce errors, and clear instructions were in place for medicines given when needed.
“Medicines were managed and stored safely.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Staff had induction, supervision and relevant employment checks.
“There were enough staff deployed around the home.” from the report
Good care planning
Care plans were person-centred, detailed and followed by staff. They recorded people's needs, risks, choices and decisions.
“Overall care plans were to a very good standard and we observed these care plans to be followed by staff.” from the report
Poor cleanliness and repairs
seriousInspectors found dirty or damaged areas, stained furniture, dirty carpets, peeling wallpaper and other maintenance problems. These conditions increased the risk of infection and harm.
“A lack of cleanliness and poorly maintained environment can impact on people's health and increase the risk of infection.” from the report
Unsafe environment
seriousSome furniture was not fixed to walls, and a nail and exposed screw were found in a corridor. The home was cold when inspectors arrived, and some people were cold.
“The environment was not safely managed. We observed occupied bedrooms had furniture which was not fixed to the wall.” from the report
Weak management checks
seriousAudits and walk-arounds did not identify all the problems. Issues previously identified by the local authority had not all been fixed within the agreed timescale.
“The provider failed to ensure audits and monitoring clearly identified issues of concerns with the safety of the environment and cleanliness of the home.” from the report
Slow action on concerns
needs fixingThe provider reacted to problems, but not quickly enough. Cleaning schedules were also unclear while the service was reviewing them.
“The provider reacted to issues and concerns, but not in a timely manner.” from the report
- 01Which cleaning, carpet, furniture and repair problems identified in the report have now been completed, and when were they completed?
- 02How do you now check that audits identify all problems with cleanliness, repairs and safety?
- 03Who is responsible for maintenance and housekeeping, and are those roles now fully staffed?
- 04How do you make sure people's bedrooms and communal areas are warm enough, especially the conservatory?
- 05What action was taken in response to the local authority's concerns, and how do you make sure agreed timescales are met?
This was a focused inspection of Safe and Well-led following infection control concerns; the other question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 19 February 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, June 2019
Ashfield Nursing Home was rated Good overall; care was safe and kind, but mealtime support and the environment needed improvement.
This was an unannounced comprehensive inspection on 29 April 2019. Inspectors reviewed care plans, medicines records, staff files, audits and other records. They spoke with people living at the home, relatives and staff, and observed care.
The home was rated Good for Safe, Caring, Responsive and Well-led. Inspectors found that risks, medicines, staffing and infection control were managed well. Staff were described as kind and respectful, and people received personalised care.
Effective was rated Requires Improvement. Mealtime support was not always organised consistently, and some people did not get the help they needed. Inspectors also found limited communal space, a lack of seating and personalisation in some rooms, and signage that needed improvement.
There had been significant improvements since the October 2018 inspection. At that time, Safe and Well-led were rated Inadequate and there were breaches relating to safe care and treatment, staffing and governance. At this inspection, the home was no longer in breach of those regulations.
Improved safety
Inspectors found major improvements in safeguarding, risk management, staffing, medicines and cleanliness since the previous inspection.
“At this inspection we found there were significant improvements in all the areas we highlighted at the previous inspection” from the report
Kind and respectful staff
People said staff listened to them and helped them. Inspectors saw positive interactions and staff protecting people's privacy and dignity.
“People were treated with kindness and respect by staff and we saw interactions between staff and people at the service were positive.” from the report
Personalised care
Care plans included people's needs, preferences and choices. Staff used this information in day-to-day care and activities.
“People received personalised care and their care plans reflected their needs.” from the report
Good management oversight
Regular audits and action plans helped the home identify and address problems. Staff said communication and support had improved.
“Since our last inspection the registered manager had worked to improve the quality monitoring systems, so they had a clear oversight of the service.” from the report
Mealtimes were inconsistent
needs fixingThe organisation of one lunchtime meal meant some people did not get the support they needed. The arrangement of the dining room also made the meal less pleasant for some people.
“The lunchtime meal on one of the floors lacked organisation and as a result some people did not receive the support they required to eat their meal.” from the report
Limited communal space
minorThere were not enough suitable communal areas for people who needed quiet or privacy. An alternative area was not regularly offered.
“There was a lack of communal areas to support people who needed quiet and privacy.” from the report
Bedrooms and signage needed improvement
minorSome bedrooms needed more personal touches and redecoration. Signage was not always accessible, although improvement plans were in place.
“Some bedrooms we viewed lacked personalisation and required redecoration, and whilst there was some easy read signage around the service, further improvements were required in this area.” from the report
- 01What changes have been made to organise mealtimes since the inspection?
- 02How will you make sure my relative receives the right level of help to eat and drink?
- 03What quiet areas are available, and how do you offer them to people who need privacy?
- 04What is the timetable for improving bedroom personalisation, redecoration and accessible signage?
- 05How are the improvements from the previous Inadequate Safe and Well-led ratings being checked and maintained?
This was an unannounced comprehensive inspection covering all five key questions and following up concerns found in October 2018. This explanation was written from the published report of 8 June 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 Ashfield Nursing Home
6 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- February 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2019Goodup from InadequateSafe: GoodWell-led: Good
- January 2019Inadequatedown from Requires improvementSafe: InadequateWell-led: Inadequate
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 8 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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