CQC report explained · a residential care home
What the CQC found at Ashfields Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines were not always managed safely. Records had missing signatures and information, some dosage details were inaccurate, and some liquid medicines were not dated when opened. People said there were enough staff and felt safe.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff received training and supervision, people were supported with food and healthcare, and the home worked with other professionals.
- Caring?
- Good
- Staff treated people with respect and understood their needs. People and relatives spoke positively about the staff, and people were involved in decisions about their care.
- Responsive?
- Good
- Care plans reflected people's preferences and communication needs. People were supported to maintain relationships and take part in activities in the home and local community, and complaints were handled promptly.
- Well-led?
- Requires improvement
- The home had a positive culture and people and staff felt listened to. However, audits did not identify problems with medicines, recruitment records or some health and safety checks, so quality systems were not robust.
What inspectors found, September 2023
Ashfields Care Home was rated Requires Improvement because medicines and quality checks were not always safe or effective, although care was kind and personalised.
Inspectors made an unannounced visit on 25 and 26 July 2023. They spoke with people, relatives and staff, and checked care plans, recruitment files, medicines records and the home's management records.
The main problems were medicines records and checks. Some records were incomplete or inaccurate, and the home could not always show that medicines had been given as prescribed. Recruitment files did not always include full employment histories. Some safety checks and risk records also needed improvement.
The home was rated Good for Effective, Caring and Responsive. People received personalised care, were treated with respect, and were supported with activities, relationships and healthcare. Safe and Well-led were rated Requires Improvement, changing the overall rating from Good at the previous inspection.
The provider breached rules about safe care and treatment and good governance. CQC said it would request an action plan and continue to monitor the home with the local authority.
Personalised care
Care plans recorded people's needs, preferences and choices. Staff understood people well and supported them to make choices.
“People's care plans were person centred and contained information on their needs, preferences and choices.” from the report
Kind and respectful staff
People and relatives spoke positively about the staff. Inspectors observed staff respecting privacy, dignity and independence.
“People were supported by staff who respected them and treated them as individuals.” from the report
Activities and community life
People were supported to take part in activities in the home and local community, including trips, music and reminiscence sessions.
“There was a strong emphasis on supporting people to engage in meaningful activities in the local community.” from the report
Support with health needs
The home worked with healthcare professionals, and records showed people received treatment and assessments in a timely way.
“We saw evidence of the involvement of chiropodists, social workers, physiotherapists and other medical professionals.” from the report
Medicines records
seriousMedicines were not always managed safely. Missing signatures and other incomplete or inaccurate records meant inspectors could not always tell whether people had received medicines as prescribed.
“Some people's MAR's had gaps where staff should have signed, to indicate medicine had been given.” from the report
Weak quality checks
seriousThe home's audits did not identify repeated problems with medicines, recruitment records and some health and safety checks. This led to a breach of the good governance regulation.
“Quality assurance systems were not robust. This placed people at increased risk of harm and was a breach of regulation 17(1)” from the report
Recruitment records
needs fixingSome staff files did not contain full employment histories, and gaps were not always explained. The manager obtained missing information during the inspection, but CQC made a recommendation to review the recruitment process.
“Staff files did not always contain a full employment history, and gaps in employment history for staff were not always explored or explained.” from the report
Risk and safety records
needs fixingSome emergency evacuation plans and individual health risk records lacked enough detail. The manager took immediate action to correct these issues during the inspection.
“People had emergency evacuation plans, but these did not contain sufficient detail to guide staff on how to evacuate people safely.” from the report
- 01What changes have been made to medicines administration records since the inspection?
- 02How do you now check that controlled drugs are recorded and witnessed correctly?
- 03How are medicine audits checked to make sure they identify problems rather than just being signed off?
- 04How do you make sure staff recruitment files contain full employment histories and explain any gaps?
- 05What changes have been made to evacuation plans and health and safety checks?
This was an unannounced inspection covering all five CQC key questions, including infection prevention and control measures. This explanation was written from the published report of 8 September 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 2019
Ashfields Care Home: Rated Good; inspectors found safe, kind and personalised care, but identified some infection control, food choice and activities shortfalls.
This was an unannounced, planned inspection on 15 April 2019. Inspectors spoke with people living at the home, a relative, staff and health professionals. They reviewed care records, medicines records and other documents.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found sufficient staff, safe medicines practice, personalised care plans, kind staff and good links with health professionals.
There were some issues to improve. Some staff did not follow infection control guidance. People gave mixed views about food choice and some wanted more activities. Inspectors also found small weaknesses in recording fire drills, privacy, audits and a delayed regulatory notification.
The home was also rated Good at its previous inspection on 12 October 2016. The report says the home continued to meet legal requirements, and no regulations were breached.
Safe staffing
Inspectors saw enough staff to meet people's needs. The home used a consistent staff team and did not use agency staff.
“During the inspection, we observed that there were sufficient staff available to meet people's needs.” from the report
Personalised care
Care plans recorded people's needs, choices and preferences. Staff knew people well and reviewed their plans regularly.
“Each person had a personalised plan of care which was regularly reviewed, providing staff with information of how best to support them.” from the report
Kind and respectful staff
People gave positive feedback about staff's kindness and patience. Staff supported people's dignity, individuality and independence.
“People were supported by staff who were kind and caring.” from the report
Good health support
The home worked promptly with health and social care professionals. A GP visited weekly and when needed.
“Staff liaised with other agencies promptly when needed, for example intermediate care team, infection prevention and control team, dietician and diabetic nurse.” from the report
Infection control practice
needs fixingSome staff did not follow the home's infection control guidance, although the manager reminded them of the requirements. Infection control audit compliance was also consistently low.
“However, we observed that some staff were not following this guidance.” from the report
Limited meal choice
minorPeople generally thought the food was good quality, but feedback was mixed about whether it matched their preferences. At the visit there was one main option, with an alternative available if requested.
“There was only one main option served with a choice of mashed potato or chips although we were informed that an alternative would be offered if people asked.” from the report
Activities
minorActivities were organised by care staff, but some people wanted more to do and said requested activities after tea had not yet been introduced.
“Some people told us that they would like more to do.” from the report
Recording and governance
minorFire drill records did not capture all relevant information, provider visits were not recorded and one notification to CQC had been submitted late because of an administrative oversight.
“However, due to an administrative oversight, there had been a delay in submission of a notification, this was addressed, and we have received all notifications as required.” from the report
Privacy in communal areas
minorStaff were heard discussing individuals in a communal area. The manager addressed this with staff during the inspection.
“However, staff were heard discussing individuals in a communal area.” from the report
- 01What changes have you made since the inspection to ensure all staff follow infection prevention and control guidance?
- 02How do residents choose meals, and how do you provide alternatives for people's preferences?
- 03What activities are now available, including after the evening meal?
- 04How do you make sure conversations about residents remain private?
- 05How are fire drills, provider quality visits and regulatory notifications recorded and checked?
This was an unannounced, planned inspection covering all five CQC questions and the overall rating; it followed the previous Good rating from 12 October 2016. This explanation was written from the published report of 14 May 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 Ashfields Care Home
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- September 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 31 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Cheshire East
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 £980 to £1,260 a week. 88 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.