CQC report explained · a residential care home
What the CQC found at Ashfields
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some people did not receive medicines as prescribed. Risk assessments and care plans did not always identify risks or set out actions to reduce them.
- Effective?
- Good
- No separate rating was given for Effective in this inspection report.
- Caring?
- Good
- No separate rating was given for Caring in this inspection report. Inspectors did observe respectful, person-centred interactions.
- Responsive?
- Good
- No separate rating was given for Responsive in this inspection report.
- Well-led?
- Requires improvement
- Governance systems had not identified or improved important problems. Care records were not always accurate or up to date.
What inspectors found, April 2022
Ashfields rated Requires Improvement; inspectors found medicines and risk-management problems, alongside caring staff and enough staff.
This was an unannounced inspection on 2 and 3 March 2022. Inspectors spoke with one person, relatives and staff. They reviewed six care records, 22 medication records, audits and staff files.
Inspectors found that some medicines were unavailable, not given as prescribed or not recorded properly. Risk assessments and care plans did not always deal with risks involving nutrition, drinking, skin care and falls. Some staff also did not wear protective equipment correctly.
There were enough staff and recruitment checks had been completed. The home was clean, visiting was supported, and staff were described as kind and respectful. However, management checks had not found or fixed important problems.
The overall rating changed from Good at the previous inspection in 2018 to Requires Improvement. The Safe and Well-led ratings were also Requires Improvement. The report says the provider must send an action plan and that CQC will continue to monitor progress.
Enough staff
Inspectors and staff said staffing levels were enough to meet people's needs. Recruitment checks had also been completed safely.
“Staffing levels are enough to meet people's needs.” from the report
Respectful care
Inspectors saw staff speaking with people in a respectful, person-centred way. The report also described a positive atmosphere.
“Staff interacted with people in a person-centred and respectful manner.” from the report
Clean environment
The home was clean and hygienic, with regular cleaning observed throughout the day.
“The environment was clean and hygienic. Records and our observations showed regular cleaning took place throughout the day.” from the report
Family contact
People were supported to keep in touch with family and friends. Relatives said they could visit when they wanted.
“Staff supported people to continue contact with and maintain relationships with family and friends.” from the report
Medicines were not managed safely
seriousSome medicines were out of stock, records had gaps and some people did not receive medicines as prescribed. Staff did not always respond properly when people refused medicines.
“Medicines had not been managed safely and people were not received their medicines as prescribed.” from the report
Risks were not always controlled
seriousCare planning and monitoring did not always manage risks linked to malnutrition, drinking enough, weight loss, falls and pressure areas.
“Risks to the health and safety of people using the service had not always been assessed, and actions to mitigate risk had not always been taken.” from the report
Management checks were ineffective
seriousAudits had not found the seriousness of the medicines problems. Known issues had remained without a service improvement plan, and some care records were inaccurate or out of date.
“Governance systems in place had not been effective in identifying and improving the quality of the service.” from the report
Protective equipment was not always used correctly
minorInspectors saw some staff wearing personal protective equipment incorrectly. The registered manager said this would be reviewed.
“We identified instances were ppe was not being worn correctly to help minimise the risk of infection.” from the report
- 01How are you making sure every person's medicines are in stock, given correctly and recorded each time?
- 02How do you respond when someone refuses medicines, including medicines given covertly and decisions involving relatives or advocates?
- 03What has changed in the care plans and monitoring for nutrition, fluids, weight loss, falls, skin care and repositioning?
- 04How will your audits identify problems promptly and confirm that agreed actions have been completed?
- 05What training and checks are now in place to make sure staff wear personal protective equipment correctly?
This unannounced inspection took place on 2 and 3 March 2022 in response to concerns about medicines, risks, records and governance, and gave ratings for Safe and Well-led only. This explanation was written from the published report of 12 April 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, February 2021
Ashfields was inspected but not rated; inspectors found good infection control arrangements during the COVID-19 pandemic.
This was a planned, announced inspection on 4 February 2021. It was a targeted inspection focused on infection prevention and control in response to the coronavirus pandemic.
Inspectors were assured that the home managed visitors, shielding, social distancing, admissions, personal protective equipment, testing, cleaning and possible outbreaks appropriately. They also found that the infection prevention and control policy was up to date.
The home had created a visiting pod in the front garden. People had individual visiting plans and risk assessments, and staff, managers and relatives could use a coronavirus helpline. The service was inspected but not rated, so this report does not give an overall quality rating.
Visiting arrangements
The home had built a visiting pod so relatives could see people without entering the home. Individual visiting plans and risk assessments recorded who people wanted to keep in contact with and how to support their wellbeing.
“The service had built a visiting pod in the front garden for visitors to see their relatives who lived in the service.” from the report
Individual plans
People had personal plans for visits and contact with relatives, including how visits could best happen and how their wellbeing could be supported.
“The people who lived in the service had their own visiting plans and risk assessments which included details of who they would like to have visit or keep in contact with” from the report
Support during the pandemic
A coronavirus helpline was available to staff, managers and relatives for questions, advice and guidance.
“Managers, staff and relatives had access to a coronavirus helpline to answer queries, give advice and guidance to support them during the COVID-19 pandemic.” from the report
Cleaning and laundry guidance
The home had detailed procedures to guide staff about cleaning and laundry during possible or confirmed COVID-19 cases.
“There were detailed, easy to follow procedures in place for standards of cleaning and laundry management” from the report
Inspectors raised no specific concerns in this report.
- 01How are the visiting pod and individual visiting plans being used now?
- 02How do you make sure personal protective equipment is used effectively and safely?
- 03How do you arrange testing for people living in the home and staff?
- 04What would happen if there was an infection outbreak, and how would relatives be kept informed?
- 05Can you explain which areas of care were not covered by this focused inspection?
This was a targeted inspection of infection prevention and control, recorded under Safe; the report did not rate the overall service or assess the other key questions. This explanation was written from the published report of 20 February 2021 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
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- April 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- June 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- December 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- March 2012
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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13 live-in carers within about an hour of Norfolk
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 £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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.