CQC report explained · a nursing home
What the CQC found at Ashgate House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and neglect, risks were assessed, medicines were managed safely, infection controls were in place and enough trained staff were deployed.
- Effective?
- Good
- People's needs and choices were assessed and recorded, staff training and supervision were in place, food and healthcare support were available, and the home worked within the Mental Capacity Act.
- Caring?
- Good
- This question was not inspected during this visit. The report says its previous rating was used to calculate the overall rating, but does not give that rating in this report.
- Responsive?
- Good
- This question was not inspected during this visit. The report says its previous rating was used to calculate the overall rating, but does not give that rating in this report.
- Well-led?
- Good
- Inspectors found visible leadership, accurate care plans, effective audits, improvement plans and systems for learning from incidents. People, relatives and staff were involved and supported to give feedback.
What inspectors found, March 2023
Rated Good and no longer in special measures; inspectors found safe, effective and well-led care, with some medicines and training processes still being improved.
This was an unannounced focused inspection. Inspectors spoke with people, relatives and staff, observed care, and checked care records, medicine records, staff files and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found improvements in safeguarding, risk management, medicines, staffing, care planning, training and management systems. People and relatives described kind staff who knew people well.
The previous inspection had rated the home Inadequate overall and placed it in special measures. The provider had been in breach of several regulations then. Inspectors found the required improvements had been made, so the home was no longer in breach and was no longer in special measures.
This inspection did not cover Caring or Responsive. Their previous ratings were carried forward when calculating the overall Good rating.
Safeguarding and risk management
The home had improved how it recorded and acted on safeguarding incidents. Risk assessments and care plans were updated and staff followed them in practice.
“People were protected from the risk of abuse and neglect.” from the report
Clean and infection-safe environment
Inspectors found effective use of protective equipment, hand hygiene and cleaning checks. Visiting was allowed without restrictions.
“The home was exceptionally clean, and the registered manager completed comprehensive checks to identify any cleanliness issues without delay.” from the report
Respectful care
Staff responded promptly, respected people's choices and anticipated when people needed help, including people who could not ask for assistance.
“People were consistently treated with dignity and respect.” from the report
Leadership and oversight
Inspectors found that management systems had been strengthened. Audits and improvement plans were being used and actions were followed up.
“Quality assurances systems and processes had been fully embedded, and improvements made.” from the report
Medicines stock control
minorThe provider had identified stock-control problems linked to its electronic system. A new medicines process was still being put in place, although inspectors found people received their medicines on time.
“the provider was in the process of changing their medicine's process to ensure these issues were resolved.” from the report
Training not complete for all staff
needs fixingTraining systems were in place, but not every staff member had completed all training at the time of inspection. The report said 88% of staff were fully trained.
“Training records evidenced 88% of staff were fully trained in all areas, remaining staff were in the processes of completing training.” from the report
- 01Have all staff now completed the training that was outstanding at the inspection?
- 02What changes have been made to the electronic medicines system and how do you check that medicines will not run out?
- 03What are the current ratings and findings for Caring and Responsive, which were not covered by this inspection?
- 04How are safeguarding incidents now recorded, reviewed and shared with staff?
- 05How are relatives involved in reviewing and changing care plans?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 8 March 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, November 2022
Ashgate House Care Home is rated Inadequate and is in special measures after inspectors found serious problems with safety, medicines and management.
This was an unannounced focused inspection on 24 May 2022. Three inspectors visited, including one who specialised in medicines. They spoke with people, staff and relatives, and checked care records, training, medicines and management systems.
Inspectors found people were not always protected from abuse or avoidable harm. Medicines were sometimes unavailable, expired or stored unsafely. Risks about wounds, skin conditions, mobility and emergency evacuation were not always properly recorded or managed. Some staff were not up to date with training, and inspectors had to prompt staff to respond to people's needs.
The home had some positive practices. People were supported with food and drinks, healthcare referrals and safe visiting. However, audits and action plans had not found or addressed the problems. The overall rating fell from Good at the previous inspection to Inadequate.
Food and drinks
People received support with eating and drinking. Their care plans recorded the support they needed, and food and fluid records were monitored.
“People were supported to eat and drink a balanced diet.” from the report
Healthcare support
The home made appropriate referrals and worked with other professionals when people needed help with swallowing, choking risks or physiotherapy.
“The service worked in partnership with other professionals such as speech and language therapists to support people to access healthcare when they needed it.” from the report
Safe recruitment
The home followed recruitment checks designed to assess whether staff were suitable for their roles.
“The service followed safe recruitment processes to ensure the staff recruited were suitable for their roles.” from the report
Visiting arrangements
Visits were facilitated safely and in line with people's preferences, with risk assessments and safety measures in place.
“The provider ensured visiting was facilitated safely and in line with people's preference and choice.” from the report
Medicines were not managed safely
seriousSome medicines were not in stock, had expired or were stored in communal areas. Records did not always show why medicines had been changed, and prescribed creams were not consistently recorded.
“People did not always receive their medicines as prescribed.” from the report
Risks and incidents were not followed up
seriousSome abuse incidents were not investigated or reported. Care plans did not always include current wounds, skin conditions, mobility risks or actions after weight loss.
“Actions had not always been taken following incidents to reduce the risk of reoccurrence.” from the report
Staff training and skills
needs fixingNot all staff were up to date with training in areas including moving and handling, safeguarding, end of life care, and fluids and nutrition. Inspectors had to prompt staff to respond to people who needed help.
“There was insufficient numbers of trained staff deployed.” from the report
Dignity and choice
seriousStaff did not consistently follow people's recorded choices or respond when people needed support with their dignity. One person fell after staff did not respond to their request for help.
“People were not consistently treated with dignity and respect.” from the report
Weak management oversight
seriousAudits did not identify important problems with medicines, infection control and records. Action plans did not address all the issues found, and there was no registered manager in post.
“The provider had not always ensured they had adequate oversight of the service.” from the report
- 01What has changed since the inspection to make sure every medicine is available, in date, stored safely and given as prescribed?
- 02How are wounds, skin conditions, falls, unexplained bruises and other incidents now recorded, investigated and followed up?
- 03Which staff training has been completed since the inspection, and how do you check staff are competent before supporting people?
- 04Who is currently managing the home, and when will a registered manager be in post?
- 05How have care plans and emergency evacuation plans been checked and updated for each person?
This was a focused inspection of Safe, Effective and Well-led only; the Caring and Responsive questions were not inspected and no ratings were given for them. This explanation was written from the published report of 25 November 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 Ashgate House Care Home
8 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- March 2023Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2022Inadequatedown from GoodSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- September 2021Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- September 2020Requires improvementup from InadequateSafe: GoodWell-led: Requires improvement
- March 2020Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 8 December 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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