CQC report explained · a residential care home
What the CQC found at Ashgate House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Medicines were not always recorded and administered safely. Inspectors also found gaps in one choking risk assessment and small discrepancies in money records.
- Effective?
- Good
- The report does not give a separate rating or detailed findings for Effective.
- Caring?
- Good
- The report does not give a separate rating for Caring, although inspectors described care as person-centred and observed positive interactions.
- Responsive?
- Good
- The report does not give a separate rating or detailed findings for Responsive.
- Well-led?
- Good
- Inspectors found an open, inclusive and positive culture, clear management roles, regular meetings and systems for monitoring and improving the service.
What inspectors found, November 2023
Rated Good overall, but inspectors found medicines recording and administration were not always safe.
Inspectors visited without notice on 8 November 2023. They spoke with people, relatives and staff, observed care, and checked care records, medicines records, recruitment files and management records.
The home was rated Good overall and Good for being well-led. Inspectors found enough staff, person-centred care, safeguarding systems, suitable recruitment checks and positive relationships between people and staff.
Safe care was rated Requires Improvement. Inspectors found problems with recording medicines, guidance for one as-needed medicine, some money records and one choking risk assessment. They recommended improvements to the recording and administration of medicines.
The last rating was Good, published in June 2018. The inspection was carried out because the home had not been inspected for over five years.
Enough staff
Inspectors found there were enough staff to meet people's needs. Staff were described as unhurried and responsive during the visit.
“There were enough staff working at the service to meet people's needs.” from the report
Person-centred support
Staff understood people's individual needs. Risk assessments were generally detailed and tailored to the people living in the home.
“Risk assessments were person centred around the needs of individuals and staff had a good understanding of people's individual needs.” from the report
Positive culture
People and staff spoke positively about the home. Inspectors found that the provider encouraged an open and inclusive culture.
“The provider promoted a positive culture that was open and inclusive.” from the report
Safeguarding and recruitment
Staff had safeguarding training and understood their responsibilities. Recruitment checks included references, identification and criminal records checks.
“Checks were carried out on prospective staff to help ensure they were suitable to work in a care setting.” from the report
Medicine records
seriousA medicated spray was recorded as given four times in one day instead of three. Guidance for one as-needed medicine explained how to give it but not when.
“on 1 occasion, records showed a medicated spray had been given 4 times in a day when it should have only been given 3 times.” from the report
Choking risk information
seriousOne person's choking risk assessment explained how to reduce the risk but did not say what staff should do if choking happened. Staff had received training and knew what to do.
“However, it did not include information about how to respond if the person did start choking.” from the report
Money records
minorThere was a small difference between the money held and the amount recorded for two people. The manager said a stronger checking process would be introduced.
“for 2 people there was a small discrepancy between the amount of money held and the amount there should have been according to records.” from the report
- 01What changes have been made to medicine recording and administration since the inspection?
- 02How do you now check that as-needed medicine guidance says both how and when the medicine should be given?
- 03Has the choking risk assessment been updated to explain what staff must do if the person starts choking?
- 04How are residents' money and records checked to prevent discrepancies?
- 05How do you monitor that the action from the CQC recommendation has been completed?
This inspection rated Safe and Well-led; the report does not give separate ratings for Effective, Caring or Responsive. This explanation was written from the published report of 30 November 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, June 2018
Rated Good; inspectors found kind, safe and personalised care, with some risk assessments needing simplification.
This was an announced comprehensive inspection on 13 June 2018. Inspectors observed care, checked records and medicines, spoke with people, relatives, staff, managers and health and social care professionals.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, clean surroundings and care that respected people's choices and dignity.
Care plans recorded people's individual needs, preferences and activities. People were supported with food, healthcare, communication and end of life choices. The home had systems for complaints, feedback, audits and learning from incidents.
Some risk assessments included risks that did not exist or stayed rated high after safety measures had been added. The managers recognised that these assessments were too complicated and had started simplifying them. The overall Good rating was unchanged from the previous inspection in May 2015.
People felt safe
People told inspectors they felt safe and trusted the staff supporting them. Relatives also described the home as safe and happy.
“All the people we spoke with indicated they felt safe in their environment and trusted the staff who supported them.” from the report
Safe medicines support
Inspectors checked medicines records for everyone using the home. Administration records were complete, and checks of as-needed medicines matched the amounts recorded.
“We looked at all the medicines administration records (MAR) charts for people using the service and saw these were completed appropriately and there were no gaps in staff signatures.” from the report
Kind and respectful care
Staff were observed speaking clearly, offering choices and explaining care. They were patient, attentive and responded promptly to people's needs.
“Staff displayed a gentle and patient approach throughout the day when caring for people in the home.” from the report
Personalised support
Care plans included people's needs, abilities, preferences and interests. People were supported to choose activities such as cooking, swimming, shopping, music and holidays.
“Each person's care plan was based on their needs, abilities, likes, dislikes and preferences in a range of areas” from the report
Strong oversight
Managers used audits, meetings and action plans to monitor the service. A previous audit had identified missed staff supervisions, and the report said these were brought up to date.
“The registered manager and area manager carried out regular audits.” from the report
Risk assessments needed simplifying
needs fixingSome personal and environmental risk assessments described risks that did not exist or were based on possibilities rather than identified risks. Some remained rated high after measures had been added, so the managers had started simplifying them.
“some risks did not show a reduced rating after measures had been put in place.” from the report
- 01Have the risk assessments been simplified and corrected since the inspection?
- 02How do you make sure a person's risk rating is reduced when safety measures are put in place?
- 03How are people's individual food, health and swallowing needs kept up to date?
- 04How are people involved in reviewing their care plans and choosing activities?
- 05How do you check that staff continue to receive regular supervision and training?
This was an announced comprehensive inspection covering all five CQC questions, and the report says the home was rated Good in each area. This explanation was written from the published report of 26 June 2018 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
3 rated inspections over 8 years: the service has held its Good rating throughout.
- November 2023Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2018Goodstayed GoodSafe: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 22 November 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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Most charge £980 to £1,230 a week. 81 can care for a couple. 11 years' experience on average.
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