CQC report explained · a nursing home
What the CQC found at Ashgreen House Residential and Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, suitable risk assessments, safe medicines management and appropriate infection prevention measures. People were protected from abuse and avoidable harm.
- Effective?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Inspectors found improved quality checks, accurate records and a management team with good oversight. People, relatives and staff were asked for their views.
What inspectors found, April 2022
Rated Good; inspectors found safer staffing, medicines and management, with improvements since the previous Requires Improvement rating.
This was an unannounced focused inspection on 24 February 2022. Inspectors spoke with 11 people, one relative and 12 staff. They also checked care, risk and medicines records, staff recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safer medicines systems, suitable risk assessments and appropriate infection control. People said they felt safe, and the home was clean.
The previous inspection had found problems with staffing, risk records and quality monitoring. The home had made enough improvement to meet the relevant legal requirements. This inspection only assessed Safe and Well-led, so the other areas were not reviewed during this visit.
Enough staff
Inspectors found enough staff to meet people's needs. Staff said staffing had improved and they no longer felt rushed.
“Staff told us staffing levels had improved and they did not feel rushed when supporting people.” from the report
Safe medicines
Medicines were stored, given and checked safely. Records showed people received medicines as prescribed, with no gaps in the medicine administration records checked.
“Records showed that people were receiving their medicines as prescribed by healthcare professionals.” from the report
Risk management
Risks such as falls, nutrition, skin care and moving and handling were assessed and reviewed. Staff had guidance on how to reduce identified risks.
“Risks to people had been identified, assessed and they had appropriate risk management plans in place to minimise or prevent risks occurring.” from the report
Improved management
The new management team had introduced regular checks covering areas such as care plans, medicines, infection control, safety and staff records.
“The systems and processes in place for monitoring the quality and safety of the service had improved.” from the report
Inspectors raised no specific concerns in this report.
- 01What were the previous problems with staffing, and how do you check that staffing levels remain suitable for my relative's needs?
- 02How will you make sure my relative's risk assessments and care plans are kept up to date as their needs change?
- 03What was the previous rating for Effective, Caring and Responsive, and when will these areas next be reviewed?
- 04How are my relative's cultural preferences, dietary needs, likes and dislikes recorded and followed?
- 05How will you keep relatives informed about visiting, activities, care and any changes in the home?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 23 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, March 2021
Ashgreen House Residential and Nursing Home: Requires Improvement; inspectors found risks from staffing, care records and weak learning from incidents.
This was an unannounced, focused inspection on 26 and 27 January 2021. Inspectors looked at whether people were safe and whether the home was well-led. They spoke with people, relatives and staff, and checked care records, medicines records, staff files and management records.
The home was not always safe. Risk plans and care records did not always give staff the right information, staffing was not always sufficient across the units, and accidents were not always properly investigated. Medicines systems were in place, but some instructions for as-required medicines were unclear and covert medicines were not always reviewed.
The home was not always well-led. Quality checks had failed to identify important problems, staff morale was low, and staff did not feel able to give feedback. There were positive findings about safeguarding, infection control during the COVID-19 pandemic, relatives' meetings and partnership working.
The overall rating fell from Good at the previous inspection to Requires Improvement. The report identified breaches of Regulations 17 and 18, and the CQC said it would monitor the home and return to check progress.
Protection from abuse
Inspectors found that people were protected from abuse. Staff understood how to report concerns, and the provider acted when concerns arose.
“People were protected from the risk of abuse.” from the report
Infection control
Inspectors were assured that infection prevention measures were in place, including safe admissions, testing, use of protective equipment and outbreak management.
“We were assured that the provider was using PPE effectively and safely.” from the report
Medicines records
Although some medicines instructions needed improvement, medicines administration records contained key information and stock checks found no discrepancies.
“Records showed the number of medicines in stock matched with the number of medicines recorded and we found no discrepancies.” from the report
Partnership working
The home worked with the local authority and health and social care professionals to support joined-up care.
“The service worked in partnership with key organisations, including the local authority and other health and social care professionals to provide joined-up care.” from the report
Risk information
seriousRisk plans did not always tell staff what action to take. Records could contradict each other, and recommendations from health professionals were not always added.
“Staff were not always provided with the information they needed to protect people from avoidable harm.” from the report
Staffing levels
seriousStaffing was not always enough across all units. On one unit, people were sometimes left without support when the only staff member collected medicines or food.
“The absence of staff, even for short periods of time, placed people at risk.” from the report
Learning from incidents
seriousFalls and other incidents were not always investigated for underlying causes. The home did not consistently take action to prevent similar events happening again.
“Accidents and incidents were not always investigated or learnt from, to prevent reoccurrence.” from the report
Medicines instructions
needs fixingSome instructions for as-required medicines were unclear, particularly where different doses could be given. Covert medicines were not always reviewed after pharmacist recommendations.
“Protocols for 'as required' medicines (PRN) were inconsistent and did not follow best practise.” from the report
Staff culture
needs fixingStaff morale was low and some staff said they did not feel supported or confident raising concerns. Staff meetings had not been held.
“Staff morale was low.” from the report
Personal preferences
needs fixingCare did not always meet people's individual or cultural needs. Inspectors gave examples involving dietary preferences and a person's preference for a daily shower.
“Care and support was not always planned and delivered to ensure the needs of people from minority and ethnic backgrounds were met.” from the report
- 01What has changed in staffing levels and deployment on each unit since the inspection?
- 02How are risk assessments and care plans checked to make sure they are accurate, consistent and include health professionals' recommendations?
- 03How are falls, incidents and people leaving the home investigated, and how are lessons shared with staff?
- 04What has been changed about as-required and covert medicines, and who now reviews these instructions?
- 05How are staff able to raise concerns, and what regular meetings or forums are now used to hear their views?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 19 March 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 Ashgreen House Residential and Nursing Home
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- April 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Ashgreen House Residential and Nursing Home →
- March 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Ashgreen House Residential and Nursing Home →
- June 2018Goodstayed GoodSafe: GoodWell-led: Good
- January 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 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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