CQC report explained · a nursing home
What the CQC found at Ashgrove Care Home - London
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, April 2023
Rated Requires Improvement; inspectors found kind care and enough staff, but safety checks, cleanliness and records were not consistently reliable.
This was an unannounced focused inspection on 7 and 8 March 2023. Inspectors spoke with people, a relative and staff, observed care, and checked care, medicines, recruitment and management records.
The home had enough staff and people generally said they felt safe and were treated with kindness and respect. Medicines, healthcare, activities, complaints and infection prevention arrangements were mostly managed well.
However, two unlocked bathrooms contained tools and had wet floors. The kitchen was unclean. Some care and monitoring records were incomplete or not person-centred. The overall rating remained Requires Improvement, meaning some aspects were not reliable and there was limited assurance about safety.
Enough staff
Inspectors found enough staff to meet people's needs and saw staff respond promptly. Recruitment checks had also been completed.
“There were enough staff on duty to meet the needs of the people who used the service.” from the report
Kind and respectful care
People described staff positively, and inspectors saw staff explain care, offer choices and treat people respectfully.
“Throughout our visit, we saw staff were respectful and kind in their approach to people.” from the report
Medicines
People received their medicines as prescribed. Storage, training and administration were checked and were generally safe.
“People received their medicines safely and as prescribed.” from the report
Healthcare and nutrition
People's healthcare and nutritional needs were met, with support to access professionals and attend appointments.
“People were supported to access healthcare professionals and to attend appointments as needed.” from the report
Complaints handled
Complaints were recorded, investigated and addressed in line with the home's procedures.
“Complaints were recorded and addressed in a timely manner.” from the report
Unsafe bathrooms
seriousTwo bathrooms were left unlocked while maintenance work was taking place. Tools, stored items and water on the floor created slip and trip hazards.
“There were stored mobility items, tools scattered around and a large amount of water on the floor. These were slip and trip hazards.” from the report
Kitchen cleanliness
seriousThe kitchen had food stains, spillages, dirt and unclean equipment. Cleaning records and audits had not identified the problems.
“We found the kitchen was unclean. For example, there were dried food stains in the fridge and freezer and spillages of food in areas of the kitchen.” from the report
Inconsistent records
seriousSome care records and behaviour records were incomplete, unclear or used language that was not person-centred. Some monitoring charts also had gaps.
“People's records were not always completed correctly, appropriately and in a person-centred way.” from the report
Communication
needs fixingSome people said some staff did not communicate well with them or spoke in a way they could not understand. The provider was recommended to seek guidance.
“Some people told us some of the staff did not communicate well with them.” from the report
Weak quality checks
seriousManagement checks had not reliably found or dealt with problems in the kitchen, bathrooms and records. This meant there was not enough assurance that improvements were being maintained.
“The provider's monitoring systems had not identified and addressed that people's records were not always completed correctly, written in a person-centred way and the language staff used was not always respectful.” from the report
- 01What has been done since the inspection to keep maintenance areas locked and free from wet floors, tools and stored items?
- 02Can you show how the kitchen is now cleaned and how managers check that cleaning has really been completed?
- 03How are care records, repositioning charts and behaviour records checked for accuracy and person-centred language?
- 04What support or training are staff receiving to meet people's communication needs?
- 05Who is currently managing the home, and what arrangements are in place while a new registered manager is recruited?
This was a focused inspection of Safe, Responsive and Well-led; the other key question ratings were carried forward from the previous inspection and were not inspected during this visit. This explanation was written from the published report of 14 April 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, March 2022
Ashgrove Care Home - London was rated Requires Improvement; inspectors found avoidable safety risks, inaccurate care records and weak oversight.
This was an unannounced focused inspection on 22 and 23 February 2022. Inspectors spoke with people, relatives and staff, and reviewed care plans, medicines records, staff files and management records.
The home was not always safe. Staff did not always follow risk plans, some care information was wrong or out of date, and some health checks had been recorded in advance. Inspectors could not be sure that people were always monitored properly.
People generally said staff were kind and that they felt safe. Medicines were managed safely, staffing levels were sufficient, and activities were available. However, the home did not always provide personalised care, deal with complaints fully or identify problems through its checks.
The overall rating changed from Good at the previous inspection to Requires Improvement. The home was rated Requires Improvement for Safe, Responsive and Well-led. Caring and Effective were not inspected during this visit, so their previous ratings were used when calculating the overall rating.
Enough staff
Inspectors found enough staff on duty to support people. Recruitment checks were also completed before staff started work.
“On both days of our inspection, there were enough staff on duty to care for and support people.” from the report
Medicines
Medicines were given as prescribed and records and stock checks were consistent. Controlled medicines were stored and recorded correctly.
“People who used the service received their medicines safely and as prescribed.” from the report
Kind staff
People gave positive feedback about staff. Inspectors saw staff speak gently, offer choices and respond to people's needs.
“During the inspection, we saw staff were responsive to people's needs, and communicated with them in a gentle and kind manner and gave them choice.” from the report
Activities
The home provided a range of activities, including music, games, art and exercises. People were encouraged to take part.
“On the day of our inspection, we saw staff organising a variety of activities and encouraging people to take part.” from the report
Risks were not managed consistently
seriousStaff did not always follow risk plans. Inspectors found unsafe footwear, the wrong hoist being used, and concerns about falls, nutrition and health monitoring.
“People who used the service were not always protected from the risk of avoidable harm.” from the report
Care records were inaccurate or out of date
seriousSome care plans contained incorrect information or had not been updated when people's needs changed or professionals gave new advice. This could lead to care not matching people's needs and preferences.
“Care plans were not always updated when people's needs changed or when there were new instructions from healthcare professionals.” from the report
People's choices were not always reflected
needs fixingInspectors could not be sure that people who could not communicate verbally were supported to choose when to sleep. Relatives also said they were not always involved in care planning.
“We could not be sure how the staff decided that people should be in bed where they could not communicate their choice and preferences verbally.” from the report
Complaints were not fully answered
needs fixingSome relatives felt their concerns had not been handled properly. One complaint had been partly investigated but other concerns raised were not investigated.
“Therefore the complainant did not receive a full response to their complaint.” from the report
Management checks missed problems
seriousAudits did not identify inaccurate care plans, incomplete checks or records written in advance. Concerns found by the local authority were not properly escalated.
“The provider's systems to communicate information and escalate concerns internally had not always been operated effectively.” from the report
Some kitchen cleaning needed improvement
minorThe ground floor staff kitchenette was not cleaned thoroughly enough, and a fridge vent upstairs had not been cleaned.
“However, we found the ground floor kitchenette used by the staff to serve meals and drinks was not cleaned robustly enough.” from the report
- 01What has changed since the inspection to make sure staff follow each person's moving, falls and equipment risk plans?
- 02How do you check that care plans are accurate and updated promptly after a person's needs change or a health professional gives advice?
- 03How are nutrition, fluid intake and blood glucose checks recorded now, and who checks that the records are completed at the right time?
- 04How will relatives be involved in care planning, including decisions about bedtime and daily routines?
- 05How are complaints investigated now, and how do you make sure every part of a complaint receives a full response?
This was a focused inspection of Safe, Responsive and Well-led, including infection prevention and control; Caring and Effective were not inspected and their previous ratings carried over. This explanation was written from the published report of 31 March 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 Ashgrove Care Home - London
6 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2022Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2021GoodSafe: GoodResponsive: GoodWell-led: Good
- January 2021Inspected but not ratedSafe: Inspected but not rated
- February 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 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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