CQC report explained · a residential care home
What the CQC found at Ashlands Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2023
Rated Requires Improvement; fire evacuation planning and governance were not safe enough, although care had improved and special measures ended.
This was an unannounced follow-up inspection on 14 and 15 March 2023. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicine, staffing and management records.
The main safety concern was fire evacuation. The fire risk assessment was out of date, some evacuation plans did not match people's current needs, and staff were not confident about evacuating people at night. The provider took immediate action during the inspection.
Inspectors also found that management checks had not identified important risks or inaccurate care information. The home was still in breach of the rules on safe care and treatment and good governance.
There had been clear improvements since the previous Inadequate rating. Care was kinder and more respectful, medicines were managed safely, and staff support, food, healthcare and consent were rated Good. The home was no longer in special measures, but CQC will continue to monitor its progress.
Kind and respectful care
Inspectors saw staff supporting people patiently and protecting their privacy and dignity. This was a clear improvement since the previous inspection.
“We saw people being supported by staff who treated people in a respectful and dignified way and helped them with patience and kindness.” from the report
Safe medicines
Medicines were stored, administered and recorded safely overall. Staff were trained and had their competence checked.
“People received their prescribed medicines safely. Medicines were managed and stored safely.” from the report
Food and healthcare
People had varied food, including options for special diets, and staff supported them to access health professionals when needed.
“People were supported and encouraged to have a varied diet that gave them enough to eat and drink.” from the report
Improving care records
Electronic records had improved access to information and care plans were more detailed and based on people's preferences.
“Staff said this enabled them to have quick access to the most up to date information about people's care needs.” from the report
Fire evacuation risks
seriousThe fire risk assessment was out of date and some evacuation plans did not accurately describe the help people needed. Staff were not confident they could evacuate everyone safely at night.
“Staff did not feel confident that they could safely evacuate people at night, given their level of training, numbers of staff on night shift and the varying levels of support people were assessed as needing.” from the report
Weak management checks
seriousAudits did not identify inaccurate care information or the out-of-date fire risk assessment. This meant managers could not be sure that people would receive the right level of care.
“Although the provider had a range of checks and audits in place, these were not always effective at identifying areas which needed improvement.” from the report
Night staffing assurance
needs fixingThe provider could not show that night staffing levels were sufficient for a safe emergency evacuation. CQC recommended improving how staffing levels were assessed.
“The provider could not assure themselves that there were sufficient staff to keep people safe at night.” from the report
Noise in communal areas
minorThe open layout could make communal areas noisy, making it harder for some people to hear conversations or follow activities. CQC recommended consulting people about ways to reduce the noise.
“This meant some people had difficulty following the individual activity they wished to be part of.” from the report
- 01Can you show us the current fire risk assessment and each person's updated evacuation plan?
- 02How would you evacuate residents safely at night, and how do you decide whether enough night staff are on duty?
- 03How do managers check that care records contain consistent and up-to-date information?
- 04Which staff have not yet completed mandatory training, and when will this be completed?
- 05What changes have been made to reduce noise in communal areas and how have residents' views been collected?
This was an unannounced follow-up inspection after a previous Inadequate rating; it examined safety, infection control and management improvements, and the report says any key questions not inspected used ratings from the previous inspection. This explanation was written from the published report of 17 May 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, December 2022
Rated Inadequate and placed in special measures; inspectors found serious risks to safety, care, dignity and leadership.
This was an unannounced inspection after concerns about care quality and safeguarding investigations. Inspectors visited on 25 and 26 October 2022. They spoke with people, relatives, staff and managers, observed care, and checked care, medicine, staffing and management records.
The home was rated Inadequate for Safe, Effective, Caring and Well-led. Inspectors found unsafe care plans, poor safeguarding arrangements, too few staff, weak infection control, gaps in staff training and problems with food, healthcare and consent. People were not always treated with dignity or given meaningful choices.
The home had been rated Requires improvement at the previous inspection and had received that rating for five consecutive inspections. The provider remained in breach of regulations. The home was placed in special measures, with CQC saying it would monitor progress and usually reinspect within six months.
Medicines
Inspectors found that medicines were generally managed, given and recorded safely. Staff had medicines training and competency checks.
“Medicines were managed and stored safely. There was a system in place to ensure people were offered their medication as prescribed.” from the report
Personalised rooms
People could help choose how their personal spaces were decorated. The building also had some adaptations for mobility needs.
“People were encouraged to make choices about decorating their personal space, and their bedrooms were personalised.” from the report
Hope for improvement
Staff and relatives spoke positively about the new manager, although the report also recorded that they wanted improvements to happen quickly.
“Staff told us they had not felt well supported to carry out their roles. However, they spoke positively about the new manager” from the report
Unsafe care planning
seriousCare plans did not reflect people's current needs. This included risks relating to skin damage, catheter care and serious health conditions.
“Risk assessments and care plans were not accurate and did not reflect people's current needs.” from the report
Safeguarding failures
seriousFive safeguarding investigations in the previous three months found abuse was substantiated. The provider had not put recommendations into practice or shared learning with staff.
“Five local authority safeguarding investigations in the last three months concluded that abuse was substantiated” from the report
Too few staff
seriousOn one morning, two care staff and one senior staff member were supporting 20 people with personal care. Inspectors also found unsafe recruitment checks and training gaps.
“There were not enough staff to keep people safe.” from the report
Poor infection control
seriousStaff did not consistently follow handwashing, waste disposal or protective equipment guidance. Some kitchen equipment and therapy dolls were dirty.
“All this put people at risk of acquiring and transmitting infections.” from the report
Dignity and choice
seriousInspectors heard undignified language and saw task-focused care. People were not always offered meaningful choices about meals or who provided intimate care.
“People were not consistently treated with dignity and respect.” from the report
Weak leadership and checks
seriousAudits did not find problems, previous concerns had not been resolved, and feedback was not used to improve care. The home had no registered manager at the time of the inspection.
“The service was not well led. People were put at risk because the provider failed to ensure suitable quality assurance checks were in place to identify issues with care and support.” from the report
- 01What has been done to ensure care plans and risk assessments are accurate and reflect each person's current needs?
- 02How are staffing levels being calculated, and what happens when a member of staff is absent?
- 03What action has been taken after the five safeguarding investigations, and how is learning shared with staff?
- 04Which staff have completed first aid, medicines and infection control training, and how is their practice checked?
- 05How are people now involved in decisions about meals, intimate personal care, consent and reviews of their care?
This was a focused inspection of Safe, Effective and Well-led, with Caring added on the first day; the report says ratings for key questions not inspected were carried over from the previous inspection. This explanation was written from the published report of 31 December 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 Ashlands Care Home
7 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- May 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2022Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateWell-led: Inadequate
- September 2021Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodWell-led: Requires improvement
- July 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 January 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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