CQC report explained · a residential care home
What the CQC found at Ashton Cross
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were ordered, stored and given safely. Staff numbers were considered sufficient, and individual risk assessments gave clear guidance.
- Effective?
- Good
- Staff had induction training and new staff completed the Care Certificate. Some refresher training for staff supporting people in their own homes was not up to date.
- Caring?
- Good
- People and relatives spoke positively about the staff. Inspectors observed kindness, respect, privacy and positive relationships.
- Responsive?
- Good
- Care plans reflected people's preferences and routines. People had access to activities, education, work and community opportunities, and knew how to complain.
- Well-led?
- Good
- The provider used audits, feedback and governance meetings to monitor the service. However, the audits had not identified that some staff training needed updating.
What inspectors found, May 2018
Ashton Cross rated Good; inspectors found safe, respectful care, but some staff refresher training was not up to date.
Inspectors visited on 14 and 23 March 2018. The first visit was unannounced and the second was announced. They spoke with people, relatives, staff and a healthcare professional. They also checked care plans, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people received their medicines safely, had enough staff support and had individual care plans and risk assessments.
People were treated with kindness and respect. They were supported to make choices, keep healthy, take part in activities and stay involved in the community. The home had systems to handle complaints and monitor its quality.
At the previous inspection in November 2016, the home had breached Regulation 12 because people's personal safety was not protected. Inspectors found that the required improvements had been made. Some refresher training for staff supporting people in their own homes still needed updating.
Safe medicines support
Inspectors found that medicines were handled safely. Records were complete and checks were carried out.
“Medicines were ordered, stored, administered and disposed of in accordance with good practice guidelines.” from the report
Kind and respectful care
People were treated with dignity and kindness. Staff knew people's histories, preferences and communication needs.
“People told us and we saw that staff treated them with respect and kindness.” from the report
Personalised activities
People could choose from a wide range of activities, education, volunteering and community opportunities.
“This meant people had access to a wide variety of purposeful activities of their choice.” from the report
Quality monitoring
The provider used audits, feedback and governance meetings to identify actions and improvements.
“The registered provider had comprehensive audit systems in place that had identified areas for development and improvement.” from the report
Refresher training
needs fixingSome staff supporting people in their own homes had not completed all required refresher training. The provider gave inspectors a plan to bring training up to date by June 2018.
“However, staff who worked to support people to live in their own homes were not all up to date with their refresher training.” from the report
- 01Has all refresher training for staff supporting people in their own homes now been completed?
- 02How do you check that staff remain competent when their training needs updating?
- 03Who is leading the home when the registered manager is absent?
- 04How are individual risk assessments reviewed when a person's needs or risks change?
- 05How are people's views and complaints used to make further improvements?
This was a comprehensive inspection covering all five questions and both the residential homes and the domiciliary care service. This explanation was written from the published report of 25 May 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.
What inspectors found, March 2017
Ashton Cross was rated Requires Improvement; inspectors found kind, person-centred care but safety and management checks were not reliable enough.
The inspection was unannounced and took place on 17 and 24 November 2016. One inspector spoke with four people, staff and managers, observed care, looked around both homes and checked care, staffing and management records.
People generally received personalised care from staff who knew them well. Inspectors rated the home Good for effective, caring and responsive care. Medicines, staffing, training, food, activities, dignity and complaints arrangements were also found to be good.
The home was not always safe. Risk assessments had not identified the need for window restrictors, and the front doors were left open during both inspection days. Management audits had not found these risks, and the home had not promptly notified CQC about its temporary closure for refurbishment and the relocation plan.
The overall rating Requires Improvement means the home was not failing in every area, but important safety and management improvements were needed. The report says the provider breached Regulation 17 on good governance.
Kind and familiar staff
Staff knew people well and inspectors saw warm, reassuring interactions. People spoke positively about the support they received.
“Staff had a good knowledge and understanding of people. Staff had spent a lot of time getting to know people and to understand the best way to support them.” from the report
Personalised support
Care plans included people's choices, needs, goals and communication methods. People were involved in developing their own plans where possible.
“Care plans reflected people's individual needs, choices and preferences and gave guidance to staff on how to make sure personalised care was provided.” from the report
Safe medicines support
Inspectors found medicines records accurate and up to date. Staff had been trained and assessed as competent to administer medicines.
“We saw that MAR sheets were correct and up to date, with people's photographs on them, this helped to avoid any potential errors.” from the report
Choice and meaningful activity
People were supported to choose activities, maintain hobbies and build independence. The home also supported links with the local community.
“People were supported to take part in activities of their choice and encouraged to maintain hobbies and interests.” from the report
Window and door safety
seriousWindow restrictors on first-floor windows were missing or did not prevent the windows opening far enough. Front doors were left open, meaning uninvited people could enter.
“Risk assessments had not identified the need for window restrictors on the first floor of the buildings or the necessity for security on the front doors.” from the report
Weak safety audits
seriousThe provider's health and safety audits had not identified the risks found by inspectors. This left people at significant risk and contributed to the Regulation 17 breach.
“The registered provider's audit systems had not identified areas of risk within the service as highlighted within the safe domain.” from the report
Missed notifications to CQC
seriousThe service did not promptly tell CQC about its closure for refurbishment and its plan for safely relocating people. This was part of the Regulation 17 breach.
“The service had closed for refurbishment and had not informed us ahead of this happening with a plan for the safe relocation of people living at the service.” from the report
Supervision had not restarted
needs fixingStaff had not received regular supervision or appraisals when inspectors visited. Management said these would restart after the home reopened.
“Records showed that staff had not received regular supervision or appraisals from the management team.” from the report
- 01Have suitable window restrictors now been fitted to all windows where people's risk assessments require them?
- 02What security arrangements are now used at the front doors, and how is entry by uninvited people prevented?
- 03How do your current safety audits identify risks such as windows, doors and other hazards in the buildings?
- 04Have regular staff supervision and appraisals restarted, and how often are they completed?
- 05What is the current position on the outstanding Deprivation of Liberty Safeguards applications mentioned in the report?
This was an unannounced comprehensive inspection of the overall service, covering all five key questions, with records checked for three people. This explanation was written from the published report of 11 March 2017 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 Ashton Cross
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- May 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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