CQC report explained · a residential care home
What the CQC found at Ashton Lane
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Medicines records and instructions were not always accurate or complete. Other safety arrangements, including staffing, safeguarding, infection control and managing risks, were generally good.
- Effective?
- Good
- People had detailed, personalised care plans and staff had suitable training and support. People were supported with food, drinks, healthcare and decisions about their care.
- Caring?
- Good
- Staff were patient, warm and respectful. People were supported to make choices and were treated with dignity and privacy.
- Responsive?
- Good
- The home understood people's communication needs and supported their interests, activities, relationships and access to the community. Families were involved in care planning.
- Well-led?
- Requires improvement
- The home had a positive, person-centred culture and supportive leadership. However, its quality assurance system did not identify the medicines record problems.
What inspectors found, March 2024
Ashton Lane is rated Requires Improvement; care was kind and person-centred, but medicines records and quality checks were not reliable enough.
Inspectors visited on 16 and 17 January 2024. They spoke with relatives, staff and health professionals, and reviewed care records, medicines records, staff files and management records.
The home was caring, effective and responsive. People received kind care, had their choices respected, and were supported with activities, communication and access to health services. Staffing levels were safe and the home was clean and well maintained.
The home was not always safe because medicines records and instructions were incomplete or inaccurate. Quality checks had not found these problems. The overall rating and the ratings for Safe and Well-led changed from Good to Requires Improvement.
Kind and respectful care
Inspectors saw a calm atmosphere and staff who treated people with warmth, patience, dignity and respect.
“Staff were patient and used appropriate styles of interaction with people and showed warmth and respect when interacting with people.” from the report
Good communication support
People had individual communication plans, and staff used pictures, objects, gestures and other visual cues to understand and support them.
“People had individual communication plans detailing preferred methods of communication, including the approach to use for different situations.” from the report
Activities and community life
People were supported to choose regular social and leisure activities and to access the local community.
“People were supported to participate in their chosen social and leisure interests on a regular basis.” from the report
Positive culture
Relatives, staff and health professionals gave positive feedback about the home and its person-centred approach.
“There was a very positive person-centred culture at Ashton Lane.” from the report
Medicines records
seriousMedicines records were not always accurate or complete. Instructions for when-needed medicines, variable doses and thickening powder were sometimes missing or not recorded properly, creating risks to people's safety.
“Information to support staff to safely give 'when required' medicines was not always in place.” from the report
Quality checks missed problems
seriousThe home's audits did not identify the medicines record shortfalls. Corrective measures were taken after the inspection, but the quality assurance system was not robust.
“Audits had failed to pick up the shortfalls in medicines records identified during the inspection.” from the report
Missed safeguarding referrals
needs fixingTwo referrals to the CQC had not been made on time and were sent after the inspection.
“Two referrals to CQC had been missed and were sent retrospectively after the inspection.” from the report
- 01What corrective measures have you taken to make all medicines records accurate and up to date?
- 02How do you now record and check when-needed medicines and variable doses?
- 03How do you record thickening powder added to drinks and check that this is done safely?
- 04What changes have you made to your audits so they identify medicines record problems promptly?
- 05How will you ensure safeguarding referrals to the CQC are made on time?
This was a comprehensive inspection covering all five CQC questions, including the premises and care provided, and it included checks of infection prevention and control. This explanation was written from the published report of 28 March 2024 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, November 2018
Ashton Lane was rated Good overall; inspectors found safe, kind and well-managed care, with Outstanding responsiveness.
This was an unannounced inspection on 7 and 9 November 2018. One inspector reviewed care records, medicines, staff files, training, rotas, safety checks, complaints and quality monitoring. They also observed care and spoke with relatives, managers and care staff.
The home supported six people with learning disabilities and complex health needs. Inspectors found safe medicines practice, suitable staffing, detailed care plans and staff with training for complex healthcare needs. People were treated kindly, involved in decisions and supported to stay in contact with family, friends and the community.
The home was rated Outstanding for Responsive care. Inspectors found especially strong personalised support, including help with behaviour, medical appointments, communication, activities, mobility and PEG care. Safe, Effective, Caring and Well-led were each rated Good.
The overall Good rating means the inspection found the home met the relevant standards and provided a good level of care. The rating was unchanged from the previous inspection in February 2016.
Personalised support
Staff adapted support to people's communication, routines, preferences and anxieties. Care plans used accessible formats, including symbols, pictures and easy-read information.
“People's daily routines, communication methods and lifestyle choices were understood by staff.” from the report
Positive behaviour support
A personalised plan helped one person manage behaviour that challenged and reduced incidents. Staff recognised signs of distress and responded quickly.
“Over the last 12 months incidents that challenged staff had greatly reduced.” from the report
Meaningful activities
Activities were varied and adapted to people's interests, abilities and mood. People were supported with outings, holidays, community activities and goals to develop skills.
“The service continued to provide people with a flexible activities programme which responded to their abilities, preferences, choices, moods and well-being.” from the report
Complex healthcare support
Staff were trained and assessed to support complex health needs. Inspectors found detailed guidance for PEG feeding and evidence that staff worked with health professionals.
“A comprehensive workbook was also used to ensure staff had the training and competency to meet the complex healthcare needs of the people living at Ashton Lane effectively.” from the report
Safe care and medicines
Inspectors found medicines were administered safely, staff understood safeguarding procedures and risks were assessed while supporting people's independence.
“Risk assessments had been completed thoroughly to ensure people were able to receive safe care, whilst also ensuring their choices and independence was promoted and maintained.” from the report
Inspectors raised no specific concerns in this report.
- 01How are staff currently trained and checked as competent to support complex needs such as epilepsy, rescue medication and PEG feeding?
- 02How are positive behaviour support plans reviewed, and how do you measure whether incidents or anxiety are reducing?
- 03How would you support my relative to attend medical appointments if they were anxious about hospitals or clinical equipment?
- 04What activities, community visits, holidays and personal goals are available, and how are they matched to each person's interests and abilities?
- 05How do you make care plans and daily choices understandable for people who communicate through pictures, symbols, facial expressions or behaviour?
This was an unannounced inspection covering all five key questions and the overall rating; the report says the ratings carried forward as Good from February 2016, with Responsive rated Outstanding at this inspection. This explanation was written from the published report of 22 November 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 Ashton Lane
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- March 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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