CQC report explained · a nursing home
What the CQC found at Ashton Manor Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2018
Rated Good; inspectors found safe, kind and personalised care, and said earlier medicines and infection control problems had been addressed.
The inspection was unannounced and took place on 4 September 2018. Inspectors spoke with people living at the home, relatives and staff. They reviewed care plans, medicines records, risk assessments, mental capacity records, audits and other management documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, clean surroundings, suitable training and good support for people's health and dietary needs.
People were described as receiving kind, respectful and personalised care. Staff knew people's preferences and backgrounds, supported independence, offered activities and handled complaints. The previous inspection in July 2017 had found a breach about medicines and infection control, but inspectors said the provider had taken action to meet the legal requirements.
Medicines were managed safely
Nurses were trained and assessed as competent. Records checked by inspectors were accurate, with no gaps, and medicines audits were carried out frequently.
“The MARs seen were accurate, with no gaps.” from the report
Kind and respectful care
Inspectors observed warm interactions, with staff offering choices and protecting people's privacy and dignity.
“During the inspection, we saw pleasant caring interactions between people and staff.” from the report
Personalised care planning
Care plans recorded people's routines, preferences and what mattered to them. Staff used this information in day-to-day care.
“Care was planned and delivered in a person-centred way.” from the report
Good health and nutrition support
Staff monitored people's health, weight and dietary needs and involved healthcare professionals when required.
“People's clinical needs were met and staff supported people to access healthcare professionals.” from the report
Strong quality checks
Management carried out several audits and used action plans to follow up issues and record when improvements were completed.
“The provider regularly checked and monitored the quality of the care that people received.” from the report
Some people reported waiting at busy times
minorOne person said staff could be rushed and that they sometimes had to wait. Inspectors told the manager and found no evidence of long wait times, but this is worth discussing if timely help is important.
“We received feedback from one person that staff were rushed and they sometimes had to wait at busier times.” from the report
- 01How many staff are usually available during the busiest times, and how do you respond if people have to wait?
- 02What are the current call bell response times, and how are urgent and non-urgent calls monitored?
- 03What changes were made after the July 2017 problems with medicines and infection control?
- 04How do you make sure care plans continue to reflect each person's routines, preferences and changing needs?
- 05How are people's weight, infections, falls and pressure care monitored and acted on?
This was an unannounced inspection covering all five CQC questions and the overall rating; it also checked whether action had been taken after the July 2017 breach about medicines and infection control. This explanation was written from the published report of 11 October 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, October 2017
Rated Requires Improvement; inspectors found kind, person-centred care but safety and quality checks were not consistently reliable.
The unannounced inspection took place on 25 July 2017. Inspectors spoke with people, relatives, staff and healthcare professionals. They reviewed care plans, medicines records, accident records, staff files and quality checks.
The home was rated Good for Effective, Caring and Responsive. People generally received kind care, suitable food, support with healthcare and activities that matched their interests. Care plans reflected people's needs and preferences.
The home was rated Requires Improvement for Safe and Well-led. Inspectors found unsafe storage of thickener, equipment shared between people without cleaning between uses, and unsafe practice when one medicine was being given. Audits had not identified some of these problems. The provider acted on the individual concerns after the inspection, but CQC required further action to make risk management more reliable.
Kind and respectful care
Inspectors saw warm interactions. Staff explained what they were doing, encouraged independence and protected people's privacy and dignity.
“During the inspection we observed kind and pleasant interactions between people and staff.” from the report
Personalised care
Care plans included people's routines, interests, preferences and goals. Staff could explain how they supported people in line with these plans.
“People's care plans were person-centred and reflected what was important to them, as well as their needs and goals.” from the report
Food and healthcare
People's dietary needs and preferences were recorded and met. Staff worked with doctors and other healthcare professionals when people needed support.
“People were served food that matched their preferences.” from the report
Activities and involvement
People could take part in exercises, quizzes, entertainers and creative activities. People and relatives were involved in decisions about the home.
“People had access to a range of activities that suited their needs and interests.” from the report
Unsafe storage and equipment sharing
seriousThickener could be reached by people living with dementia. Toilet slings were shared between people without cleaning between uses, increasing the risk of infection.
“People had been living in an environment in which the risk of infections spreading was increased due to the sharing of slings.” from the report
Unsafe medicine practice
seriousA nurse began to override the electronic system to give an as-required pain medicine before it was due. The medicine was not given after inspectors questioned this.
“People's medicines were not always administered safely.” from the report
Weak quality checks
needs fixingAudits were regular but had not picked up several important problems, including thickener storage and staffing pressures. CQC required further action so risks would be identified more proactively.
“However, they were not always effective as we identified concerns that had not been picked up by audits.” from the report
Staff stretched at busy times
needs fixingThere were enough staff to meet people's needs on the inspection day, but staff appeared rushed around lunchtime. The provider was changing staff deployment and introducing extra lunchtime roles.
“However we did note that staff were stretched and busy at certain times of day.” from the report
Communication information
minorInspectors found one occasion when agreed communication methods for a person with complex needs were not followed. They recommended that the home improve how this information is shared with staff.
“We recommended that the provider reviews their system for updating staff on people's communication needs.” from the report
- 01How is thickener now stored, and how do you stop people from accessing it?
- 02Does each person have their own hoist sling, or how are slings cleaned between uses?
- 03What checks make sure staff cannot give an as-required medicine before it is due?
- 04What staffing changes were made at lunchtime, and are staff still rushed at busy times?
- 05How do your audits now identify problems with medicines, equipment, thickener storage and staffing?
This was an unannounced inspection of the overall service and all five key questions, prompted partly by concerns about an incident, falls and another person's care. This explanation was written from the published report of 4 October 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 Manor Nursing Home
3 rated inspections over 2 years: the service has held its Good rating throughout.
- October 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 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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