CQC report explained · a nursing home
What the CQC found at Ashtonleigh
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe medicines administration, regular risk assessments and appropriate safeguarding arrangements. Accidents and incidents were reviewed and action was taken to reduce repeat problems.
- Effective?
- Good
- Staff had relevant training and support. People's nutritional, health and communication needs were met, and staff supported people to make choices and receive input from health professionals.
- Caring?
- Good
- People, relatives and a professional described staff as kind and attentive. Inspectors saw positive relationships and found that privacy, dignity, independence, equality and personal choices were promoted.
- Responsive?
- Good
- Care plans reflected people's needs, preferences, life stories and routines. Activities were tailored to individuals, concerns were addressed promptly, and end of life care was described as caring and dignified.
- Well-led?
- Good
- People, relatives, staff and a professional spoke positively about the management team. Regular audits, feedback and development plans gave the managers oversight of the service.
What inspectors found, February 2019
Ashtonleigh was rated Good; inspectors found safe, kind and personalised care, with significant improvements since the previous inspection.
Inspectors visited on 7 and 10 January 2019. The first visit was unannounced. They spoke with people, relatives, staff and a visiting health professional, and reviewed care plans, medicines records, staff files, rotas and other records.
The home was rated Good in all five areas. Inspectors found enough staff, safe medicines practice, suitable risk checks and good safeguarding knowledge. People received support with food, health needs, communication, activities, privacy and dignity.
The home had previously been rated Requires Improvement in October 2017, with one breach of the regulations. Inspectors found significant improvements and said the home was now meeting the regulations. The overall Good rating means inspectors judged the service to be performing well in all five areas at this inspection.
Enough staff
Inspectors found staffing levels were suitable and saw staff respond promptly when people needed help, including at a busy lunchtime.
“We saw there were sufficient numbers of staff to meet the needs of people.” from the report
Kind and respectful care
Staff knew people well and supported their privacy, dignity and independence. Inspectors saw warm, positive relationships between people and staff.
“People's independence, privacy and dignity was continually promoted.” from the report
Personalised support
Care plans included people's preferences, life stories and routines. Activities were chosen around individual interests and past experiences.
“Care plans were tailored to individual's and detailed support needs, preferences, people's life stories and routines.” from the report
Strong oversight
The management team used regular audits, meetings and feedback to monitor care and make improvements.
“Quality assurance systems were robust and any issues identified, well managed.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you make sure there are enough staff at all times, including overnight and during busy periods?
- 02How are staff trained and checked as competent to give my relative's medicines safely?
- 03How often will my relative's care plan be reviewed, and how will relatives be involved if they wish?
- 04Which activities could be adapted to match my relative's interests, history and abilities?
- 05What checks are now used to make sure the improvements identified after the October 2017 inspection are maintained?
This was a planned inspection of the overall service and all five key questions, including care, accommodation and management systems. This explanation was written from the published report of 6 February 2019 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, January 2018
Ashtonleigh was rated Requires Improvement; inspectors found kind and responsive care, but weaknesses in safety checks and management oversight.
This was an unannounced comprehensive inspection on 24 and 26 October 2017. Inspectors observed care, spoke with people, relatives, staff and health professionals, and checked care records, medicines, staff files and safety checks.
The home was rated Good for effective, caring and responsive care. People were treated kindly, supported to make choices, given suitable food and healthcare, and offered activities based on their interests. There were enough staff on duty.
The home was rated Requires Improvement for safe and well-led care. Inspectors found unstable furniture, unsafe water temperatures in some areas, a cluttered laundry and unclear responsibility for insulin administration. The home took immediate action on several issues, but its own checks had not found them.
The overall rating changed from Good at the previous inspection to Requires Improvement. The report says improvements made after the 2015 inspection had been sustained, but new concerns meant further improvement was needed.
Kind relationships
Staff were described as friendly and compassionate. They respected people's lifestyle choices, dignity and independence.
“Staff had built positive relationships with people and supported them to be as independent as they were able.” from the report
Individual care
Care plans included people's needs, preferences, life histories and communication methods. Relatives were involved in reviews.
“People received individual care in accordance with their agreed care plan. Plans were reviewed regularly.” from the report
Enough staff
Inspectors found enough staff to meet people's needs, including at night. People were supported to get up when they wished.
“There were enough staff on duty to meet people's needs.” from the report
Food and healthcare
People had a choice of meals and received support with special diets and swallowing difficulties. Weekly GP visits and visits from community nurses supported access to healthcare.
“People received a well-balanced and nutritious diet.” from the report
Activities and dementia support
The environment was adapted to help people living with dementia find their way around. Activities included music, games, pumpkin carving and trips out.
“The environment was homely and comfortable, and had been adapted to support people living with dementia.” from the report
Safety checks missed risks
seriousAn environmental audit had not found wardrobes that could tip over. Inspectors also found water at some hand basins was hotter than the recommended safe level.
“We toured the building with the provider and identified wardrobes that were unstable and unsecured to the walls which could have been pulled over onto people.” from the report
Insulin responsibility was unclear
seriousInspectors found unclear arrangements for staff training, supervision and accountability when insulin was administered. The situation was clarified after the inspection and no inappropriate administration was found.
“We identified a risk in relation to a lack of clarity over the training and support, monitoring and supervision of staff administering insulin to a person living with diabetes.” from the report
Hydration guidance was incomplete
needs fixingFluid records showed what some people drank but did not state an individual target. Inspectors recommended adding target figures so staff could better judge the risk of poor fluid intake.
“We recommend the registered person ensures where people are at risk of poor fluid intake their care plans record a target figure” from the report
Laundry needed better infection control
needs fixingThe laundry was cluttered and did not clearly separate clean items from potentially contaminated items. It was cleaned and reorganised during the inspection.
“There was no clear separation between clean and potentially contaminated clothing or linens.” from the report
Management systems were not effective enough
seriousThe provider's audits and care planning checks had not identified several of the risks found by inspectors. This resulted in a breach of the good governance regulation.
“Some management or governance systems had not been effective in identifying improvements needed at the service.” from the report
- 01What checks now confirm that wardrobes and other furniture are securely fixed and safe?
- 02Who is accountable for insulin administration, and how are staff training, supervision and competence checked?
- 03How are individual fluid targets recorded and reviewed for people at risk of poor intake?
- 04How is the laundry kept clear and how are clean and potentially contaminated items separated?
- 05What evidence can you show that the Regulation 17 improvement plan was completed and is still working?
This was an unannounced comprehensive inspection covering all five key questions, with visits on 24 and 26 October 2017. This explanation was written from the published report of 17 January 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 Ashtonleigh
3 rated inspections over 4 years: the service has held its Good rating throughout.
- February 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2018Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 24 March 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
28 live-in carers within about an hour of West Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.