CQC report explained · a residential care home
What the CQC found at Ashurst House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safer risk management, medicines, recruitment, staffing, fire checks and infection control.
- Effective?
- Good
- This question was not assessed during this focused inspection. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not assessed during this focused inspection. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not assessed during this focused inspection. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- The new management team had created a more open, person-centred culture. Audits, action plans, staff supervision and feedback systems had improved, although daily care notes still needed more detail.
What inspectors found, January 2022
Rated Good; major improvements were found and the home is no longer in special measures, although daily records still need improving.
This was an unannounced focused inspection on 07 December 2021. One inspector spoke with six people, two relatives and six staff. They reviewed care, medicine, recruitment, fire safety and management records, and sought information from health professionals and commissioners.
The home was rated Good for Safe and Well-led. Inspectors found that people felt safe, staff were kind, medicines were managed safely and staffing levels had improved. People were supported to make choices, be more independent and take part in activities outside the home.
The home had previously been rated Inadequate and had been in special measures. The new leadership team had made significant improvements, so the home was no longer Inadequate or in special measures. Inspectors said staff records about people's daily activities and mood still needed to become more informative.
Kind and respectful care
People told inspectors they were happy and fulfilled. Staff supported people's privacy, dignity, choices and independence.
“People told us they were happy and fulfilled at the service and staff were kind and supportive.” from the report
Safer medicines
Medicine reviews, clearer guidance and regular audits had improved safety. Inspectors found that people received their medicines as prescribed.
“Regular medicines audits were completed to identify and address any errors.” from the report
More independence
People were supported to take positive risks and do more for themselves. This included making hot drinks, going out and taking part in holidays and activities.
“People were supported to take positive risks to develop their skills and maintain their independence, such as making hot drinks and going out alone.” from the report
Stronger leadership
The new leadership team had introduced better monitoring, action plans and staff support. People, relatives and staff were asked for their views, and suggestions were acted on.
“Effective action had been taken to improve the service since our last inspection.” from the report
Daily records need more detail
needs fixingSome daily support notes were still focused on tasks rather than recording how people had spent their time or how they felt. Inspectors said this remained an area for improvement.
“They were supporting staff to complete more informative notes, and this remains an area for further improvement.” from the report
- 01How are you making sure daily notes record each person's activities, mood and progress, rather than only completed tasks?
- 02How will you continue checking that medicine guidance and medicine records remain accurate?
- 03How are people involved in decisions about their care, activities and key worker?
- 04How do you monitor staffing levels, including the use of agency staff, at different times of day and night?
- 05What action will you take if safeguarding concerns or incidents happen again?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 1 January 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.
What inspectors found, December 2021
Rated Inadequate and placed in special measures; inspectors found serious risks in safety, staffing, medicines and leadership.
This was an unannounced focused inspection after concerns about medicines and people's care needs. Two inspectors spoke with all eight people living in the home, staff and other professionals. They checked care records, medicines, recruitment files, incidents, safety checks and quality records.
The home was rated Inadequate for Safe and Well-led. Inspectors found people were not always protected from harm, risks were not properly assessed, medicines were not always managed safely and there were not enough staff for people's needs. Records were often incomplete or inaccurate, and concerns raised by people had not been acted on.
The home had no registered manager for 18 months. The provider's checks had not found or fixed important problems. Infection prevention was satisfactory, and some building, equipment and moving-and-handling checks were in place, but these strengths did not outweigh the serious shortfalls.
The previous overall rating was Good, published on 24 May 2019. The overall rating fell to Inadequate after this inspection. The home was placed in special measures and CQC said it would continue monitoring and normally re-inspect within six months.
Infection prevention
Inspectors were assured about infection prevention, including hygiene, protective equipment, testing and visits.
“The service was clean, and people were supported with cleaning, laundry and tidying their rooms.” from the report
Some moving support
For people who needed help to move, assessments and detailed guidance were in place.
“Other risks had been mitigated. For example, when people needed help to move this had been assessed and detailed guidance was in place for staff.” from the report
Some medicines support
People said they received medicines when needed. Administration records and stock balances were accurate at the inspection.
“People told us they received their medicines when they needed them.” from the report
Risks were not controlled
seriousPlans did not adequately manage risks such as pressure ulcers, diabetes, scalding, falls and night-time fire evacuation. People were not properly involved in planning how to take risks safely or build independence.
“The provider had failed to assess and mitigate risks with people, to keep them safe while supporting their independence and development.” from the report
Medicines were unsafe
seriousInstructions for some medicines did not match prescriptions. Guidance for emergency medicine could have caused choking, and storage arrangements were not always safe.
“The provider had failed to ensure service user's medicines were managed safely.” from the report
Not enough staff
seriousStaffing levels did not reliably meet people's needs, especially at night. The provider added staff during and after the inspection.
“There were not enough staff on each shift to meet people's needs and keep them safe.” from the report
Poor records
needs fixingCare records, incident records and risk information were incomplete, inaccurate or not written at the time. Poor Wi-Fi also made electronic records difficult for staff to access.
“Records of the care people received were not accurate, contemporaneous and complete.” from the report
Concerns were not acted on
needs fixingPeople had raised concerns, including about being shouted at, but the manager could not show that effective action had been taken. Relatives, staff and health professionals had not been asked for their views.
“People's views had not been used to improve the service.” from the report
Unsafe recruitment
seriousRequired employment histories and references were missing or inconsistent for some staff, although criminal record checks had been completed.
“The provider failed to operate effective recruitment processes to ensure staff were of good character and had have the qualifications, competence, skills and experience necessary to complete their role.” from the report
- 01What conditions has CQC placed on the registration, and how are you showing that they have been met?
- 02How do you now make sure there are enough staff on every shift, including overnight?
- 03How have you corrected the medicines instructions, emergency medicine guidance and storage arrangements?
- 04How are people's concerns now recorded, investigated and acted on?
- 05How have you improved care plans, risk assessments and incident records so they are accurate and completed at the time?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 8 December 2021 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 Ashurst House
5 rated inspections over 6 years: the service has held its Good rating throughout.
- January 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2021Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- May 2019Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 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.
- November 2010
Registered with the Care Quality Commission on 25 November 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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39 live-in carers within about an hour of Kent
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Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
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