CQC report explained · a residential care home
What the CQC found at Ashville House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People felt safe and there were enough staff, with risk assessments and infection control in place. However, recruitment records were incomplete and as-required medicines were not managed or recorded safely.
- Effective?
- Requires improvement
- People received health support and were supported to eat and drink enough, but staff training and supervision were not up to date. Food choices were not always respected.
- Caring?
- Good
- People said staff were kind, patient and respectful. Staff protected privacy and dignity and encouraged people to remain independent.
- Responsive?
- Good
- Care plans were personalised and communication needs were recorded. People were supported with activities, relationships, outings and holidays, and systems were in place to respond to complaints.
- Well-led?
- Requires improvement
- The atmosphere was warm and positive, but management oversight and audits were not effective. Views from people, relatives and staff were not gathered regularly enough to drive improvement.
What inspectors found, February 2024
Rated Requires Improvement; inspectors found kind, personalised care but serious weaknesses in medicines, recruitment, staff training and management checks.
Inspectors made unannounced visits on 7 and 21 December 2023. One inspector spoke with people, staff and a relative, observed care, and checked care, medicines, recruitment, training and management records.
People generally felt safe and said staff were kind, respectful and helpful. Care plans reflected people's needs and preferences. People were supported with activities, outings and health appointments, and the home was clean and accessible.
However, medicines records for as-required medicines were not reliable and there were no clear instructions for when these medicines should be given. Recruitment records were incomplete, and some checks and references were missing or out of date.
Staff training and supervision were not up to date. Management audits did not identify important problems, so the overall rating fell from Good at the previous inspection to Requires Improvement. The provider was asked for an action plan and progress will be monitored.
Kind and respectful staff
People and a relative described staff as kind and caring. Inspectors saw staff treating people with respect and supporting their independence.
“People received care and support from staff who treated them with kindness and respect.” from the report
Personalised care
Care plans recorded people's likes, dislikes, history and support needs. Staff said they had time to read and understand them.
“People's care plans were individual to them and met their needs and choices.” from the report
Support with activities and travel
People took part in activities they enjoyed, including outings and holidays. The home supported one person to have a short break in Paris.
“Other short holidays, day trips and weekly outings were arranged by the home.” from the report
Good health support
The home worked with health professionals and arranged appointments at the home where possible. Staff also helped people who felt anxious about medical appointments.
“The registered manager worked well with health professionals to ensure people received prompt health support.” from the report
Medicines records
seriousThere were no protocols explaining when as-required medicines should be given. Records did not always show why they were given and did not always match the medicine administration chart.
“The systems to manage medicines was not safe and put people at risk of potential harm.” from the report
Recruitment checks
seriousOnly one of four recruitment files checked was complete. Other files had a missing or old criminal records check or missing references.
“The provider was not following safe recruitment practices. This placed people at risk of potential harm.” from the report
Staff training and supervision
seriousSome staff training had expired or was not evidenced, and staff were not receiving regular supervision. Inspectors could not be sure staff had current knowledge for their roles.
“The provider failed to ensure all staff had up to date training and supervision support while they supported people.” from the report
Weak management checks
seriousAudits did not identify problems with medicines, recruitment or staff training. Resident meetings were also not held regularly and staff surveys were not kept up to date.
“Systems to monitor the quality of the service and risk were not effective as they did not ensure a safe service was always being provided to people living at the service.” from the report
Food choices
needs fixingPeople had enough food and drink, but the report found that choices were not always respected. One person was given a different lunch option without this being confirmed beforehand.
“However, during lunchtime we observed people were provided with a different option without asking them.” from the report
Equality and diversity
needs fixingStaff understood people as individuals but did not fully understand equality and diversity, including the risk of discrimination linked to protected characteristics.
“Staff knew to respect people as individuals but not fully aware of equality and diversity” from the report
- 01What changes have you made to the protocols and records for as-required medicines?
- 02How do you now check that every staff member has current criminal records checks and references?
- 03Which staff training and supervision was overdue, and has it now been completed?
- 04How often are medicines, recruitment and training audits now completed, and who checks the results?
- 05How do people and relatives give feedback, and how are their views used to change the service?
This was an unannounced inspection covering all five CQC questions, including the premises and care provided; the previous overall rating was Good in 2018. This explanation was written from the published report of 17 February 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, February 2022
Ashville House was inspected but not rated; inspectors found good infection control, support for activities and family relationships.
This was an announced, targeted inspection on 14 January 2022. Inspectors looked mainly at infection prevention and control, visiting arrangements and whether COVID-19 staffing pressures affected care. They gave the home 24 hours' notice.
The home supported people to stay active during restrictions and to keep in touch with friends and family. Inspectors were assured that infection risks were being managed, including the use of protective equipment, testing, cleaning, visiting and vaccination requirements.
The overall rating was ‘Inspected but not rated’. The Safe question was also inspected but not rated. This was not a full inspection of all five areas of care.
Infection control
Inspectors were assured that the home had measures to prevent and manage infection, including safe use of protective equipment, testing and visits.
“Staff knew and followed national guidance around infection prevention and control which ensured people were safe from the risks of infection.” from the report
Activities during restrictions
People were helped to remain active in creative ways when normal activities were limited by national restrictions.
“People were supported in a creative way to stay active when national restrictions prevented access to their normal range of activities.” from the report
Family contact
The home supported people to maintain relationships with friends and family. One person re-established contact with a family member during the pandemic.
“People were supported to maintain their relationships with friends and family where they wished to do so.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you currently managing any staffing pressures, and what effect have they had on people's care?
- 02How do you support visits from family and friends under your current arrangements?
- 03How do you make sure people can take part in activities that suit them when restrictions affect normal plans?
- 04How are protective equipment, testing and infection control managed now?
- 05What current ratings or inspection information can you provide for the areas that this targeted inspection did not assess?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated and the other care questions were not assessed. This explanation was written from the published report of 9 February 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.
Every inspection of Ashville House
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- February 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- April 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 9 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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