CQC report explained · a residential care home
What the CQC found at Dimensions Somerset Ashbury
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People received medicines safely, risks were assessed and staff numbers were adequate. Staff had training in recognising and reporting abuse, and recruitment checks were in place.
- Effective?
- Good
- People's needs, nutrition and health care were assessed and supported. Staff had relevant induction and training, although inspectors said the home and some bathrooms needed further redecoration.
- Caring?
- Good
- Staff were kind, respectful and knew people well. People and their representatives were involved in day-to-day care, but the home had identified that families were not always involved in care planning.
- Responsive?
- Good
- Care was personalised around people's routines, communication and wishes. Inspectors noted that staff did not actively involve people in some activities, transport restricted some outings and a talking aid was not seen in use.
- Well-led?
- Good
- The acting manager and provider had quality checks and an action plan, and staff felt supported. The registered manager had resigned shortly before the inspection and the acting manager planned to apply for registration.
What inspectors found, September 2019
Rated Good; inspectors found safe, kind and personalised care, but noted limited activities and some home improvements were still needed.
The inspection visit took place on 21 August 2019. One inspector met all seven people living at the home, observed staff, spoke with seven staff members and reviewed care plans, medicine records, meeting records and safety records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were supported by staff who knew them well, received their medicines safely, had their health needs supported and were treated with kindness and dignity.
The inspection also found some areas to improve. The home needed further redecoration, staff did not always involve people in activities, transport arrangements limited some outings and a talking aid was not seen in use. The acting manager was also taking over after the registered manager had resigned.
Safe medicines
Medicines were given by trained staff whose competence had been checked. Records of medicines given or refused were clear, including guidance for medicines given when needed.
“People received their medicines safely from staff who had received training to carry out the task.” from the report
Kind relationships
Inspectors saw friendly interactions and found that people appeared relaxed and comfortable with staff. Staff understood people's individual communication and needs.
“People were supported by staff who were kind and caring.” from the report
Personalised support
Support plans reflected people's wishes and preferred routines. Staff adjusted care when people's needs changed and supported people to make everyday choices.
“People received care and support which took account of their individual needs and wishes.” from the report
Health support
Staff worked with health and social care professionals, supported appointments and recorded information for hospital care. Specialist dietary needs were also followed.
“Staff worked with other professionals to make sure people's needs were met.” from the report
Improvement since last inspection
The home had acted on earlier concerns about medicines records, risk guidance, confidentiality and quality checks. The overall rating improved from Requires Improvement to Good.
“At this inspection this key question has now improved to good.” from the report
Home needs redecoration
minorThe home was reasonably well maintained, but inspectors said more redecoration was needed. The front garden also looked unkempt and unwelcoming.
“People lived in a home which was reasonably well maintained but further re decoration was needed” from the report
Limited activities and outings
needs fixingStaff did not actively involve people in some household activities. The number of staff able to drive the home's vehicle restricted some opportunities to go out.
“Staff socialised with people but did not actively involve them in activities.” from the report
Communication aid not seen
needs fixingOne person had a talking aid, but inspectors did not see it being used. This could have limited that person's opportunity to express themselves.
“One person had a talking aid, but we did not see this in use during the inspection.” from the report
Family involvement
needs fixingThe home had identified that families or representatives were not always involved in care and support planning. The acting manager was contacting families to improve this.
“The provider had identified staff were not always involving people's families or representatives in planning their care and support.” from the report
Change in manager
minorThe registered manager had resigned shortly before the inspection. An acting manager was in post and intended to apply to register with the CQC.
“The registered manager had resigned from their job just before the inspection.” from the report
- 01What progress has been made with the planned redecoration of the home and bathrooms?
- 02How do you now involve people in activities, including helping with everyday tasks such as meal preparation?
- 03How many staff can drive the home's vehicle, and how do you make sure people have enough opportunities to go out?
- 04Is the talking aid now being used regularly, and how are each person's communication methods checked?
- 05How are families and representatives involved in care planning, and has the acting manager applied to register with the CQC?
This inspection covered all five CQC questions and looked at accommodation as well as personal care; people could not fully take part in discussions, so the inspector also observed care and spoke with staff. This explanation was written from the published report of 14 September 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, July 2018
Rated Requires Improvement; inspectors found kind care and good support with communication, but safety, involvement and management needed improvement.
Inspectors visited on 5 and 6 June 2018. This was an announced, comprehensive inspection. They observed care, spoke with staff, relatives and visiting professionals, and checked records including medicines, recruitment, training, complaints, incidents and monitoring.
The home supported seven people with learning disabilities and complex physical disabilities. Inspectors found staff were kind, trained and able to communicate well with people. People had access to health professionals, suitable meals and activities that matched their interests.
However, some important safety records were incomplete. Risk assessments were missing for some known risks, medicines records and staff competency checks were not always complete, and basic hand-washing supplies were missing from three communal toilets. The home also did not consistently involve people or relatives in care decisions, and its systems for checking and improving the service were not effective.
The overall rating was Requires Improvement. Effective and Responsive were rated Good. Safe, Caring and Well-led were rated Requires Improvement. This was the first inspection since the service transferred to Dimensions in April 2017.
Kind staff
Inspectors saw staff treating people warmly and supporting them at their own pace. Relatives also spoke positively about how staff treated people.
“The staff were friendly, cheerful, and encouraging at all times.” from the report
Relevant training
Staff had induction training, completed the Care Certificate when new to care work, and received training linked to people's needs, including epilepsy.
“People were supported by staff who had the appropriate skills, knowledge, and experience to deliver effective care and support.” from the report
Communication
Staff understood people's individual ways of communicating, including signs, pictures, facial expressions and gestures.
“Staff were able to communicate with, and understand each person's request and changing mood as they were aware of people's known communication preferences.” from the report
Activities and interests
Staff supported people to continue hobbies and arrange activities that reflected their wishes, including swimming and a planned activity centre visit.
“The provider carried out person-centred activities and encouraged people to maintain their hobbies and interests.” from the report
Missing risk assessments
seriousStaff had identified some health and safety risks but had not always written clear assessments and management plans. This could leave new or agency staff without the information needed to support people safely.
“New staff coming into the service would not know this key information.” from the report
Medicines records
seriousTwo protocols for medicines given when needed were missing, covert-medicine instructions had not been recorded, and competency checks had not been completed for every staff member giving medicines.
“This meant the provider could not be assured that all staff giving people medicines were safe to do so.” from the report
Infection-control supplies
needs fixingThree communal toilets did not have the signs, soap or hand towels needed for hand washing. The manager acted during the inspection to put this right.
“We found three of the communal toilets did not have hand washing signs, soaps, or hand towels for people to wash their hands.” from the report
Limited involvement in decisions
needs fixingRecords did not show that people or their relatives had been involved in best-interest meetings or care planning when appropriate. This meant care might not reflect the person's preferred choice.
“Records showed that the provider involved care professionals in these meetings but did not involve the person or their family members.” from the report
Weak quality checks
needs fixingThe home's internal monitoring had not identified several shortfalls. There was no clear action plan setting out priorities for improvement at the time of the inspection.
“Current governance arrangements had not consistently identified shortfalls within the service.” from the report
Staffing and outings
needs fixingStaff and a relative said reduced staffing sometimes meant people could not go out during the day. One relative provided regular support for a person's outing.
“Staff told us the current reduction had had an impact on people living at Ashbury because occasionally people could not go out during the day due to staff shortages.” from the report
- 01What risk assessments are now in place for choking, eating safely and other known risks, and how are new or agency staff shown this information?
- 02Have all staff who give medicines completed practical competency checks, and are all 'when required' and covert-medicine protocols up to date?
- 03How are people and their relatives now involved in care planning and best-interest decisions?
- 04What staffing levels are guaranteed each day, and how will you make sure people can attend their usual outings and activities?
- 05What audits and action plans are now used to identify and fix problems in the home?
This was the home's first comprehensive inspection since its transfer to Dimensions; inspectors looked at all five key questions and the overall service. This explanation was written from the published report of 18 July 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 Dimensions Somerset Ashbury
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- April 2017
Registered with the Care Quality Commission on 3 April 2017.
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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76 live-in carers within about two hours of Somerset
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 £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
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