Archived: Ascot Nursing Home - Hartlepool

Following an inspection in November 2013, the provider was required to make improvements to a number of regulations. As part of our regulatory response we issued the provider with notices detailing how and why they were breaching these regulations. We carried out further inspections in January and February 2014 and found that improvements had not been made.

During this inspection we found that people's needs were not fully assessed. Care and treatment was not planned and delivered in a way that ensured people's safety and welfare. Staff did not always seeking the advice of other healthcare professionals or follow their guidance.

People said, "Staff are very kind to me and look after me well" and "They are ok but they don't have a good home here. The staff don't explain anything, I would rate them 50/50."

There were not enough qualified, skilled, suitably trained and experienced staff to meet people's needs. The recruitment process was not effective. Staff had not had the training necessary to deliver treatment to an appropriate standard.

The system to regularly assess and monitor the quality of service that people received was not effective and care records were not accurate.

The continued breaches led us to continue to take further regulatory actions.

Following an inspection in November 2013, we found that the provider was required to make improvements to a number of regulations. As part of our regulatory response we issued the provider with notices setting out how and why they were breaching these regulations. When we carried out a further inspection in January 2014 we found that the improvements had not been made.

During the inspection we found that people's needs were not fully assessed. Care and treatment was not planned and delivered in a way that ensured people's safety and welfare. Staff did not always seeking the advice of others healthcare professionals or follow their guidance.

People said, 'The staff are kind and helpful' and 'If you want anything you only have to ask.'

Care records were not accurate.

There were not enough qualified, skilled, suitably trained and experienced staff to meet people's needs. The recruitment process was not effective. Staff had not had the training necessary to deliver treatment to an appropriate standard.

The provider did not have an effective system to regularly assess and monitor the quality of service that people received.

The continued breaches and failings across the service provision led to us to continue to take further regulatory actions.

Following an inspection in November 2013, we found that the provider was required to make improvements to a number of regulations. As part of our regulatory response we issued the provider with notices setting out how and why they were breaching the regulations. We review what improvements had been carried out during our inspection in January 2014 and found the home remained non-compliant.

We found at the inspection in January 2014 that warning notices issued following previous inspections were not met. We are taking action away from this process to address this.

We completed this inspection following concerns being raised around the nursing staff competency to ensure specialist dietary needs were met and that medicines were managed appropriately. We found that the provider was not protecting people against the risks of receiving inadequate nutrition and hydration for their needs.

Following an inspection in November 2013, we found that the provider was required to make improvements to a number of regulations. As part of our regulatory response we issued the provider with notices setting out how and why they were breaching the regulations. We asked the provider to make improvements and carried out this inspection to assess the actions that had been taken to achieve compliance.

We found that care and treatment was not planned in a way that was intended to ensure people's safety and welfare. People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

The provider had developed a system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others. At the time of the inspection we were unable to assess the effectiveness of the systems that had been designed.

We also found that where people did not have the capacity to consent, the provider failed to act in accordance with legal requirements.

As we carried out the inspection out of normal hour's most of the people who lived at the home were asleep, we spoke with two people at breakfast time. They told us that they were well and that they were happy.

During our visit we found that the home did not have a registered manager in post. We are taking regulatory action, away from this inspection, to follow this up.

We found that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were not cared for in a clean, hygienic environment.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

During the inspection we spoke with the the provider and management team, five members of staff and a visiting professional. Staff told us, 'It has been challenging lately and I think they are aware of things that need to improve.' Another said, 'As a team we support each other, we work well together.'

We also spoke with one relative and a number of people who were living at the home. Overall people were happy with the care delivered by the home.

We found that care and treatment was not planned and delivered in a way that was intended to ensure people's safety and welfare. People's health, safety and welfare was not protected when more than one provider was involved in their care and treatment, or when they moved between different services. People were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.

There were not enough qualified, skilled and experienced staff to meet people's needs and people were cared for by staff who were not supported to deliver care and treatment safely and to an appropriate standard.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive.

People who lived at Ascot Nursing Home received care which had been planned and risk assessed and on the whole met their needs. Best interest decisions and deprivation of liberty only took place after involvement of appropriate people and after risk assessments had taken place.

Staff were aware of safeguarding for vulnerable adults and their responsibilities and people and relatives felt that care was delivered in a safe environment.

Historically, some pre employment checks had not been carried out, however, Criminal Record Bureau checks were present for all staff and a new recruitment method had been introduced to improve the recruitment procedure.

Records produced and held within the service contained enough information to ensure that people received care and support which met their needs and ensured their safety.