Ashgrove Nursing Home

Updated 24 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was conducted by 1 inspector, a specialist nurse advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Ashgrove Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ashgrove Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. Management of the home was overseen by the area manager. However, a new manager had been in post for 1 day and planned to submit an application to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 3 relatives about their experience of the care provided. 2 visiting professionals also shared their feedback with us. We also spoke with 6 staff, the deputy manager, the new manager, the area manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records, these included 7 people’s care records, medicines administration records and governance and quality assurance records. We also looked at 3 staff recruitment files.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 24 August 2023

About the service

Ashgrove Nursing Home is a nursing home with a residential unit on site, providing personal and nursing care to up to 57 people. The service provides support to older people, younger adults and people living with dementia. At the time of our inspection there were 45 people using the service.

The home accommodates people across 2 separate areas, each of which has separate adapted facilities. One of the areas specialises in providing care to people living with dementia and the other specialises in nursing care and offers support to people leaving hospital.

People’s experience of using this service and what we found

People did not always receive their medicines as prescribed. There were gaps in medicine administration records and staff were unable to confirm if people had received their medicines. Some people did not receive their medicines consistently.

There was an on-going improvement plan to address environmental concerns in relation to infection prevention and control. Governance systems were not always effective in identifying the concerns we found during the inspection in relation to medicines.

People felt safe. Staff knew how to identify and report concerns for people’s safely and wellbeing. Risks were assessed and managed by staff who knew people’s needs. There were enough staff to support people safely and staff had been safely recruited. Where things had gone wrong the management team responded and took learning from events to improve future care.

People’s needs had been assessed and plans developed to ensure staff understood how to support them as individuals. Staff received training relevant to their role and felt supported by the management team. People were supported with eating and drinking to maintain their health and staff worked in partnership with healthcare professionals to ensure people’s needs were met.

Staff sought people’s consent before providing care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with kindness and compassion by a staff team who knew them well. Staff promoted people’s independence and encouraged them to make decisions for themselves.

People’s care was responsive to their changing needs. Information about changes to people’s care was shared with staff so they could provide consistent, timely care and support. People’s communication needs were considered and they were supported to spend time both alone and with others enjoying activities and interests. People and relatives knew how to raise concerns about their care and there was a system in place for the management of complaints.

With the exception of medicines, audits used to monitor the quality of care provided were effective and identified areas of improvement. These were then actioned to ensure lessons were learned and improvements were made. People, relatives and staff felt able to offer feedback about their experiences and spoke positively about the management team. The staff team worked in partnership with other professionals to meet people’s needs and improve the quality of care people received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service under the previous provider was good, published on 24 March 2022.

Why we inspected

The inspection was prompted in part due to concerns received about poor quality care and the home environment. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to the safe management of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.