Ashley Gardens Care Centre

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Risk assessments had improved since our last inspection and contained a good level of detail to inform staff how to keep people safe. People and their relatives told us they felt safe living in Ashley Gardens Care Centre. Staff were knowledgeable about safeguarding and knew when to report concerns and to whom. The service and people’s rooms were clean and tidy and corridors unobstructed. Medicines were managed safely in accordance with guidelines. People told us that at times they needed to wait for care tasks as the staff can be busy. Observation showed that on some floor staff appeared very busy and rushed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People spoke positively about living at the service, the care they received and the support they received from staff who knew them well and met their needs. Comments about staff listening and taking action included, “They always listen to me, I can tell them anything.” Another person told us they had raised concerns about their mattress which was then changed by the staff.

The provider had robust measures in place to analyse incidents and accidents and to share any lessons learned from each one. Lessons learned were documented and retained for audit purposes and for continual professional development.

There was a robust system in place for recording accidents and incidents and staff knew what to do if someone had an accident. Records had been completed and were up to date. Professional advice had been sought, if necessary, for example, from the GP or emergency services. Accidents and incidents had been investigated, and trend analyses done to identify and reduce a reoccurrence.

There were processes in place to ensure people were assessed prior to being accepted into the service.

New people referred to the service were assessed before being accepted into the home. The manager did this to ensure the service had the right staffing levels and skill mix to meet individual needs. If there was any doubt, people were not accepted.

We received positive feedback from external healthcare professionals regarding the health needs of people using the service. The local GP surgery told us they were in regular contact with the service and visited weekly to support people’s health needs. Another health care professional told us they felt there had been positive improvements made since the new management team started and said the staff team were informative and knew people and their health needs well.

People told us their health needs were met by staff and nurses who understood their health needs comments from people included, “They look after me very well I am diabetic” and, “Overall (staff) are very good.”

The provider had a safeguarding policy and procedure in place. Safeguarding concerns had been raised with the local authority safeguarding team. Safeguarding outcomes from the local authority had been received and recorded, which showed that action had been taken by the provider following a safeguarding incident to reduce the risk of re-occurrence. Staff had received training in relation to safeguarding which had been included within their induction.

We observed staff providing safe and effective care by following the guidance within people’s individual risk assessments and care plans. Staff knew what they needed to do and how they needed to do things to keep people safe.

People told us they felt safe living at Ashley Gardens Care Centre and felt comfortable raising any concerns they had with the staff. People said they would like to go home however, living at Ashley Gardens was the next best thing. Comments from people included, “It’s ok would rather be at home but I do feel safe knowing the staff are here to help me” and, “I love it here this is one of the nicest, they are all friends here, oh yes, they all look after me.”

Staff were knowledgeable about safeguarding and knew how to report potential signs of abuse and to whom. Staff were confident that action would be taken if they were to report something. Staff told us and records confirmed that safeguarding training was up to date. Managers had reported safeguarding concerns to the relevant authorities and fully cooperated with any actions or recommendations.

People told us they had been involved in the development and review of their care plans and risk assessments. Comments from people included, “I am quite particular in what I want” and, “I can tell them (staff) what I want.”

Risk assessments and care plans had improved since our last inspection, they were clear, comprehensive, and up to date. They contained enough information for staff to provide safe care and manage any risks, such as the risk of falls, skin damage or choking. The provider used recognised tools for assessing risks such as skin damage, nutrition, and pain. Where people required monitoring charts such as, weight, fluids or repositioning, these were in place and had been completed appropriately. Where people required special pressure relieving mattresses, the required settings were documented and checked regularly.

Staff were observed following people’s care records. For example, staff were trained in moving and handling people and we observed staff using appropriate equipment to support people to move safely.

Staff knew people well and knew how to manage their risks safely and in accordance with their assessments and care plans. Staff were aware that people’s behaviour maybe indicating physical pain or emotional upset which they would report to the nurse on duty.

Observation of the communal rooms and corridors showed they were clean and free from obstructions. Staff were using appropriate personal protective equipment, and this was disposed of safely. Where moving and handling equipment was required to assist people’s mobility, for example, hoists, these were being used safely by staff. Open windows checked on each floor had restrictors in place to reduce the risk of a potential fall.

People told us they felt the building was well maintained. People were aware there was a member of the maintenance team available as and when required. Comments from people included, “The man comes in and does any repairs” and, “The man come round he has been doing some painting.”

The provider had policies in place in relation to health and safety and environmental safety. Regular audits were undertaken in infection control and health and safety. The provider had an up-to-date business continuity plan in place.

Staff told us that daily meetings were held with the heads of departments including, the nursing team, care staff, housekeeping, maintenance, and the kitchen team. This gave staff the opportunity to raise any concerns including any maintenance repairs that had been identified.

The provider used a dependency tool to determine the number of staff and skill mix required to provide safe care. The provider told us staffing levels exceeded this calculation. However, staff told us they felt there were not enough staff on one of the floors. Staff told us on this floor care was sometimes compromised because there were not enough staff, in particular the ability to give quality one to one time to people. Staff said answering call bells was important as it might be an emergency, but other tasks were sometimes interrupted in order to do so.

The management team used a dependency tool to determine the levels of staffing they needed to meet people’s needs. The dependency tool was reviewed on a regular basis by the clinical lead or a member of the management team. The provider had a policy and procedure in place for performance review and supervision and a disciplinary policy and procedure. Both policies and procedures would be used to address poor performance and practice had these been identified. Supervisions gave staff and the management team an opportunity to raise and receive any feedback or concerns. The training matrix sent to us by the deputy manager showed that care staff had been trained to meet people’s assessed needs. Staff had been recruited safely with appropriate checks in place to reduce the risk of unsuitable staff being employed.

There appeared to be enough staff deployed to meet people’s needs on two of the floors, but staff did seem rushed on another floor. We fed this back to the provider who said they would review this. Rotas showed that planned shifts were filled, and the use of agency staff had declined due to improved staffing levels. We observed that call bells were answered promptly throughout the visit.

People felt there were enough staff to meet their needs and that staff were available when they needed them. However, some people felt they needed to wait for staff if they were busy. Comments included, “They come when they can, I try not to bother them” and, “I can go and find them but if they’re busy I may have to wait.”

Staff were using appropriate personal protective equipment, and this was disposed of safely. Where moving and handling equipment was required to assist people’s mobility, for example, hoists, these were being used safely by staff, were clean and has been appropriately maintained. The provider had a team of house keeping staff who followed cleaning schedules. IPC audits were completed on a regular basis.

Staff told us they had received training and reminders about good Infection Prevention Control (IPC) practices, all were aware of IPC audits carried out by managers but not aware of any concerns with these. Staff told us they had access to personal protective equipment (PPE) such as, gloves and aprons.

People told us they felt their home and bedroom was kept clean and tidy. Comments included, “I like it clean and tidy, the staff come in and put the hoover around for me” and, “The cleaning ladies come in, they are very friendly and always have a laugh.”

The service was observed to be clean and tidy with no odours. Corridors were observed to be free of obstruction, floors appeared clean and clear. People’s bedrooms viewed were observed to be clean, tidy with call bells in place. We observed staff washing their hands between the food stations. The kitchen was observed to be clean and tidy, all food seen was in protective storage or being actively prepared. Kitchen staff were wearing appropriate clean clothing, uniforms and headwear.

Staff responsible for administering medicines had received appropriate training and their competencies were assessed regularly. Training and competency records viewed were up to date.

Medicines were stored appropriately in locked trolleys, cupboards or fridges and temperature monitoring was in place and had been completed. Creams and bottles were labelled with the dates of opening to ensure they remained safe to use. Where people had their medicines through an injection or a patch, sites were rotated to minimise the risk of skin irritation. Risk assessments were in place for people that required blood thinning medicine. Medicines were checked and audited on a regular basis to ensure the safe storage, administration and disposal of people’s medicines.

People told us they received their medicines on time and as they needed them. Comments included, “They (staff) arrange my medication for me and give me my insulin injection”, “The nurse comes round twice a day, morning and night” and, “I need them to help me, so they do it all for me.”