Archived: Ashbourne

Updated 19 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 02 and 08 April 2015 and was unannounced. The inspection team consisted of one inspector and an expert by experience who had experience of older people and dementia care. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the completed PIR and we checked information that we held about the service and the service provider. This included statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We also reviewed information that we received from five external professionals who provide a service to people who live at Ashbourne and with their consent have included their views in this report. We used all this information to decide which areas to focus on during our inspection.

We spoke with 14 people who lived at Ashbourne and five relatives. We also spoke with three care staff, the deputy manager, the registered manager, the nominated individual and a visiting nurse.

The majority of people who lived at the home were living with dementia at different stages. Many of these people were unable to hold long conversations with us. We had to keep questions at a basic level that only required a yes or no response coupled with observing facial expressions and body language.

We observed care and support being provided in the lounges and dining areas. We also spent time observing the lunchtime experience people had. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We also observed part of the medicines round that was being completed.

We reviewed a range of records about people’s care and how the home was managed. These included care records and medicine administration record (MAR) sheets for four people and other records relating to the management of the home. These included staff training, support and employment records, quality assurance reports, policies and procedures, menus and accident and incident reports.

Ashbourne was last inspected on 13 August 2013 where no concerns were identified.

Updated 19 May 2015

The inspection was unannounced and took place on 01 and 08 April 2015.

Ashbourne is a residential care home that can accommodate up to 18 older people. It is situated in a residential area of Selsey, a short distance from the sea in West Sussex. At the time of this inspection, there were 15 people living at the home. The registered manager told us that most people required help with moving and mobility and some people were living with dementia. Two people required full assistance with all aspects of care. Other people required encouragement and prompting and others minimal supervision.

During our inspection the registered manager was present. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they felt safe in the home. Staff understood the importance of protecting people from harm and abuse. Staffing levels ensured that people received the support they required at the times they needed. An overall, formal dependency assessment tool for deciding staffing levels was not in place. Despite this we observed that on the day of our inspection there were sufficient staff on duty.

External entertainers visited the home at least once a week to provide activity sessions for people. The home had recently introduced a new activity of ‘Informative Talks’. This was an entertainment and reminiscence service that used digital technology with pictures, video and music to involve people and encourage mental stimulation.

The registered manager had sought people’s consent and acted on advice when she thought people’s freedom was being restricted. Best interest decision making pathways had been followed for people who did not have the capacity to consent. The registered manager had completed mental capacity assessments and made DoLS applications when required. This meant that people’s rights were protected.

Staff were sufficiently skilled and experienced to care and support people to have a good quality of life. Staff said that they felt supported by management to undertake their roles. They received an annual appraisal. However, they had not been receiving regular, formal, supervision that would support their development and allow the manager to formally monitor staff practice.

People’s nutritional, health and personal care needs were assessed, planned for and met. When recommendations were made by external healthcare professionals these were acted upon to ensure people received the care and support they required. Staff knew the needs of people and treated people with kindness and respect. People said that they were happy with the medical care and attention they received and we found that people’s health and care needs were managed effectively. Assessments and care plans were detailed and informative and could be used to monitor that people were receiving effective treatment.

People told us that they exercised a degree of choice throughout the day. For example, what time they got up, went to bed, where they ate and what help they needed. Everyone said that management and staff at the home were approachable and listened to people’s views, opinions and concerns. People said that they would speak to staff if they were worried or unhappy about anything.

Medicines were managed safely. Care records were clear and gave descriptions of people’s needs, including any potential risks and included instructions how these should be managed and met safely.

Risks to people’s safety were assessed and actions taken to reduce reoccurrence where possible. Staff were knowledgeable about the individual needs of people. Equipment was available in sufficient quantities and used where needed to ensure that people were moved safely and staff were able to describe safe moving and handling techniques.

People’s privacy and dignity was promoted. Staff understood the importance of respecting people’s rights. Staff were seen spending time with people on an informal, relaxed basis and not just when they were supporting people with tasks.

People said that the home was well-led and that management was good. A variety of tools were used to obtain and act on feedback from people. The registered manager showed a commitment to improving the service that people received and ensuring her own personal knowledge and skills were up to date. A range of quality assurance audits were completed by the manager to help ensure quality standards were maintained and legislation complied with.