19 and 20 March 2015
During a routine inspection
The inspection was carried out on 19 and 20 March 2015 and the first day was unannounced. The last inspection took place on 1 November 2013 and the provider was compliant with the regulations we checked.
Ashwood Care Centre is a nursing home providing care for a maximum of 70 people. The service has three floors. The ground floor is for people with general nursing and personal care needs, the first floor is for people with nursing dementia care needs and the second floor is for people with personal care and dementia care needs. At the time of the inspection there were 62 people using the service.
The service is required to have a registered manager in post, and the registered manager has been managing the service since June 2014. 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.
Staff were aware of safeguarding and whistle blowing procedures and demonstrated a good understanding of what constituted abuse. Whistleblowing procedures needed reviewing as contact with outside agencies was not included.
Call bells were not always available to people, which could place them at risk of being unable to access for assistance when they required it.
Medicines were being managed safely, however we have made a recommendation about some aspects of medicines management to improve monitoring processes.
Staff we spoke with and records we saw confirmed recruitment procedures were being followed.
The registered manager had identified gaps in training and was taking action to address this. A programme of training and updates for staff had commenced. Staff had received training and, apart from one exception where we observed some poor handling, we saw staff putting their learning into practice.
We found the service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). DoLS are in place to ensure that people’s freedom is not unduly restricted. Where people were at risk and unable to make decisions in their own best interest, they had been appropriately referred for assessment under DoLS. They were not always meeting the requirements of the Mental Capacity Act 2005 (MCA) with respect to gaining consent, for example, the taking of photographs.
People and their relatives were happy with the care provided. Although care records were comprehensive, some were not up to date and it was not always clear if people had been given the opportunity to be involved, so their wishes could be included. This had been identified and action was being taken to address it.
Staff treated people in a gentle and respectful manner. Procedures for staff handovers needed to be reviewed as they did not respect people’s dignity and privacy.
People had a choice of meals and staff were available to provide support and assistance with meals. Where food and fluid intakes were being recorded for some people, the results were not being effectively monitored, so could place people at risk. Staff referred people for input from healthcare professionals when required.
People were encouraged to take part in activities and these were planned and led in a manner that was inclusive and enjoyable.
People and their relatives felt confident to express any concerns, so these could be addressed.
People using the service, relatives and staff said the registered manager and the deputy manager were approachable and listened to them. Systems were in place to monitor the quality of the service. However, these had not been fully effective in highlighting the shortfalls identified during this inspection.
We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.