Archived: Ashlea Court

Updated 13 July 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 was planned to check 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 2 December 2014 and was unannounced. We visited again on 3 December 2014 and this visit was announced. The inspection was completed by one adult social care inspector.

During this inspection we carried out observations using 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 reviewed a Provider Information Return (PIR) as part of this inspection. A PIR 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 other information we held about the home, including any notifications we had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale.

We also contacted the local authority safeguarding team, commissioners for the service, the local Healthwatch and the clinical commissioning group (CCG).

Healthwatch is a statutory body set up to champion the views and experiences of local people about their health and social care services. For each local authority with social services responsibility there is one Healthwatch. We also reviewed information from the local authority safeguarding and commissioning teams. The information we gained was positive and indicated that there were no outstanding safeguarding issues and that the local authority commissioning team was happy with the provision within the home.

During the inspection we spoke with eight people, two relatives, four staff and the registered manager of the home.

We reviewed six sets of records relating to people’s care. This included their care plans, any associated risk assessments, review documentation and the daily records which reflected the care they received.

We viewed other records within the home such as three staff files relating to staff member’s support, training and recruitment, and other records held by the registered manager relating to the things they did to manage and monitor the work done in the home.

Updated 13 July 2015

This inspection took place on 02 December 2014 and was unannounced. We visited again on 03 December 2014 and this visit was announced.

Ashlea Court is a 40 bed care home. The service provides personal and nursing care to older people with mental health and general care needs, some of whom are living with dementia. The service is set in its own grounds. There were 18 people accommodated at the time of the inspection.

The home had a registered manager in place. 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.

We examined the recruitment records and found that the registered manager was careful to recruit staff in a safe way. They made sure they were interviewed, that their work history was known about, that they had two good references that were relevant to their work and that DBS checks were done. The Disclosure and Barring Service (DBS) helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups, including children.

We spoke to staff and asked them what they knew and what they would do about abuse. They told us the signs and symptoms of abuse and that they would report any such concerns to the registered manager, or social worker or report it to the local authority adult safeguarding team. They had received suitable training in regard to keeping adults safe.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards exist to ensure people are only deprived of their rights if it is within their best interests. The registered manager understood the home’s responsibilities under the Mental Capacity Act 2005 (MCA). We saw that the registered manager had made the relevant referrals to the local authority and was waiting for a response from them.

The home undertook careful assessments of people’s needs. People had clear concise and full plans relating to their care and needs. There was good evidence that people participated in the development of their care plans. Their views were sought about their care and the home they lived in. People spoke of their quality of life whilst living at the home. One person told us, “The trouble here is you don’t want for anything”. Another told us, “Although I want to go home I wouldn’t change anything here.”

Staffing levels were good and we saw that people’s needs were met promptly. We spoke to the manager about how they determined staffing levels. We were told they explored people’s needs and adjusted the staffing levels in accordance with the complexity and dependency of people who lived there.

We saw staff treated people in a friendly way that supported their privacy and dignity whilst offering them choices when meeting their needs. We saw people enjoyed the care and interactions with staff. People said, “The carers are kind and helpful”, and “I get attention if I need it, and if you need a GP they get one quickly.” Other people commented that the support they received in relation to their health needs was good. One person told us, “I feel all of my health needs are met, the staff are kind and helpful.”

We saw careful monitoring of the service and good systems in place to make sure people were safe. Staff had good levels of training and were supported and guided about how to meet people’s needs.

There were systems in place to ensure the environment people lived in was clean, comfortable and safe.

People were encouraged to live healthy lifestyles. There was a range of stimulating activities on offer that people liked and they had a say on what was provided. We saw people were encouraged to eat well. When there were difficulties, they received the support they needed.

Staff received guidance from other professionals about how best to support people. We saw this guidance was included in care plans and we saw staff put that guidance into practice. For example where a person had been assessed by the speech and language therapy team for their ability to swallow and they determined that person should only get pureed food and staff should assist them, we saw that is what happened. In other cases we saw guidance given by a dietitian about people who were in danger of dehydration or poor diet, that the home should monitor and encourage good fluid intake and that the person received fortified food. Records and observations showed that this happened.

Records showed what people liked to eat. The staff and the cooks tried to meet people’s needs. People said they enjoyed the food they had. We saw the registered manager was careful to ensure the home met people’s needs. They checked that good assessments and plans were in place and that staff adhered to them through regular support and guidance.

The registered manager and provider had good systems to check on things in the home. They made sure assessments and plans were up dated when needed, they made sure people were doing their jobs. For example, keeping a hygienic environment, talking to people as they should and making sure people were kept at the centre of the care the home provided.

We saw very good records that showed peoples life histories. People and staff felt those were important as they helped staff understand people’s needs ensured that staff knew what people liked and importantly for the staff. One staff member said, “We have good histories of people here, when you read them you feel as if you get to know the person rather than just a client, it gives you something to connect with them”

Relatives spoke highly of the care people received. One relative told us, “The care is really good, I and [my relative] feel a part of the process at meeting [my relatives] needs”, and they had “Absolutely no complaint to make”.

The Provider and the registered manager had good systems in place to check that the home was suitable for meeting people’s needs and that people’s needs were being met.