The Care Quality Commission (CQC) has rated Ashleigh House care home in Nottingham inadequate and placed it in special measures to protect people, following an inspection in May.
This unannounced inspection was prompted, in part, due to concerns received about neglectful care and environmental safety issues at the service.
The care home, run by W Scott provides accommodation and personal care for to up 24 people. It provides support to older people, those living with dementia, a learning disability, substance abuse, sensory impairment or mental health needs. At the time of the inspection there were 18 people using the service.
As well as the overall rating dropping from requires improvement to inadequate following this inspection, safety at the home has also declined from requires improvement to inadequate. Well-led was again rated as inadequate. Effective, caring and responsive were not inspected on this occasion, therefore remain rated as requires improvement.
The service is now in special measures, which means it will be kept under close review by CQC to keep people safe and re-inspected to check sufficient improvements have been made.
Rebecca Bauers, CQC’s director for people with a learning disability and autistic people said:
“We expect health and social care providers to guarantee people with a learning disability and autistic people the safety, choices, dignity, and independence that most people take for granted. When we inspected Ashleigh House, we found this wasn’t happening. It was also unacceptable that leaders were allowing a culture to exist where people weren’t being given the opportunity to lead their best lives.
“We found signs of a closed culture where people felt they couldn’t raise concerns due to management changes which resulted in no consistency or clear guidelines for staff to follow. This poor and inconsistent leadership created additional risk and reduced Ashleigh House’s own ability to identify, achieve and sustain improvement.
“The provider didn’t ensure staff had received safeguarding training, meaning they didn’t always know how to recognise and report abuse. We were told about safeguarding incidents which weren’t reported to the relevant professional bodies, meaning these could not be investigated fully or learnt from so they don’t happen again, putting people at risk of harm from abuse.
“Additionally, the provider had private flats within the care home which were occupied by members of the public. They had full access to all areas of the care home which means the provider failed to ensure people using the service were safe. There weren’t any proper safety checks for those who had access to the home which could put vulnerable people at risk of harm.
“It was clear the manager acknowledged the seriousness of our concerns, telling us that they knew people’s lives were being put at risk by the provider, W Scott, and that they would prefer people to be moved out of the home to keep them safe.
“Following the issues we identified, we've been working with the local authority and fire service to ensure people’s safety.
“What we found at this inspection was completely unacceptable and we expect the provider to take immediate action to address our concerns. We are considering what further regulatory action to take to keep people safe and we will report on this when we are able to.”
Inspectors found:
- The premises and environment were poorly maintained, placing people at risk of harm. Staff had received limited fire safety training on undertaking effective evacuation furthermore there was insufficient fire detection or staff to keep people safe in an emergency situation
- People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice
- Ineffective care planning led to people experiencing poor care and restrictive practices
- The service failed to provide a safe, well-maintained environment; areas were unfit for purpose and significantly damaged, which posed a risk to people
- Medicines were not managed safely. The provider failed to appropriately store medicines leading to harm. Multiple medicines could not be accounted for meaning people were at risk of under or over administration of medicines
- The service did not have enough suitably qualified and skilled staff to meet people’s needs
- Risk management was poor. A lack of support plans and assessments in place meant people's individual needs were not identified assessed or managed effectively, and their care wasn’t personalised
- The culture of the home was negative, and the manager told inspectors the home was not safe and people needed to leave. Meaning there was no drive for improvement or quality within the service.