Archived: Ashleigh Care Home

Updated 2 December 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 9, 10, 11 and 14 September 2015 and was unannounced.

The inspection was carried out by three adult social care inspectors on all four days . Prior to our inspection we had received information of significant concern from a whistle blower. We also spoke to other agencies who worked with the service to gather further information; these included Environmental Health and Infection Control officers and the Local Authority Contracts team.

During our inspection we looked at the care records of 18 service users, the medication administration records for all service users, weight records, bathing records, complaints file, incident and accident files, one staff recruitment file, all staff training records, staff rotas and handover records. We asked to see auditing records which the provider was unable to produce. We spoke with all the people living at the service, some of their relatives, a dietician, an external activity provider, ten staff members and all members of the management team.

Updated 2 December 2015

The inspection took place 9,10,11 and 14 September 2015 and was unannounced.

The service was last inspected in March 2015, at this inspection the service was in breach of Regulation 12 Safe Care and Treatment of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This was in relation to poor standards of cleanliness throughout the service which mean that there was a risk of infection control not being effective.

We found that the service had not made the necessary improvements in relation to this breach since our last inspection and we found that there were a high number of breaches of other regulations.

Ashleigh Care Home is a residential care service, who offer personal care to up to 37 people. At the time of our inspection there were 29 people living within the service.

At the time of our inspection there was no permanent manager. The service was being managed by an acting manager who had been in the service for two weeks and an area manager who had been with the provider for two years.

We found that the standards of care in the service had deteriorated significantly since out last inspection. This was in relation to multiple breaches of the regulations.

Regulation 9, person centred care. We found that people’s care needs had not been assessed and there were no care plans for some of the people who lived at the service.For those people who did have care plans these were out of date and the information did not reflect their current needs or the care which was being given to them.

We found that people in the service were not treated with dignity and respect. Some of the people living in the service were unable to access the toilet without assistance and were being left for long periods without being given this assistance. Staff did not recognise how people’s dignity could be promoted and did not assist people when they needed help. This was a breach of Regulation 10 dignity and respect

The people living in the service were not asked for their consent for care to be carried out. The provider and the staff failed to recognise restrictive practices which were being carried out. There were no mental capacity assessments being carried out for the people living in the service to measure whether they were able to make their own decisions and which decisions they were able to make. This was a breach of Regulation 11, need for consent

The provider did not have safe processes in place to ensure that people were given the medications that were prescribed to them in the way in which they had been prescribed. We found that people who were in pain were not receiving their pain killers. There were very few risk assessments in place for people in the service and those that were in place were out of date and had not been reviewed. The equipment which was being used to assist people with poor mobility was limited. There were no assessments carried out to make sure that the equipment which was being used was safe or suitable for the needs of the person. We found widespread evidence that infection control measures were not in place and there was a poor standard of cleanliness throughout the service. This was a breach of Regulation 12 safe care and treatment

Staff did not recognise safeguarding incidents that were occurring. There were no safeguarding referrals made to protect vulnerable people living in the service until incidents were highlighted by CQC during the inspection. This was a breach of Regulation 13, safeguarding service users from abuse and improper treatment.

We found that some people were not being adequately hydrated as they were left for long periods without access to drinks. We saw that food records were inaccurate and were not filled in for long periods, which meant that staff could not monitor people’s fluid intake. This was a breach of Regulation 14, meeting nutritional and hydration needs.

We found that the equipment in the service did not meet the needs of the people living there. This was a breach of Regulation 15, premises and equipment.

We found that the provider was not dealing with complaints appropriately or in a timely manner. This was a breach of Regulation 16, receiving and acting on complaints

There were no processes in place to monitor the performance of the service or to maintain accurate records of the care which was being delivered. We found that there was no effective leadership within the service. This was a breach of Regulation 17, good governance.

There were not enough staff to care for people safely and to meet their needs. We found that the staff were not well trained and were not competent in all areas of their roles. This was a breach of Regulation 18, staffing.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

You can see what action we told the provider to take at the back of the full version of the report.