About the service
Ashley Care Centre is a care home service with nursing, providing personal and nursing care to 43 people aged 65 and over at the time of the inspection. The service can support up to 49 people.
The care home has three units. On each unit people have their own bedroom and can choose to spend time in the communal lounge and dining area within that unit. There are communal bathrooms and toilets on each unit with a main kitchen and laundry.
People’s experience of using this service and what we found
Records of care provision for pressure relief and continence care showed they were not always being provided as often as people’s care plans stated they should be. This put people at an increased risk of developing pressure sores. Some areas of risk had not been identified or risk assessed, and some care plans lacked information.
Infection control practices were inconsistent and while people had been supported to isolate and staff had been cohorted. Basic hygiene practices during lunchtime were not implemented. Staffing levels had been maintained during the COVID-19 outbreak by using regular agency staff and the registered manager had worked alongside staff to provide direct care to people when needed.
The registered manager monitored the service through communicating regularly with people, staff and relatives. Management meetings helped to review the service and identify changes in people’s needs. However, these did not always pick up on the daily provision of care and look at whether this was being met.
The service had recently had an outbreak of COVID-19. The registered manager and staff acknowledged this had been a difficult time which had impacted on care provision and record keeping. Feedback from relatives was very positive about staff’s approach with people and how they were kept informed. The service had worked closely with external professionals to help monitor people’s health and gain advice and support in relation to managing the service during COVID-19.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 7 January 2020) and identified two breaches of regulation. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.
At this inspection enough improvement had not been sustained and the provider was still in breach of regulations.
The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The inspection was prompted in part due to concerns received about infection control, moving and handling, personal care, pressure care, support with nutrition and the care of people with COVID-19. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service remains the same. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashley Care Centre on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.