Ashdown Nursing Home

Updated 7 April 2021

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.

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. We also received information of concern about infection control and prevention measures at this service. This was a targeted inspection looking at the IPC practices the provider has in place.

This inspection took place on 5 March 2021 and was unannounced.

Updated 7 April 2021

The inspection took place on 4 September 2017 and was unannounced.

Ashdown Nursing Home is located in Worthing. It is registered to accommodate a maximum of forty people, as some of the rooms were large enough for dual occupancy. However, rooms had been converted and were single occupancy, therefore the provider was only able to accommodate a maximum of thirty-one people. At the time of our inspection there were thirty people living in the home. The home provides care and support for people living with dementia, some of whom have complex health needs and who may require nursing support. The home itself is a large detached property spread over two floors. People had their own rooms and had access to shared, communal bathrooms. There was a lounge and a dining area. There was a well- maintained garden and paved area as well as a summer house that people could use during the summer months.

There have been another two comprehensive inspection since January 2016. We carried out an announced comprehensive inspection on 6 and 8 January 2016. Breaches of legal requirements were found and the home received a rating of ‘Inadequate’ and was placed into ‘special measures’. The purpose of special measures is to provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example, cancel their registration. Services placed in special measures will be re-inspected again within six months. If sufficient improvements have been made, the service can come out of special measures and the overall rating can be revised. You can read the report from our previous inspection, by selecting the 'all reports' link for (Ashdown Nursing Home) on our website at www.cqc.org.uk.

We carried out another comprehensive inspection on 3 and 13 May 2016. It was evident that improvements had been made and the home received a rating of ‘Requires Improvement’ and as a result was no longer in ‘special measures’. However, the legal requirements in relation to safe care and treatment, the need for consent and dignity and respect had not been fully met. Areas for improvement were also identified in order to further improve some practices in relation to staffing levels, medicines, communication and interaction and providing choice.

At this inspection it was evident that improvements had been made and the providers had ensured that this had been sustained and embedded in practice. The providers were no longer in breach of the regulations, however, although the providers were no longer in breach, we noted that further improvement was needed to ensure that there was a consistent approach to assessing peoples’ capacity and making decisions on peoples’ behalves.

At the previous inspection on 3 and 13 May 2016 the home had been without a registered manager for seven months. 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. The providers had been responsible for the day-to-day management of the home and peoples’ care. A new manager had been in post for one month. Following the inspection the manager left employment and one of the providers had become the registered manager. At this inspection it was evident that considerable efforts had been made to continually improve the service. A clinical lead nurse had been recruited to improve the nursing care people were receiving. In addition, a general manager was in post who had worked hard to improve the leadership and management of the home and had introduced mechanisms to ensure that the service was meeting peoples’ needs.

At this inspection people received care that was safe. There were sufficient numbers of suitably trained staff to meet peoples’ needs and people told us that when they required support, staff responded in a timely manner. People were assisted to move and position in a safe way. Staff had received training in safe moving and handling and their practice was observed and monitored by the management team as well as senior staff to assure peoples’ safety. People received their medicines on time from nursing staff as well as staff who had received the required training. Records showed that relevant healthcare practitioners had been involved in decisions that related to peoples’ care and their access to medicines. The home was clean and people were protected from the risk of infection.

People were treated with dignity and respect. Observations showed staff explaining their actions, treating people with kindness and compassion and being sensitive when supporting them with their personal care needs. Positive relationships had developed between people and staff and people and relatives told us that staff were kind and caring. A relative told us, “I can‘t see how they can do anything else, they’re fantastic. I have to trust these people, and I do”. People and relatives were involved in peoples’ care and able to share their thoughts and suggestions. Regular care plan reviews took place as did residents’ and relatives’ meetings where people and relatives were kept informed of peoples’ care and the running of the home. People were able to stay at the home until the end of their life. People and their relatives had been involved in planning how the person wished to be supported during this stage in their life.

The management team and staff ‘knew’ people and took time to find out about their life before they moved into the home. People were encouraged to participate in a wide range of activities, external entertainment and meaningful occupation that occupied their time. People received care that was personalised to their needs. Care plans documented peoples’ preferences and wishes as well as their healthcare needs. People and their relatives were involved in the development, review and implementation of peoples’ care.

The management team welcomed feedback and used various mechanisms to obtain this from people, relatives, staff and external professionals. Feedback was positive and any suggestions that had been made had been recognised and changes made as a result. This related to peoples’ choices of activities or the food that they were provided with. There was a positive culture and a warm, calm, friendly and welcoming atmosphere.

People told us that they liked the food. One person told us, “The food is very good, very good, better than at my last place”. Observation showed people could choose what they had to eat and drink and peoples' right to change their mind was respected by staff. Communication aids were used to adapt communication for both staff and people. For example, pictures of meals were shown to people to help them to choose food and guidance had been translated in staffs’ first language to promote understanding and aid their development.

The home was well-managed and people, relatives, staff and external professionals were complimentary about the leadership and management of the home. Rigorous quality assurance processes audited the care that was provided to ensure that it was meeting peoples’ needs and they experienced a service they had a right to expect. The management team worked with external healthcare professionals to ensure people were receiving good quality care, to promote learning amongst the staff team and the sharing of best practice guidance.