Ashleigh House

Updated 8 December 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Ashleigh House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ashleigh House provides personal care only. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. The registered manager post had been vacant since October 2022.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During our visits we spoke with 10 people who used the service about their experience of the care provided. We looked at records relating to the management of the service. These included medicines, accident and incidents, safeguarding, recruitment and quality assurance records. We looked at 4 people's care and support files. We spoke with 7 members of staff, including the area manager, acting manager, senior support worker and support workers.

After the visit we continued to seek clarification from the provider to validate evidence found. We looked at quality assurance systems and training records. We spoke by telephone with 3 visiting professionals.

Updated 8 December 2023

About the service

Ashleigh House is a care home providing personal care to up to 30 people. The home provides support to younger adults who may live with dementia or mental health issues. At the time of our inspection there were 20 people living at the home.

People’s experience of using this service and what we found

We carried out this inspection in response to concerns that had been raised with us regarding the cleanliness of the building. We shared these concerns with the local authority lead infection control nurse who visited Ashleigh House on 11 October 2023. Significant concerns were found regarding cleanliness of the home and equipment used for medicine administration. The provider responded to these concerns promptly with deep cleans, staff training and additional housekeeping staff.

Care records were not always completed or accurate. Some care plans, risk assessments and best interest decisions had not always been completed with specific details required about people’s care. Audits did not always identify the recording issues we found.

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. We found not all capacity assessments and best interest records had been completed when required and people subject to Deprivation of Liberty Safeguards (DoLS) were able to leave the building freely.

Accidents and incidents and safeguarding notifications had not always been consistently recorded and reported. Medicines were not always managed safely. Some records regarding as and when required medicines needed updating and administration practice we observed was poor. A recent provider audit had found the concerns we had relating to medicine records and there was an action plan in place to address this.

There were no planned activities taking place and people said there was nothing much to do. People's care plans did not reflect clear goals and outcomes to support their independent living skills.

We observed that staff did not always uphold people's dignity and that professional boundaries might not always be maintained. We have made a recommendation about this about.

The acting manager, senior management team and staff were open and honest with us during the inspection. Staff said the last 6 months at the service had been "chaotic" and "a bad whirlwind" as several managers had come into the service then left. Staff told us they felt supported by the acting manager who had only been in post since August 2023. Staff told us they were keen to learn and drive improvement to ensure people received the best possible care.

Staffing levels were sufficient to meet people’s needs and staff were recruited safely.

People were offered choices at mealtimes and told us they enjoyed the food provided in the home. The home ensured people had access to health care professionals when required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 29 June 2021).

Why we inspected

The inspection was prompted in part due to concerns received about areas of concern such as infection control and staffing. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified breaches in relation to person-centred care, safe care and treatment and governance of the service.

Please see what action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.