About the service:

Ashwood Court is registered to provide personal and nursing care to a maximum of 30 older people, including people who live with dementia or a dementia related condition. At the time of Inspection 26 people were living at the home.

People’s experience of using this service:

Medicines were not always managed safely. Medicine records were not always accurate. High calorie drinks were out of date. Fire safety improvements had not been made promptly.

Some improvements had been made to staff training, but some staff had not completed training in key areas.

People received person-centred care which met their needs. People had detailed and individual care plans which were regularly reviewed and updated as people’s needs changed. Risk assessments were in place to help keep people safe.

People told us they felt safe. People and their relatives told us staff knew them well and provided care that was kind and considerate. During the inspection we saw staff treated people with great kindness and respect.

The provider worked with other local healthcare professionals. People had access to and were referred to a variety of other healthcare services, such as GPs, dentists and dieticians.

Since the last inspection the provider had made improvements to the décor to support people living with a dementia. Decoration is ongoing to make further improvements.

The home employed an activities co-ordinator who organised activities both inside and outside of the home for people to enjoy.

Staff and people who used the service said the registered manager was supportive and approachable.

At the last inspection in December 2017 and January 2018, we identified a number of breaches in relation to staffing levels; safety of premises; staff training; person-centred care and governance.

At this inspection we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in connection with medicines and premises safety, good governance issues and staff training. We also identified a breach in Regulation 18 of the Care Quality Commission (Registration) Regulations 2009, notification of other incidents. We are dealing with this matter outside of the inspection process.

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

Rating at last inspection:

Requires improvement (report published 12 April 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor the service through information we receive from the service, provider, the public and partnership agencies. We will re-visit the service in-line with our inspection programme. If we receive any concerning information we may inspect sooner.

This was an unannounced inspection carried out on 14 December 2017 and 4 January 2018.

This was the first inspection of Ashwood Court since it was registered with the Care Quality Commission in May 2017. It was previously registered under a different legal entity.

Ashwood Court is registered to provide personal and nursing care to a maximum of 30 older people, including people who live with dementia or a dementia related condition. At the time of inspection 27 people were using the service.

Ashwood Court is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

A registered manager was in post. 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.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to safe care and treatment, staffing levels, staff training, person-centred care and governance.

Although people told us they felt safe, systems were not in place to keep people safe and to provide consistent care to them. Strategies were not in place to support distressed behaviours effectively. Risk was not well-managed. There were insufficient staff to meet people’s needs.

Care was provided with kindness but people’s dignity was not always respected. People did not all receive a varied and nutritious diet. We considered improvements were required to people’s dining experience. There were limited activities and entertainment available for some people. We have made a recommendation about this.

Improvements were required to staff training and staff supervision to ensure people received safe and effective care. Staff knew people’s care and support requirements. However, record keeping required improvement to ensure it reflected the care provided by staff.

A robust quality assurance system was not in place to assess the quality of the service. Audits that were required were not all carried out and some that were carried out were not effective as they had not identified issues that we found at inspection.

People were able to make choices about aspects of their daily lives. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice. However, we have made a recommendation about best interest decision making and medicines management.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. Staff told us communication was effective within the service.

Changes had been made to the environment. Some areas had been refurbished. However, not all areas of the home were clean and well maintained for the comfort of people who used the service. The home was not all designed to promote the orientation and independence of people who lived with dementia, although plans were in place to address this. We have made a recommendation that the environment should be designed according to best practice guidelines for people who live with dementia.

A complaints procedure was available. People had access to an advocate if required. Staff and relatives said the management team were approachable. Communication was effective to ensure staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

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