Ashcroft Care Home

However, the information shared with CQC about the incident indicated potential concerns about the management of risk of safe environments. This inspection examined those risks.

Ashcroft Care Home is a care home providing nursing and personal care for up to 53 people, some of whom were living with dementia or mental health needs. The accommodation is provided over 3 floors.

At the time of the assessment, there were 50 people living at Ashcroft Care Home, all of whom received support with personal care.

The provider was in breach of the legal regulations relating to safe care and treatment and good governance.

This assessment found that, although people received kind and compassionate care from dedicated staff, improvements were needed to ensure care was consistently safe, effective and well managed.

We identified concerns relating to safeguarding, governance, risk management, consent and record keeping. Care plans and risk assessments were not always accurate, up to date or reflective of people’s current needs. Mental Capacity Act (MCA) assessments and Deprivation of Liberty Safeguards (DoLS) records were not always managed appropriately, and some restrictive practices had not been supported by the required assessments or documentation. The provider had also not always reported incidents to relevant agencies as required, limiting opportunities for external oversight and learning.

Governance and auditing systems were not effective in identifying and addressing risks. Issues found during the assessment, including environmental hazards, care planning inaccuracies and medicines management concerns, had not been identified through the provider’s own monitoring processes. This demonstrated a lack of effective oversight and a limited culture of learning and continuous improvement.

Staffing levels were sufficient to meet people’s needs, infection prevention and control practices were effective, and people had access to healthcare services when required.

Leaders were receptive to feedback and took prompt action to address concerns identified during the assessment. However, further work was needed to ensure improvements were embedded and sustained.

We have asked the provider for an action plan in response to the concerns found at this assessment.