Ashley Grange Nursing Home

The service was in breach of 3 regulations for person-centred care, need for consent and meeting nutrition and hydration needs. At this inspection we have found the service had improved and was no longer in breach of regulations.

People were now being offered fluids and staff were recording amounts offered and fluids consumed in people’s care records. People were now being asked for consent before care was delivered and where people lacked capacity staff were following the principles of the Mental Capacity Act 2005. People now had personalised care plans which outlined the care and treatment to be provided. We observed people were receiving care in line with recorded guidance and assessment of needs.

Staff were recruited safely and there were enough staff available to meet people’s needs. Staff had been provided with an induction, training and ongoing support. The provider had systems to support staff wellbeing. There was a diverse team at the service who were all respected and at times different cultures were celebrated.

The service was clean, and health and safety checks were being regularly completed. Systems and facilities for areas such as fire were checked by on-site maintenance staff and external contractors. Staff practiced fire evacuation procedures during the day and night.

Staff worked with a range of healthcare professionals to make sure people’s health needs were met. Feedback from professionals about the approach of staff and management was positive. A local GP surgery visited weekly and more often if needed.

There was a registered manager and clinical lead at the service who were both approachable and supportive of staff. Staff were confident any concerns including safeguarding would be managed safely and in a timely way.

Governance systems were effective in monitoring and assessment quality and safety. Various checks and audits were completed and when actions were identified they were added to action plans. Both the registered manager and the provider monitored action plans to make sure work was completed to make improvements and maintain compliance. Statutory notifications to Care Quality Commission had been submitted appropriately and when needed.

Some risk management plans were not detailed enough to give staff clear guidance when supporting people with distress. Daily records were at times conflicting when staff had recorded incidents of anxiety and distress.

Medicines had not been managed consistently. Some time specific medicine had not been administered on time. Topical creams were not being recorded consistently when applied. Staff had training on medicines management and were assessed for competence.