Ash Hall Nursing Home

The provider was previously in breach of the legal regulations in relation to safe care and treatment and good governance. Improvements were not found at this assessment, and the provider remained in breach of these regulations. ​ We also identified additional concerns during this inspection, which meant the provider was in breach of the legal regulations relating to person-centred care, safe staffing and the need for consent.

This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.

The provider could not demonstrate people consistently received safe care and treatment. Risks to people's health, safety and welfare were not always effectively assessed, monitored or managed. Concerns identified at the previous inspection, including staffing, environmental safety and oversight of care, had not been fully addressed. Systems for monitoring care delivery were ineffective, resulting in gaps in records, concerns with the management of time-critical medicines, and delays in people receiving support. Although audits and monitoring processes identified some issues, action taken had not resulted in sustained improvement. As a result, people remained at risk of harm.

People did not always receive effective care and support because systems for assessing needs, monitoring outcomes and reviewing care were inconsistently applied. Although staff understood people's health needs and people had access to healthcare services, gaps in oversight and record keeping meant there was limited assurance that care was consistently delivered in line with assessed needs and best practice.

Staff were described as kind, compassionate and respectful, and positive feedback was received from people and relatives about their approach. However, people did not always experience care which reflected their individual preferences and choices. Delays in receiving support also had the potential to impact people's dignity, comfort and wellbeing.

Care and support were not always organised around people's individual needs and preferences. Opportunities for people and relatives to influence service development were limited, information was not always available in accessible formats, and arrangements to promote social engagement and meaningful occupation were inconsistent. Systems were in place to support future care planning and access to healthcare services when required.

Leaders had not established effective governance and quality assurance systems to ensure safe, person-centred care or to continually drive sustained improvement. Concerns identified at the previous inspection and through enforcement activity had not been fully addressed, and oversight arrangements failed to identify and respond effectively to ongoing issues. As a result, the provider did not demonstrate a culture of continuous improvement, learning and accountability.

In instances where CQC has begun a process of regulatory action, we may publish this information on our website after any representations and/or appeals have been concluded, if the action has been taken forward.