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Care Services

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Ashford House, Stanwell.

Ashford House in Stanwell is a Nursing home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, dementia and treatment of disease, disorder or injury. The last inspection date here was 19th March 2020

Ashford House is managed by Barchester Healthcare Homes Limited who are also responsible for 186 other locations

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2020-03-19
    Last Published 2017-05-12

Local Authority:

    Surrey

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

8th March 2017 - During a routine inspection pdf icon

The inspection took place on 08 March 2017 and was unannounced. This was a comprehensive inspection.

Ashford House is a nursing home providing support to up to 54 people. At the time of our inspection there were 47 people living at the home. Most people at the home were living with dementia. Some people also had complex physical health needs.

There was a registered manager 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.

Our last inspection was in January 2016 where we identified concerns with medicines management. At this inspection we found actions had been taken to ensure this regulation had been met but we identified one other breach of regulation regarding staff deployment and made a recommendation that communications be improved with people and relatives.

People were not cared for by sufficient numbers of staff. Staff deployment across units meant that on one unit staff were rushed and unable to spend time with people apart from meeting their personal care needs. People waited longer for support and staff were rushed. We observed inappropriate moving and handling techniques used by staff on this unit, despite staff having been trained in these techniques.

People’s medicines were administered safely by trained staff. Improvements had been made to record keeping and staff demonstrated competence in handling and administering medicines. Staff worked alongside healthcare professionals to ensure that people’s healthcare needs were met.

People were kept safe from abuse as staff understood their role in safeguarding people. Risks to people were assessed and plans were in place to minimise risks to people. Where incidents had occurred, measures were taken to prevent a reoccurrence.

People had access to a wide range of activities, although not everyone we spoke to agreed there was enough to do. The provider was in the process of implementing changes to how activities were provided to people living with advanced dementia. People were provided with a choice of food that matched their dietary requirements.

People were supported by kind and committed staff. People were encouraged to make their own choices and decisions. People’s cultural and religious needs were supported by staff. Where people were not able to make decisions, their rights were protected as staff worked in accordance with the Mental Capacity Act 2005.

Staff had input into how the home was run and regular staff meetings took place. People and relatives also had regular meetings so they could discuss the running of the home. The provider maintained up to date records. People’s feedback was regularly sought and where complaints were raised these were dealt with.

Appropriate checks were undertaken to ensure that staff were appropriate for their roles. Staff had access to a range of training and received regular supervision. Clinical staff were supported to keep up to date with good practice.

Systems were in place to reduce the risk of fire and to ensure people’s health and safety. A plan was in place to ensure that people’s needs would continue to be met in the event of an emergency.

18th January 2016 - During a routine inspection pdf icon

This was an unannounced inspection that took place on 18 January 2016. This inspection was to follow up on actions we had asked the provider to take to improve the service people received.

Ashford House is registered to provide accommodation with nursing care for up to 54 people. At the time of our visit, there were 38 older people living at the home. The majority of the people who lived at the home were living with dementia, some have complex needs and the home also provided end of life care. The accommodation is provided over two floors that were accessible by stairs and a lift.

The home did not have a registered manager in place. ‘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.’ The provider had arranged temporary management coverage at the home. We have been informed that a new manager for the home had been recruited and they would then submit an application to be registered as manager with Care Quality Commission (CQC).

At our previous inspection on 6 and 7 May 2015 we found breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action in relation to the standards of cleanliness, infection control, management of medicines, dignity and respect, assessing and monitoring the quality of the service provided. Where the regulations were not being met, we took enforcement action. The provider sent us an action plan on 18 August 2015 and provided timescales by which the regulations would be met. The provider also sent us the updates in relation to progress they had made.

The home had also been placed in ‘Special measures’ by the Care Quality Commission. As this was the second time the home has been rated inadequate for one of the five key questions.

At this inspection we found that some improvements had been made. However, there was still a breach of the regulations. They had not met the requirements regarding the management of medicines.

People were at risk because the arrangements in place to manage medicines were not followed correctly. Medicines administration records (MARs) were not always accurately completed when verified against medicines in stock. The provider was not able to demonstrate when a medicine is correctly administered in line with the instructions provided. People were at risk of not receiving their PRN [to be taken as required] medicines in a consistent way. Documentation was not always completed in line with current legislation.

Staff were up to date with current guidance to support people to make decisions. However where people did not have capacity, not all of the records were completed and did not contain information about who could make certain decisions on their behalf. We made a recommendation that the provider ensures that the contents of their documentation is in line with current legislation.

Improvements had been made to the systems and arrangements in place to regularly assess and monitor the quality of the home, however they were still not effective enough to minimise risk or correct poor practice.

People’s needs were assessed when they entered the home and on a continuous basis to reflect changings in their needs. However there was some discrepancies between information provided by healthcare professionals was not always integrated into practice. We made a recommendation that the provider ensures that the contents of their documentation is in line with people’s current care and support needs.

Medicines were stored safely. Any changes to people’s medicines were prescribed by the person’s GP and administered appropriately.

The standard of cleanliness had improved and staff were following the provider’s In

26th April 2013 - During a routine inspection pdf icon

We inspected Ashford House in response to some concerns we had received.

During our visit we saw that staff treated people with respect, dignity and kindness. People told us that they thought the staff were “wonderful” and “kind”. We saw that people were cared for in a way that promoted their independence and that people were encouraged to make choices.

We looked at people’s care files and saw that each person had an initial assessment, a care plan and risk assessments. These were up to date and reviewed at least once a month or after changes in people’s care needs.

We spoke to three people who were visiting who told us that they thought their relatives were well cared for and safe. One relative told us “It’s not easy looking after my relative. The staff do an amazing job”.

We saw that staffing levels throughout the day and evening were sufficient to meet people's needs. Relatives confirmed that they did not have any concerns. One relative told us, "There is a lot to do but staff do a good job”.

We saw that the provider had a complaints policy and saw examples of some of the complaints that had been received. These had been investigated and that in each case the complainant had been informed of the outcome.

We looked at the provider’s statutory notifications as we had noted that there had been delays in reporting of incidents to the Commission. We saw that recent notifications were dated and submitted within appropriate timescales.

19th April 2012 - During an inspection in response to concerns pdf icon

We used a number of different methods to help us understand the experiences of people using the service these included spending time talking with people and observing their general demeanour, talking with staff and gathering evidence of peoples experiences through looking at compliments, the complaints log and the responses from seeking peoples or their relatives and friends views through the organisations formal quality assurance process.

We spoke with five peoples relatives on the telephone following our visit. Some of people’s responses included ‘Overall, not bad at all. Quite a good job. My relative has a difficult type of dementia and they deal with it very well’ ‘Nothing bad, everyone tries their best and, to be honest they do a “damned good job.”

1st January 1970 - During a routine inspection pdf icon

This was an unannounced inspection that took place on 6 and 7 May 2015. This was a focussed inspection to follow up on actions we had asked the provider to take to improve the service people received.

Ashford House is owned by Barchester Healthcare Homes and is registered to provide accommodation with nursing care for up to 54 people. At the time of our visit, there were 52 older people living at the service. The majority of the people who live at the service are living with dementia, some have complex needs and the service also provides end of life care. The accommodation is provided over two floors that were accessible by stairs and a lift.

Ashford House had a registered manager 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.

At our previous inspection on 23 & 25 July 2014 we found breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These correspond with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which came into force on 1 April 2015. We asked the provider to take action in relation to the standards of cleanliness, infection control, obtaining consent, staffing, supporting staff and assessing and monitoring the quality of the service provided. The provider sent us an action plan on 13 March 2015 and provided timescales by which the regulations would be met. The provider also sent us the updates in relation to progress they had made.

At this inspection we found that some improvements had been made. However, there were still breaches of the regulations. They had not met the requirements regarding cleanliness, and assessing and monitoring the quality of the service provided.

As this is the second time the service has been rated inadequate for one of the five key questions. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.

People were at risk because there were inadequate systems and arrangements to protect people from the spread of infection. Appropriate standards of cleanliness were not being maintained. The staff were not following the providers Infection control policies and procedures. We raised concerns about the conditions of mattresses, carpets, chairs, commodes, toilet seat frames and bedding in the home.

People were at risk as their medicines were not administered safely. People were not observed taking their medicines even though the medicine administration records (MAR) sheet were completed. Information had not been recorded if people had refused their medicines. We noted that any changes to people’s medicines were prescribed and verified by the person’s doctor.

The registered manager ensured staff had the skills and experience which were necessary to carry out their role. We found the staff team were knowledgeable about people’s care needs; however staff’s knowledge and understanding of people living with dementia was not sufficient to support their additional needs.

There were inconsistencies in how staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. People’s relatives and friends were able to visit at any time.

There were quality assurance systems in place, to review and monitor the quality of service provided, however they were not robust or effective at identifying and correcting poor practice.

People told us if they had any issues they would speak to the nurse or the manager. People were encouraged to voice their concerns or complaints about the service and there were different ways for their voice to be heard.

People had access to activities that were important and relevant to them. People were protected from social isolation through systems the service had in place. We found there was a range of activities available within the service and the local community.

People told us that they felt safe at Ashford House. People told us, “Very lucky living here. I feel safe and the staff are good to me.” Staff had a good understanding about the signs of abuse and were aware of what to do if they suspected abuse was taking place. There were systems and processes in place to protect people from abuse.

Recruitment practices were safe and relevant checks had been completed before staff commenced work.

People had enough to eat and drink throughout the day and night and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and healthcare professionals were involved in the regular monitoring of people’s health. The service worked effectively with health care professionals and referred people for treatment when necessary.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

 

 

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