Askham Grove is a care home with nursing. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Askham Grove accommodates up to 29 people in one two-storey building. The home provides care to adults with complex physical disabilities.

Askham Grove is one building with two separate units (upper and lower floors) each offering single, ensuite bedrooms and shared facilities such as lounge/dining and kitchen areas. At the time of this inspection there were 12 people living on the upper floor. There are also four one-bedroom flats on the upper floor, separated by a code-locked door from the main unit and with their own lift/staircase access to a separate front door. At the time of this inspection, the flats accommodated one person using the service, a relative of a person living in one of the other care homes on the site and two members of staff. Rooms on the lower floor accommodated staff members.

Askham Grove is the newest of five care homes on one site, on the outskirts of the village of Doddington. Each home is registered with CQC as a separate location. There are some shared facilities such as a café and function room where some activities take place.

This inspection included two site visits to the home on 26 June 2018 and 10 July 2018. This was the first inspection of this care home since it was registered. Adults requiring long-term rehabilitation moved into the upper floor of Askham Grove at the end of January 2018.

The home has been rated Requires Improvement overall. This is the first time the home has been rated Requires Improvement.

The service was not well-led. Systems for identifying, capturing and managing organisational risks and issues were ineffective. Leadership was not visible or open and leaders were out of touch with some of what was going on in the service. People’s views were not always sought or responded to. Leadership did not understand the importance of working within a person-centred equality, diversity and human-rights approach. Staff did not always understand, promote, uphold or work within the provider’s stated values and ethos of community, empowerment, dignity, respect and quality. Oversight and governance had not identified four breaches in regulations.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the home. 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 home is run. The registered manager had not provided the leadership that people and staff needed in order to give people the best possible quality of life.

There were not enough staff deployed to make sure that people’s needs, including social and emotional needs were fully met.

Some staff treated people well and showed empathy and understanding. However, not all staff treated people with kindness and compassion and people’s emotional needs were not always recognised or met. People’s need for privacy was not always upheld and confidentiality was not always maintained. Some staff were patronising and treated people as though they were children. People were not offered a choice of having their personal care provided by male or female staff. Staff did not always support people to maintain their independence.

Care plans were in place but did not always give staff guidance that was up to date enough for them to meet people’s needs in a personalised way. Some information in care plans was contradictory. Not enough activities, based on people’s individual interests and preferences were organised to ensure that people led fulfilling and meaningful lives.

Staff understood the ways in which the Mental Capacity Act