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The provider had taken action to rectify the concern and people were now able to sit in the lounge area with their privacy respected. Many bedrooms were not made personal and homely at the last inspection. This had much improved and people had their personal belongings and mementoes around them. Ashley Down Nursing Home is a large converted detached property providing nursing care and accommodation for up to 19 older people, some of whom may have dementia or physical disabilities. Archived services are ones which are no longer part of a provider's registration with CQC. You can find out more about archived services and how you can use the information on our page about searching for the history of care services.
Two people told us, “I often don’t feel like joining because it is not very exciting” and, “The activities are all right I guess”. The registered manager and activities co-ordinator were aware of people’s views and had begun to look into how to provide more stimulation for some of the people who were living with dementia. They told us, “At present the activities programme is not as stimulating as it could be due to people’s varied levels of ability but we are working on improving it”. People told us that staff were caring and we observed staff engaging with people in a kind and compassionate way.
DMC Consulting Services – Gravesend
This means they are providing inadequate care for the residents who are frail, unwell and very elderly people. Ashley Down in Clarence Place was one of 14 homes named among the worst care providers in England by OlderLivingMatters4.net. Because of the strain on staff, those employed had not received all the necessary training and did not have any time to spend with residents, inspectors found. – the service is performing well and meeting our expectations. People living in the home said that staff asked them for their choices about day to day events, such as if they wanted a bath or a shower, and if they wanted it in the morning or evening. They also asked them if they wanted to stay in their own rooms, or go to the lounge or elsewhere.
We recommend that best practice guidance is sought and followed regarding providing meaningful activities of people’s choosing. We found that people who used the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises. We talked with people who used the service or their relatives. Two people told us that there was a smell of urine in the home; one person told us that staff are often cleaning the carpets. At the time of our inspection on 22 April 2014 the home did not have a registered manager in post but the provider had indicated that they wished to undertake this role in the future.
'I experienced Christmas party season outside Kent's 'rowdiest' McDonald's'
At the time of this report, CQC judged the service to be Good. See CQC's page explaining ratings for more details about ratings and inspection practices of care homes in England. People’s feedback was sought and they were involved in the planning of their care. Complaints, comments and suggestions were taken into account and most but not all of these had been acted on.
There were risk assessments in place that were personalised to people’s needs and updated as their needs changed. However, there was little evidence that people had been involved in the drawing up or review of their care plans. The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
Inadequate
We found breaches of the Health and Social Care Act Regulations 2014. The kitchen was well stocked and people told us they enjoyed the food. The provider had put into place new policies and procedures but they had not established that some of them were not fit for purpose. Some policies could not be practically implemented and the registered manager was unaware of the content and details of other policies which conflicted with practice.
Registered nurses, including the manager, were able to provide nursing care to people. Health care professionals were referred to when people needed further support with their health needs. People were supported at the end of their life and their final wishes were recorded. Access to activities and interests was more available since the last inspection.
They wrote to us on 18 December 2013 and stated that all records apart from staff files were kept in the nurse's office. However, during our inspection of 22 April 2014 we found that a number of records could not be located promptly as the provider unavailable. Staff had a safeguarding procedure to access the information they needed to protect people and raise concerns. A copy of the local authority procedure with their full guidance for reporting concerns was kept in the home, however, it was an old copy with the wrong information available. The provider had not displayed the ratings of the previous inspection in a prominent place as required by the regulations. New staff had not had the appropriate checks made of their suitability to care for and support the people living in the home.
When a complaint had been received, the provider had investigated and responded to the complainant in line with their policy. The Care Quality Commission is the official regulator for the care sector. They inspect care homes and care services to make sure they are safe, caring, effective, responsive and well-led. Autumna is the UK's largest and most comprehensive later-life living & elderly care directory. Our website is free to use, we are proudly independent, and we never take referral fees. The provider sent the CQC an action plan which described how and when the improvements would be made.
People and their relatives were given opportunities to give their views of the service through meetings. People told us they were listened to and their views were taken into account. Staff felt supported and confirmed they could speak with the manager at any time if they needed to.
Fire evacuation practice drills had not been carried out to ensure people and staff knew what to do in the event of a fire. Quality audits, to monitor the safety and good quality of the service were effective in identifying where improvements were needed and action was taken to quickly remedy areas of concern. If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
The home had systems in place to audit and monitor the quality of the service. However, these were not robust and did not demonstrate that improvements had taken place as a result. The registered manager frequently worked care shifts and not supernumerary therefore did not have the time to complete their role and responsibilities as the manager. The principles of the Mental Capacity Act were not embedded into practice. Appropriate processes in regard to mental capacity assessments had not been followed for the use of potentially restrictive care practices such as bed rails and wheelchair lap belts.
Referrals to appropriate health care professionals was now better evidenced. A consistent approach was not taken when monitoring the blood sugar of people with diabetes. An assessment tool used to monitor the risk of malnutrition was erroneously scored, showing a score that was not correct. Staff knew their responsibilities in keeping people safe from abuse. The provider and manager had worked with the local safeguarding teams when concerns had been raised. People’s privacy and dignity was not always respected at the last inspection.
