New report raises fresh concerns at 'Inadequate' Exmouth care home

A targetted report on Exmouth's Ashfield care home, published this month by the Care Quality Commission, has raised concerns regarding safeguarding, risk assessments and how the weight of residents is monitored.

The report did also point out that positive changes have been made at the home, located on Windsor Square. Staff told the the CQC's inspector that the home's manager ' was working tirelessly to make improvements to the quality of care'.

Ashfield is a residential care home providing care to 14 people aged over 65, with capacity to support 25 people.

The most recent inspection took place on March 4 this year. However, due to the Covid-19 pandemic the CQC inspector was unable to complete the inspection as it was initially planned.

Due to the necessary changes made to the planned inspection, the inspection was converted from a full comprehensive inspection, that would have normally been completed over two days, to a one-day targetted inspection.

Targetted inspections look at key areas in need of improvement rather than a typical full inspection.

Targetted inspections cannot change the rating from the previous inspection. Therefore, the overall rating for Ashfield has remained 'inadequate', as not enough areas were inspected in order to change the rating.

The CQC plans to return to Ashfield in the near future to carry out a comprehensive inspection which could potentially change the rating of the service.

The CQC's inspector raised concerns about an incident at the home, the report states: "During the inspection, staff said there had been an incident where a staff member's actions had impacted on some people's dignity, as well as putting them at risk of pressure damage. Staff alerted the new manager, who took prompt action to protect people.

"They also informed the provider's operations team about the steps they had taken to keep people safe. However, there had been a delay in notifying the Care Quality Commission and making an alert to the local safeguarding team. A safeguarding alert was made following our inspection."

After this the inspector made a small number of safeguarding referrals to the local authority

Nub News contacted Ashfield to ask about the points raised by the CQC, South West Care Homes Ltd's director of operations, Len McMorrow, said: "During their inspection in March, CQC made a small number of safeguarding referrals to the local authority, but one case was immediately closed, and once we had clarified with further information, the remainder were closed with no action required.

"In one instance, although we had dealt with the problem, we had not realised it also required a safeguarding referral, but as the report makes clear elsewhere, the Local Authority are happy with the way we usually report to them."

The CQC inspector also raised concerns about risk assessments not being up to date, with some contradicting 'other assessment tools'. The report states: "For example, in the case of a person who was losing weight, an action was for them to be weighed weekly, but this was not happening.

"There was insufficient oversight as to whether agreed actions were effective. They had been prescribed food supplement drinks, but records contained gaps and it was unclear if the supplements had been drunk.

"Prior to the new manager starting, their weight was also poorly monitored with gaps of three months despite significant weight loss, but this was now being addressed."

Nub News asked Mr McMorrow what he made of the inspector's criticism of the home's risk assessment plans and weight monitoring. He said: "We were updating all of the risk assessments, and as the report says, most were done, but a small number of them had not been finished on the day we were inspected.

"They, were completed within a day of the inspection. The report makes clear that there had been inconsistent weight monitoring in the past, but that this had had already been dealt with by us and was no longer a problem."

In the CQC report's findings concerns were also raised regarding management at the home, the report states: "There is currently no registered manager at the service; a new manager has been in post since January 2020. They have not applied to register as a manager with CQC yet. We were told the service's care quality and compliance manager, managers from other homes in the group and the nominated individual were supporting them.

"In the last year, there had been four different managers at the home, which staff said had been unsettling. The new manager was busy on the day of our inspection, so we were unable to spend time with them to discuss how they were being supported in their new role. This was because they were working as part of the care team and administering medicines."

However, the inspector was encouraged by what staff said about the new manager, the report states: "Staff told us they had confidence in the new manager to address issues of poor practice and to make changes to improve the quality of care people received. They said the introduction of a well-being staff member and more social activities was benefiting people living at the home. Staff said the manager listened to them, which they said had not always been the case in the past."

Mr McMorrow is keen to have a fresh inspection from the CQC, he said: "We are pleased that after a long delay, caused by the lockdown, a progress report by CQC from March is published, showing that there has been a lot of improvement at Ashfield since our old 2019 rating.

"As the report says, there has been more improvement since March. Just last week, the Environmental Health Department rated us at the highest, 5 stars.

"Its frustrating that we can't have a full inspection and new rating yet; CQC are only inspecting homes they have concerns about for now, but we look forward to re-inspection as soon as possible, to demonstrate the turnaround."

The full targetted inspection report is available to the public, click here to read the report in full.