Background to this inspection
Updated
20 July 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This unannounced inspection took place on 11 March 2015. The inspection was undertaken by two inspectors. Before our inspection we looked at the information we held about the service. This included the actions the provider told us they would take in response to concerns raised at our last visit. The provider had recently commenced sending notifications about accidents/incidents and safeguarding alerts which they are required to send us by law.
During the inspection we met and spoke with the two people who were living at the home. People’s care needs meant that the information they were able to share with us about their experience of the home was limited. We spoke with three of the staff who were on duty, the home manager, the registered provider and a person working on behalf of the registered provider. After the inspection we spoke with one relative and with two health and social care professionals who support people living at Ascot Lodge.
We looked at records about people’s needs and the care and support they had been offered and received, the recruitment records of three members of staff, the systems in place to manage and administer peoples medicines and the systems in place to ensure the service was safe and providing a good quality service.
Updated
20 July 2015
This inspection took place on 11 March 2015 and was unannounced. We last inspected this service in May 2014 and at that time the registered provider was failing to meet two of the regulations of the Health and Social Care Act 2008 which we looked at. We found that people were not adequately protected as new staff were not subject to robust recruitment procedures and the systems in place to monitor the safety and quality of the service were inadequate. Following that inspection we met with the registered provider, and they submitted an action plan detailing how they would develop and improve the service to meet these shortfalls. We returned to the service in March 2015 and found that the registered provider had made improvements to the service but the breaches of regulation had not been fully met.
Ascot Lodge is registered to provide care and accommodation for up to three people who have a learning disability, who are living with autism, and who may experience mental ill health. At the time of our inspection there were two people residing at the home. The accommodation comprised of three single ground floor bedrooms. The home had a bathroom, communal living space and facilities for people to cook.
The home did not have a registered manager. 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. Although a manager was in post they had not applied for registration with the Commission. There had not been a registered manager for over six months which put the registered provider in breach of their conditions of registration. There was a manager in place who had been working in the home for several months.
People living at Ascot Lodge were not consistently safe. We found that the registered provider was not using the information they had gathered about people to help plan their care, assess risks or protect people from avoidable harm. There were inadequate numbers of staff on duty to provide people with the support they required and to help people stay safe. You can see what action we told the provider to take at the back of the full version of the report.
Medicines were being well managed and we found people were receiving their prescribed medicines at the correct time, in the correct dose.
The registered provider was not complying with the requirements of the Mental Capacity Act 2005. Staff we met told us that they did not have the knowledge required to enable them to work confidently or competently within the act however staff had changed some of their practices in an attempt to comply with the act. This had resulted in people being placed at increased risk of harm.
People had been supported to attend healthcare appointments and some people had made significant improvements to their health. However the systems in place to monitor and evaluate people’s health were not good enough to identify if people were receiving care which met their needs.
People were being supported to eat and drink a varied diet that was to their liking and met their cultural preferences.
People told us they valued the relationships they had built up with staff over time. We observed and heard caring and compassionate interactions between people and staff.
People had a variety of different activities they could do each day. These included attending day centres operated by the local authority and undertaking activities related to running a home. Although people were supported to pursue an interest or hobby that was of interest to them people did not have the opportunity to undertake some of the activities regularly.
The leadership of the service had not ensured people always got a safe and good quality service that met their needs. The registered provider had not ensured that the service met the specific needs of the people living at Ascot Lodge. You can see what action we told the provider to take at the back of the full version of the report.