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Ashton Lodge Residential Home Good

We are carrying out a review of quality at Ashton Lodge Residential Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 14 May 2019

During a routine inspection

About the service: Ashton Lodge is a care home that provides personal care and support for 27 people. The care home supports older adults and people who have mental health or physical disability support needs. There were 26 people at the time of the inspection.

People’s experience of using this service:

People lived in an environment that met their support needs. However, bath and shower hot water presented a potential scalding risk to people. The provider told us that they would take action to set water temperatures at safe levels.

The provider’s arrangements relating to infection control and hygiene monitoring could be improved.

We have made a recommendation about infection control arrangements.

People were protected from fire by the provider’s safety checks and personal evacuation plans were in place. However, some fire exit doors were fitted with keypad locks. We have made a recommendation about the fire exit arrangements.

People told us they felt safe. Care staff knew how to safeguard people from the risk of abuse.

People received kind and caring support from staff who knew how to meet their needs in line with national guidance and legislation. There were enough care staff to be able to support people safely.

People were supported to access healthcare in a timely manner and to take their medicines safely. We have made a recommendation about the storage of controlled medication.

People had personalised plans of care which care staff used to develop their knowledge about people’s needs and preferences. The provider assessed, reviewed and managed risks associated with people’s individual care needs. The registered manager supported staff to provide person centred support and care in line with local and national guidance and best practice guidelines.

People had the choice to engage in a variety of activities if they wished.

People were supported with their dietary needs. People were positive about the choice of food although some said they would like more variety.

The registered manager worked in partnership with others to ensure people received safe care and support.

Provider had a plan in place for the refurbishment of bedrooms and the provision of a smoking shelter in the garden.

People’s bedrooms were personalised although bedroom doors did not have distinguishing features other than room numbers. We have made a recommendation about dementia friendly environments.

People were supported to have maximum choice and control of their lives and care staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were regularly asked about the care they received and the registered manager implemented changes to care plans accordingly.

Resident’s meetings took place, which people could attend if they wished, and action taken by the registered manager in respect of the things discussed.

Privacy and dignity was maintained when care staff supported people with personal care.

People, and their relatives, told us that the registered manager was approachable, and that any concerns they raised had been dealt with effectively. Care staff told us they felt supported by the registered manager.

The registered manager had quality monitoring systems in place. They were aware of their responsibilities and worked in partnership with others to ensure people received safe care and support.

More information can be found in the detailed findings below.

Rating at last inspection: Good (7 October 2016).

We previously rated the service as ‘Requires Improvement’ in respect of ‘Effective’’. This related to people not having a mental capacity assessment in place. Also ensuring people were supported to consent to their care and treatment.

During this new inspection we found that the provider had made the required improvements in that respect.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monito

Inspection carried out on 25 August 2016

During a routine inspection

The inspection took place on 25 August 2016, and the visit was unannounced. We returned for a second day and this was an announced visit.

Ashton Lodge Residential Home provides care and accommodation to older people including people recovering from mental health issues and some who are living with dementia. Ashton Lodge is registered to provide care for up to 27 people. At the time of our inspection there were 26 people using the service.

A registered manager was 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.

People felt their privacy and dignity was respected in the delivery of care and their choice of lifestyle. People told us staff were kind and caring and ensured they remained safe. Staff mostly understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives. Some improvements were needed to the way staff implemented this legislation

People’s care and support needs had been assessed and people were involved in the review of their care plans, or when appropriate, happy for their relatives to be involved. Care plans included changes to peoples care and treatment, and people attended routine health checks.

We observed staff offered people choices and respected their decisions. Staff had access to people’s care plans and received regular updates about changes to people’s care needs. Visiting health professionals were complimentary about the staff and the care offered to the people using the service. There were enough staff available to meet people’s care and support needs and staff worked as a team in order to do this.

Medicines were ordered and stored safely and staff were trained to administer the medicines to people as they were required. Staff sought medical advice and support from health care professionals.

People were provided with a choice of meals that met their dietary needs. Staff were provided with up to date information about people’s dietary needs, and sought people’s opinions to meet their individual meal choices. There were sufficient personalised activities provided on a regular basis. Staff had a good understanding of people’s care needs, and people were able to maintain contact with family and friends as visitors were welcome without undue restrictions.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse.

The building was well maintained and staff were aware of the reporting procedure for faults and repairs and were able to arrange emergency repairs when necessary.

The provider had a clear management structure within the home and staff knew who to contact out of hours. The provider undertook quality monitoring in the home supported by the registered manager and their deputy. The provider had developed opportunities for people, relatives and health and social care professionals to express their views about the service including an annual questionnaire. We received positive feedback from visiting professional and the contracting staff from the local authority with regard to the care and service offered to people.

Staff felt confident they could make comments or raise concerns with the management team about the way the service was run and knew these would be acted on.

Inspection carried out on 26 June 2013

During a routine inspection

We spoke with four people who used the service, one relative, two carers and the registered manager. We briefly observed people in the communal areas and observed people eating their meal at lunchtime.

People we spoke with told us they were satisfied with the care and support being provided and that their choices were respected. Staff had a good understanding of the needs of people who used the service and demonstrated a good rapport with people. We found that people were confident approaching staff and that carers were responsive to people�s needs.

We looked at the records of four people who used the service and found care plans were detailed and thorough and provided clear guidance to staff about how the persons� care should be delivered.

However, we found that the home did not have suitable arrangements in place for acting in accordance with the best interests of the person when they were unable to consent to the care and treatment being provided.

Staff had been appropriately screened to ensure they were suitable to work with vulnerable people.

There were appropriate arrangements were in place for the obtaining, recording and administration of medicine.

Records were accurate and fit for purpose.

Inspection carried out on 26 November 2012

During an inspection looking at part of the service

Our inspections of 28 May 2012 and 10 October 2012 found the provider was not compliant with a number of the essential standards of quality and safety that we inspected. We identified shortcomings with the standard of cleanliness and maintenance of the home and in the assessing and monitoring of the quality of service provided. We issued a formal warning saying the service must make improvements or face further action.

We briefly spoke to some people using the service and asked them about their experiences of the home. People were positive and told us they liked the decorating and refurbishment that had recently been carried out. We saw that people were involved in making plans for Christmas arrangements at the home. Our brief observations showed people were comfortable and confident with staff. At our inspection of 28 May 2012 we spoke to a number of people in more detail. Please see our previous report for further details.

At this inspection we found that the service had made significant improvements. There were now effective systems in place to reduce the risk and spread of infection. In addition, we saw that the service had commenced a planned and ongoing programme of maintenance. We found the service had made improvements to its quality monitoring system. There was evidence that the provider and manager were assessing and monitoring the quality of the service provided to ensure people were protected from the risk of inappropriate or unsafe care.

Inspection carried out on 10 October 2012

During an inspection looking at part of the service

At our last inspection on 28 May 2012 we found that the provider was not compliant with a number of the essential standards of quality and safety that we inspected.

We briefly spoke to some people using the service during this inspection and asked them about their experiences of living at Ashton Lodge. They all were positive in their responses and said they were looking forward to the Halloween party. At our last inspection we spoke to a number of people in more detail. Please see our previous report for further details.

We found the service had made improvements to peoples� records and care plans. Care plans we looked at gave clear guidance to staff about how care should be provided and records showed that people�s health was monitored.

The service had made improvements to some areas of the property and gardens but we found the standard of cleanliness and maintenance was still poor. We found

the home was still not clean or hygienic and there were risks to people using the service getting or passing on infections because of this.

We found the service had not made improvements to its quality monitoring system. There was limited evidence that the provider or manager were assessing and monitoring the quality of the service provided to ensure people were protected from the risk of inappropriate or unsafe care.

We are following up areas of non-compliance identified during this inspection and will report on any action taken when it is complete.

Inspection carried out on 28 May 2012

During a routine inspection

People told us in the main that they were well cared for and supported at Ashton Lodge. Most people said the staff were helpful and they could talk to them. People said:

�it�s a beautiful place, staff are nice�

�the food is gorgeous, we have two choices�

�I like it here and wouldn�t change it�

Comments from relatives in a recent survey included:

�there has never been any problems whenever I�ve visited�

�they are kept clean, well fed and warm and the carers are kind to them. You couldn�t ask for more�.

Two people told us that they were bored with watching the television and one person said they would like to do more activities outside of the home.

Reports under our old system of regulation (including those from before CQC was created)