Archived: Ashdown Lodge

Updated 4 March 2016

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.

Before the inspection, we checked the information that we held about the home and the service provider. This included previous inspection reports and statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We also reviewed feedback from healthcare and social care professionals. We used all this information to decide which areas to focus on during inspection. One inspector carried out the inspection.

Some people living at the home were unable to tell us about their experiences; therefore we observed care and support in communal areas We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with five people, three relatives and we spent time looking at records. These included eight care records, three staff records, medication administration record (MAR) sheets, staff rotas, the staff training plan, complaints, quality assurance audits and other records relating to the management of the service.

During the inspection we spoke with the provider, the registered manager, the chef and two members of care staff. We also spoke with a visiting health care professional.

The service was last inspected on 14 October 2013 and no issues were identified.

Updated 4 March 2016

Ashdown Lodge provides support and accommodation for up to thirteen older people with a variety of long term conditions and physical health needs. Some people were also living with dementia. It is situated in a residential area of Rustington, West Sussex. It is situated in a residential area of Rustington, West Sussex. People had their own room, there was a dining and lounge area which people could spend time in.

The service had 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.

There was an audit schedule for aspects of care such as infection control, accidents and incidents and maintenance of the home. However the monitoring processes were not robust and did not include the areas which we identified at the inspection. The provider told us that they were in the process of compiling a more robust quality assurance system to ensure that issues could be identified and responded to in a timely way.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

Consent to care and treatment was not always sought in line with legislation and guidance We reviewed people’s care records and found that there was not a robust process in place to identify when people needed to have a DoL’s application submitted. Within these care records we saw no evidence that capacity assessments had been completed or that people’s abilities to consent to care had been considered.

Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk actions were identified on how to reduce the risk and referrals were made to health professionals as required.

There were sufficient numbers of staff on duty to keep people safe and meet their needs. We observed that people were not left waiting for assistance and people were responded to in a timely way. New staff received an induction to ensure they were competent to start work. Staff had undertaken a comprehensive training programme to ensure that they were able to meet people’s needs however new staff felt that additional dementia awareness training would be beneficial. The registered manager was planning future dates for this training.

People were supported to maintain good health and had access to health professionals. Staff worked in collaboration with professionals such as doctors and the falls prevention team to ensure advice was taken when needed and people’s needs were met. Relatives told us staff responded quickly if people were unwell “if she’s not well they will be straight on the phone to the GP”.

People received enough to eat and drink. People who were at risk were weighed on a monthly basis and referrals or advice was sought where people were identified as being at risk.

Staff knew people well and they were treated in a dignified and respectful way. People told us “the staff are absolutely wonderful” and their relatives told us “it’s absolutely fantastic, it’s not a care home, it’s a caring home”. Another relative told us “for us it’s not just a care home, they look after us as well”.

The care that people received was responsive to their needs. Care plans included information on people’s key relationships, personality and preferences. They also contained information on people’s social and physical needs. People’s care plans contained a document which detailed people’s likes and dislikes. An example was about a person’s preferred morning routine. The document read “(named person) liked to have their breakfast at 7am and likes to remain in bed until just after 10am, they prefer a blanket rather than a duvet. They like to have their coffee in the lounge at 10.30am”.

There was a weekly schedule of activities for people to take part in which included reminiscence games, bingo and a quiz and this was made available for people to read and chose what activities they would like to take part in.

The registered manager told us there vision was to create a homely atmosphere which provided quality care to people. Staff shared this vision and told us “it’s just like a little guest house, everybody has good words to say about Ashdown”. We were also told “we’re like one big family, it’s really important as it’s their home at the end of the day”.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.