Archived: Ashford Lodge

Updated 10 October 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.

Inspection team

The inspection team consisted of three inspectors. One inspector visited the service and two reviewed documentation and spoke to staff. This was to minimise the time spent at the service due to the current pandemic.

Service and service type

Ashford Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection to check the service’s COVID 19 status.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four members of staff including the two temporary managers, and two support staff. We observed interactions between people and staff. We offered people the chance to speak to us, however, they declined.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment, staff supervision and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We contacted and spoke with two staff members.

Updated 10 October 2020

About the service

Ashford Lodge is a residential care home providing personal care for up to nine people with a learning disability. At the time of the inspection there were seven people using the service. One person lived in an annex on the grounds of the service giving them their own space.

People’s experience of using this service and what we found

People were not always treated in a way which was person- centred or took into account their wishes. Some people were restricted by staff and prevented from having a choice in their day to day activities. A few staff had raised some concerns with the registered manager, however, when these were they had not been acted upon or escalated outside the service

Professional help or guidance had not always been sought when people had unaccounted for lost weight. Fire checks and drills had not been completed in a timely fashion. Risk assessments had not been updated when people’s needs changed. Relatives stated that communication was poor, and they were not always informed of changes in their loved ones needs.

There were not always enough staff to keep people safe and ensure they could go out or take part in activities they enjoyed. Staff did not have regular supervision and told us their views were not listened to. Incidents were not reviewed for learning and had not been shared with relevant professionals or notified to CQC.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service rarely applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons, people had restrictions placed on them for example the times they could watch television. People had limited access to food and were given food staff knew they did not like with no alternative available. Low staff levels restricted people’s ability to go out or take part in activities they enjoyed.

The provider had put in place temporary managers from two of its other services to support the service, after the registered manager recently resigned, identify shortfalls and take action to improve the care people received. The manager had identified the shortfalls found at this inspection and a plan was in place to address them. When action was urgent such as seeking medical advice for people this had been done. The managers were working to challenge poor practice and role model for staff.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 06 July 2018).

Why we inspected

We received concerns about people being restricted and not having full choice in their lives, a closed culture and a lack of consistent support. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ashford Lodge on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safeguarding people from abuse and improper treatment and good governance. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.