Archived: Ashford Lodge Nursing Home

Updated 17 May 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager. However, they were not acting as the manager at the time. The provider had taken over as the acting manager.

Notice of inspection

This inspection was unannounced.

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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with eight members of staff including the provider, clinical lead and care staff. We spoke with four people and two of their relatives about their experiences of the care provided. 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 reviewed seven people’s care records, multiple medicine records, three staff files and other records relating to the running of the home.

Updated 17 May 2023

About the service

Ashford Lodge Nursing Home is a residential care home providing personal and nursing care to up to 20 people. The service provides support to older people, younger adults and people living with dementia. At the time of our inspection there were eleven people using the service.

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

The service was not well-led. The management arrangements were not clear. There was no effective governance system and improvements since the last inspection were not sufficient to meet the requirements of regulation.

There were widespread concerns about safety. When people had accidents, there was no review or follow up to see how to prevent the same thing happening again. Staff were not provided with effective guidance to know how to keep people safe from harm. Some people had lost weight and no action was taken. Some areas of the home were visibly unclean. Medicine procedures were not always in line with best practice guidance.

Staff were not supported to undergo effective training. There was no training to know how to communicate effectively with people. People were not supported to have drinks at mealtimes until they had finished their food. There was limited choice of food at mealtimes. Information in people’s care plans was not always in line with best practice guidance.

At times, people’s dignity was compromised. People did not have access to outside space. The main lounge and the quiet lounge were cluttered, and many areas were in a state of disrepair including frayed carpets that posed a trip hazard.

People’s care was not always planned or delivered in a person-centred way. There were practices in the home which were designed to be easier for staff rather than to meet the needs and preferences of the people who lived there. Care staff were kind and caring towards people, however, they were busy and had to carry out tasks throughout the day, so had limited time to offer companionship to people.

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

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

Rating at last inspection and update

The last rating for this service was inadequate (published 5 March 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches of regulations in relation to leadership and governance, safety, person-centred care and staff training.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.