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Ashlee Lodge Requires improvement

Reports


Inspection carried out on 21 June 2019

During a routine inspection

Ashlee Lodge is a residential care home providing personal care to a maximum of five people. At the time of inspection, five people were living at the service. People living at Ashlee Lodge have a learning disability and may also have autism.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them. However, staff levels, on occasions, did not always support this. See below.

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

Staff rotas did not demonstrate there were always enough staff to meet people’s assessed needs. Whilst the service had referred potential safeguarding matters to the local authority, they had failed to send these to CQC. The quality assurance systems were not always effective and had not identified some of the shortfalls found at inspection. For example, in relation to some people’s health needs, complaint records, fire drills and staff recruitment.

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.

People’s medicines were managed safely. Staff attended regular training to update their knowledge and skills. They attended regular supervision meetings and told us they were very well supported by the registered manager. A staff member told us, “I’m definitely supported.”

People were supported to attend health appointments, such as the GP or dentist and attended appointments for specialist advice and support when needed. People had enough to eat and drink and menus were varied and well balanced.

Staff were kind and caring in their approach. They had a good understanding of people as individuals, their needs and interests. Most people needed some support with communication and were not able to tell us their experiences; those who could told us they were happy, and we observed people were happy and relaxed with staff.

People were supported to take part in activities to meet their individual needs and wishes. This included trips to the local parks, theatres, cafes and restaurants and trips to places of interest. A relative told us “We are invited to parties twice a year, often barbeques and buffets. We all know each other, and it is lovely to meet up and chat.”

The environment was well maintained. A new shower had recently been fitted. The provider had ensured safety checks had been carried out and all equipment had been serviced. Fire safety checks on equipment were all up to date.

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 7 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified three breaches of regulation in relation to staffing, reporting incidents and the governance of the service. The provider had failed to ensure there were always enough staff to meet people’s needs. The provider had failed to submit notifications and the provider had failed to ensure that systems to assess, monitor and improve the quality and safety of the service were sufficiently robust.

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 from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the pro

Inspection carried out on 4 October 2016

During a routine inspection

This service was last inspected in July 2013 when we found it was meeting the requirements of the five areas we inspected. This is the first comprehensive rated inspection under the Care Act 2014. This inspection took place on 4 October 2016 and was announced. We gave short notice as this service is small and we needed to ensure people were available as well as to access records.

Ashlee Lodge is registered to provide care and support for up to five younger adults. People living at this service have a learning disability and may also have autism. The service does not provide nursing care. At the time of the inspection there were five people living at Ashlee lodge.

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 2014 and associated Regulations about how the service is run. The registered manager was present throughout the inspection and was responsive to feedback and suggestions.

People’s needs were well met by staff who understood people’s needs, wishes and preferred routines. Staff had training and support to do their job effectively and safely.

People were protected because there were good recruitment practices whereby any potential new staff were fully checked to ensure they were suitable to work with vulnerable people. All staff received training in understanding about abuse and knew how and when they should report any concerns.

People were supported to take part in activities which were meaningful to them. This included trips out using a vehicle owned by the service, as well as activities within the house. The service was close to shops, cafes and the seafront so people could walk to local amenities.

People’s nutritional needs, likes and dislikes were taken into consideration when planning menus. People were offered a balanced diet to maintain good health. Mealtimes were relaxed and staff sat with people to make it a sociable event.

Care was well planned, with risk assessments in place to keep people safe and ensure care and support was being offered in the least restrictive way. Staff knew people well, understood their needs and what they enjoyed doing. This helped staff to provide a person centred approach and ensured individualised care.

People were supported to express their views in a variety of ways. Staff understood people’s ways of communicating and this helped to ensure people were involved in decision making about their care and were offered day to day choices. Staff sought people’s consent for care and treatment and ensured they were supported to make as many decisions as possible. Staff confidently used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity, relatives, friends and relevant professionals were involved in best interest decision making. This ensured people’s rights were protected and the service consulted and worked with others to ensure the right care and support was being offered.

The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they live in a care home and do not have capacity to make decisions, and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. People's consent to care and treatment was sought. Where they were unable to provide informed consent the principles of the MCA and DoLS were followed, so people's legal rights were upheld.

There were sufficient staff with the right skills and support to enable them to provide safe, effective and responsive care and support to people. Staff received training in all areas of health and safety

Inspection carried out on 4 July 2013

During a routine inspection

We weren't able to speak to people using the service because of their complex needs which meant they were not able to tell us their experiences. We gathered evidence of people's experience of the service by questionnaire responses from relatives and feedback forms from visiting professionals.

Relatives of people living at the home were complimentary about the care and support they received. One had written, "There has been an incredible positive change in my daughter in her short time here," and "A home from home." Another stated that their relative was, "Always happy to go back there after a visit."

Professionals working in partnership with the home to provide support for the people living there had commented, "Our client has been very successful since living at Ashlee Lodge," and "The staff are always friendly and courteous." A visiting chiropodist stated, "I love coming here."

There were proper recruitment and training systems in place to ensure that people were kept safe and cared for by suitably qualified and experienced staff.

The premises were homely, safe and met the needs of people who used the service. People were enabled to be involved in making decisions about their care and treatment. We found that care and treatment was planned and delivered in a way that ensured people's safety and welfare.

There was an effective complaints system available but there had been no complaints received by the home since our last inspection.