Archived: Ashling Lodge

Ashling Lodge is registered to provide residential accommodation and care for 11 people. Bedrooms are on the ground and first floor and there is a stair lift access to the first floor. At the time of the inspection there were nine people using the service. Prior to the inspection concerns had been raised with CQC about staffing levels at the home. We were also made aware of the uncertainty of the long term future of the home. The provider told us they had written to people and relatives in June 2017 to advise them about this. At the time of the inspection no final decision had been made.

Following the inspection the provider’s representative informed us a decision had been taken to close the home and that people, their relatives and relevant local authorities had been advised of this.

At this inspection there was no registered manager in post. The previous registered manager had left the home suddenly in June 2017. 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. The home had been managed by a representative of the provider since the departure of the registered manager.

At this inspection we judged there were sufficient staff deployed to meet people’s needs. However, we found breaches of regulation with the governance of the home and with recruitment arrangements. Aspects of the quality of the service were not well monitored to reduce risk. Previous fire safety recommendations on the gradual replacement of older smoke detectors had not yet been started. While legionella checks were completed arrangements for the assessment of risk from legionella did not comply with legal requirements. Audits did not always identify issues effectively. The provider did not regularly seek formal feedback from people or their families about the service or act on feedback to drive improvements. Recruitment systems were not always effective as we found employment histories for three staff had not been verified to ensure the provider had a full employment record as required under the regulations.

You can see what action we told the provider to take at the back of the full version of the report.

Some further improvements were needed. Most risks to people were identified and assessed but some risk assessments were not up to date to accurately reflect the level of risk or provide guidance to staff on how to reduce risk. Maintenance checks on a piece of fire safety equipment were not always effective. Staff knew people well, but people or their relatives, where appropriate, were not always consulted or invited to reviews of their care. People’s preferences about their care and support were not always recorded in their care plans.

The provider’s representative told us they had been busy with the day to day management of the home and had not had time to oversee the overall quality of the care provided. They took action to begin to address these issues described at or following the inspection.

There were some good aspects to the care provided. People told us they felt safe and well care for. Staff understood how to protect people from abuse or neglect. People‘s nutritional needs were met. Medicines were safely managed. People had access to health professionals when needed. Staff received sufficient training and support to carry out their roles.

People were asked for their consent before care was provided and were involved in the day to day decisions about their care. People told us that staff were kind and caring and we observed this was the case. Staff knew people well and interacted with them sensitively and with respect. People’s needs for stimulation and social interaction were met.

There was a complaints system that people had access to. People told us they thought the home was well run. Staff told us they felt the home was being well managed and that the provider’s representative was approachable.

Ashling Lodge is registered to provide residential accommodation and care for 11 people. Bedrooms are on the ground and first floor and there is a stair lift access to the first floor. At the time of the inspection there were nine people using the service.

There was no registered manager in place but the manager told us they were in the process of applying to register as the 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.

At this inspection on 1 September 2016 we found improvements had been made. Medicines were now safely managed. People’s needs were assessed fully before they came to stay at the home so that staff would know if they could meet those needs. Assessments were undertaken to identify people’s health and support needs and any risks to people who used the service. Staff received training on MCA and there were processes in place to enable staff to follow the law in relation to mental capacity.

We found that there were some areas that required improvement. Staff had received fire safety training and took part in fire drills; however, they were not sure of their role in the event of the need to evacuate people from the building. The manager told us they would address this as a priority. Audits were conducted to monitor the quality of the service; however systems required some improvement to maintain consistency in identifying and completing some actions needed to address issues.

People and their relatives told us that they felt safe and well looked after. Staff knew how to recognise signs of abuse and how to report any concerns. People told us the home had earlier in the year had difficulty with recruiting staff and agency staff had been employed which they had found difficult. However things had now improved. The manager confirmed this and told us they were now fully staffed. There were enough staff to meet people’s needs and safe recruitment procedures were followed. People had enough to eat and drink and gave positive feedback about the quality of the food. People’s health needs were met and plans were in place to meet people’s support needs.

Staff received enough training, supervision and support to enable them to carry out their roles. People told us staff respected their privacy, dignity and independence. We observed staff engaged with people in a caring manner and knew them well. They understood and responded to people’s diverse individual needs and were familiar with people’s histories and preferences. There was a complaints procedure in place and people told us they knew how to make a complaint if they needed to.

People and their relatives told us the manager was approachable and involved in the running of the home. They felt their views were listened to through residents and relatives meetings or informally when they visited. The provider also carried out an annual survey to understand people and their relatives’ views.

Staff told us they felt the manager had supported them through a difficult period with staffing and been hands on when it was needed. They were confident the manager would deal with any issues and they told us the staff team worked well together.

At our last inspection of June 2013 we had raised concerns that the care records were not accurate in all cases and the provider's quality monitoring processes were not always effective.

At our inspection of October 2013 we found that improvements had been made to the care records. Quality checks had been included in the regular reviews of the service and policies and procedures were being updated.

We found that people's wishes were taken in to account in most cases and they were consulted with about decisions related to their care. We found that care and treatment was planned in accordance with people's assessed needs and the provider worked with other health and care professionals to ensure people received safe care. However we found that records were not accurate in all cases and the provider's quality monitoring processes were not always effective.

On our inspection we found that the nutritional needs of people who used the service were met adequately. There were sufficient staff available to provide support to people and the care records were stored securely and were mostly accurate.