We carried out an unannounced comprehensive inspection of Ashley Lodge Residential Care Home on 31 March and 4 April 2016.The service provides accommodation and support for up to eleven people who have learning disabilities. Ashley Lodge Residential Care Home aims to support people to lead a full and active life within their local community and continue with life-long learning and personal development. The service is situated in a village and consists of three houses on a large plot which has been furnished to meet individual needs. At the time of our inspection ten people were using the service.
The service had a registered manager in place. 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 service is required by a condition of its registration to have a registered manager.
The senior staff provided clear and direct leadership and systems were in place to assure the quality of the service and drive improvements. However, some improvement was needed to ensure the service's medicine audit was sufficiently comprehensive to support the registered manager to assess whether the service’s medicine practices met national best practice guidelines. Where decisions had been made for example, how to mitigate recruitment, risks these had not always been recorded so that the registered manager could review the effectiveness of these decisions. We have made a recommendation about the evaluation of the effectiveness of their risk assessment and monitoring systems.
There were enough staff to keep people safe and support people to do the things they liked. The provider had recruitment process in place to identify applicants' who were suitable to work with people.
Staff understood how to keep people safe from abuse. People's safety risks were identified, managed and reviewed and staff understood how to keep people safe at home and in the community. Systems were in place to protect people from the risks associated with medicines.
People living at Ashley Lodge Residential Care Home received care and support from knowledgeable and experienced staff. Many of the staff had supported people living at the service for some years and demonstrated an in-depth knowledge of people's needs and aspirations. The joint working between professionals and the service was outstanding and this resulted in people receiving highly personalised care.
Staff were supported to undertake training to support them in their role, including nationally recognised qualifications. They received regular supervision and appraisal to support them to develop their understanding of good practice and to fulfil their roles effectively.
Staff sought people's consent before they provided their care and support. Where some people were unable to make certain decisions about their care the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. Where people had restrictions placed upon them to keep them safe, the staff continued to ensure people's care preferences were respected and met in the least restrictive way.
People were supported to have their health needs met by health and social care professionals including their GP and dentist. People were offered a healthy balanced diet and when people required support to eat and drink this was provided in line with professional's guidance. People received the support they needed to effectively manage their epilepsy.
For those people who needed support to manage their behaviour, behaviour support plans had been drawn up. Staff had received training in positive behaviour support, understood the triggers for people's behaviours and ensured people were sufficiently occupied during the day to reduce the risk of them becoming anxious or frustrated..
Staff supported people to identify their individual wishes and needs by using their individual methods of communication. People were encouraged to make their own decisions and to be as independent as they were able to be.
Relatives told us people were happy and content in the home. We observed people appeared relaxed and calm in the company of staff who they readily approached for support when required.
Relatives told us they had no reason to complain but knew how to do so if required and that the staff always took immediate action if they had any concerns. The registered manager listened to people's comments and implemented identified learning from incidents and accidents to ensure action would be taken to prevent future harm.