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Ashley Lodge Residential Care Home Good


Inspection carried out on 30 October 2018

During a routine inspection

Ashley 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.

Ashley Lodge is registered to provide care and support to 11 people with learning disabilities and autism in three ‘homes’ within Ashley Lodge: the house, the annexe and the bungalow. Ten people were living in the home at the time of our inspection, and one person was in the process of being assessed before they moved in.

The care service has been developed and designed in line with values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 of the Health and Social Care Act 2008 and associated regulations about how the service is run.

At our last inspection on 31 March 2016, we rated the service overall as Good. The key questions Safe, Effective, Caring and Responsive were rated Good. The key question Well-led was rated Requires Improvement. This was because quality assurance and risk management systems did not always show how checks were completed to ensure the service was meeting the requirements of the regulations.

At this inspection, on 30 October 2018, improvements had been made and the key question Well-led is now rated as Good. We found the evidence continued to support the overall rating of Good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service continues to be rated as Good.

People were protected from harm and abuse. Staff had received training and understood their responsibilities regarding safeguarding people.

People’s medicines were safely managed and people received medicines when they needed them.

People were treated with kindness and respect. People’s privacy was respected and their independence promoted.

People’s care and support was delivered in a way that met their diverse needs and promoted equality.

Staff were aware of the importance of supporting people to make choices. They worked within the requirements of the Mental Capacity Act (2005).

Safe recruitment procedures were completed. Sufficient staff were deployed to make sure people’s needs were met. Staff received supervision and training to enable them to meet people’s needs.

Quality monitoring systems and checks were completed to make sure shortfalls were promptly identified and improvements made.

The proprietor, registered manager and staff team worked well and in partnership with external health professionals to support care provision.

Inspection carried out on 31 March 2016

During a routine inspection

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

Inspection carried out on 17 December 2013

During a routine inspection

At the time of our inspection there were ten people living at Ashley Lodge. Some people living at Ashley Lodge had complex needs and were not able to tell us what they thought about the care and support they received. We were welcomed into the house by one of the people who lived there. We noted that all the people who lived in the house were involved in making decisions about what went on. We observed staff speaking to people in a respectful manner, staff addressed them using their preferred name. We spoke with four people who lived at at Ashley Lodge. One person we spoke with told us about their forthcoming visit to see the horses at Olympia. Another person told us �all the staff are nice to me. They help me get up out of bed�.

People expressed their views and were involved in making decisions about their care and treatment. There were regular residents meetings where everyone living in the house was able to raise any concerns and tell others about ideas they would like to introduce. We saw that these were minuted.

People were supported in promoting their independence and community involvement. There were numerous activities which took part both on and off site. While we were inspecting some of the people living in Ashley Lodge went out on a shopping trip to choose and buy presents for each other for New Year�s Day.

We found that people were provided with a choice of suitable and nutritious food and drink. People we spoke with told us that they had a choice of food. We observed that at lunchtime people were offered a variety of choices of what they wanted to eat.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We spoke with seven members of staff and the home manager. Staff we spoke with told us that they had access to regular supervision and training. They also told us that they felt comfortable with raising any concerns and felt supported by the management team and other staff. One staff member we spoke with told us �I feel very supported, the management are always there for you to talk to�.

The provider had effective monitoring systems in place to identify, assess and manage risks to the health, safety and welfare of the people who used the service. We saw that the provider, management team and staff all undertook regular checks to ensure the quality of service provision.

Inspection carried out on 28 November 2012

During a routine inspection

We spoke with three of the people using the serivice who all said that they liked living at Ashley Lodge. They told us that their families could visit whenever they wanted and that all staff were helpful.

We heard that people had opportunities to get involved in planning their care or support. They were able to choose when they wanted to take part in activities. People told us they enjoyed a variety of activities which included swimming, music, horse riding and trips out. We were told about a recent holiday at Butlins and a forthcoming trip to the Theatre.

We found that staff demonstrated a good understanding of the individual needs of the people living at Ashley Lodge and how they should be met.

Inspection carried out on 29 March 2012

During a routine inspection

People told us they visited Ashley Lodge before deciding if it was the best place for them. They told us staff respected people�s dignity and rights.

Everyone we spoke to were very complementary about the staff and the care provided.

�Staff help me to do as much for myself as I can.�

People told us that they had plenty of opportunities to get involved in having their say about how the service is run. They also told us that they were confident that if they reported any problems, they would be dealt with promptly and effectively.

One person said they �really enjoyed going horse riding that morning, and were looking forward to going trampolining in the afternoon�.