Astral Lodge Residential Home

We found the following examples of good practice.

Individual risk assessments were in place to allow for safe visiting at the service. The registered manager had created a visiting room for relatives to use. When visits were unable to go ahead video and telephone calls had been used.

The registered manager had followed government guidance on infection prevention control measures and had kept these up to date.

All staff had received training on infection prevention control and how to use PPE effectively.

People and staff had regularly been tested for COVID-19 in line with government guidance.

At the last inspection, the service was rated Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing 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.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. The environment was appropriately designed and adapted to meet people’s needs.

Staff were well trained and attentive to people's needs. Staff could demonstrate that they knew people well. Staff treated people with dignity and respect.

People were provided with the opportunity to participate in activities which interested them. These activities were diverse to meet people’s social needs. People knew how to make a complaint should they need to. People were provided with the appropriate care and support at the end of their life.

The registered manager had a number of ways of gathering people’s views, they held regular meetings with people and their relatives and used questionnaires to gain feedback. The registered manager carried out quality monitoring to help ensure the service was running effectively and to make continual improvements.

Astral Lodge Residential Home is registered to provide accommodation and personal care for up to a maximum of fourteen people, some of whom may be diagnosed with dementia. At the time of our inspection they were fourteen people living in the service.

The service is required to and did have a 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.

Staff delivered support effectively and care was provided in a way that to promoted people’s independence and wellbeing, whilst people’s safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient numbers of staff enabled people’s individual needs to be met adequately. Qualified staff dispensed medications and monitored people’s health satisfactorily.

Staff understood their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The registered manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.

Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to identify their own interests and pursue them with the assistance of staff. Person centred social activities took place within the service as well as in the community.

Systems were in place to make sure that people’s views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits the manager carried out, which identified any improvements needed. A complaints procedure was in place and had been implemented appropriately by the management team.

We considered our inspection findings to answer five key questions; is the service safe, effective, caring, responsive and well-led? This is a summary of what we found;

Is the service safe?

When we arrived at the service a member of staff checked our identity and we were asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

Staff had received a range of training to ensure that they worked in ways that were safe. Training included fire safety, first aid, the safeguarding of vulnerable adults from abuse (SOVA) and the Mental Capacity Act (MCA) 2005. This assured people who used the service that staff had the knowledge to know how to care for them safely and protect them from harm.

During our inspection we assessed how the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were being implemented. Mental capacity assessments had been completed for people correctly to maintain the safety and rights of people who used the service.

People told us they were content living in the service and that they would speak with the staff if they had concerns.

We found that appropriate arrangements were in place to ensure that people who used the service were protected against the risks associated with the unsafe use and management of medicines. People had their medicines at the times they needed them, and in a safe way.

We found that people lived in a pleasant and safe environment which was well maintained. We saw records which showed that the health and safety in the service was regularly checked. This included regular fire safety checks which meant that people were protected in the event of a fire.

Is the service effective?

People told us that they were very happy with the service and that it met their needs. People made comments such as, "I am very happy," and, "The staff are lovely." People who were unable to verbally express their views were relaxed, interacted well with staff and were being well supported. Feedback from relatives showed that they were happy with the care and support offered at Astral Lodge. One person told us, "I really can't fault it here."

People's care was supported through assessments, care plans and risk assessments being in place. This ensured that staff understood people's needs and could care for them safely, effectively and consistently.

Staff who worked in the service were supported through on-going training and supervision to offer people care and support that met their needs.

Is the service caring?

We saw and heard good interactions between the staff and people who used the service. Staff were respectful, caring, encouraging and supportive towards people.

We saw that feedback from relatives about the service included comments such as, "[Carers] are so caring and very kind we are comforted that they are being looked after so well," and, "All the staff are very caring."

Is the service responsive?

We saw that staff consulted with people and offered them choices in their daily lives. People's choices were taken into account and listened to.

Staff were responsive to people's changing wishes and needs about where they went and what they did and supported them well.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from other health care professionals.

Is the service well-led?

The service had an experienced manager in post. Senior staff provided leadership on each shift. The provider had systems in place such as quality surveys and audits to monitor and improve the service. These mean us that the service was being well led.

Relatives told us that they were involved in developing the care that was required for their relative. One relative said, "The care here is excellent and the staff go above and beyond the call of duty." Another said, "I always get informed about health issues and hospital appointments. The staff are very kind and the food is good."

We found that care plans were personalised and met the needs of individuals. Risk assessments were clear and contained steps to take to reduce risks. Staff told us that they contained sufficient detail to enable them to provide the level of care required for each person.

We found that the kitchen hygiene was of a good standard. Food was stored and cooked in line with relevant guidelines and this protected people using the service from infection. All rooms were clean and tidy. The home had just begun a programme of re-decoration which included residentss bedrooms and other rooms within the home.

The provider had systems in place that monitored the quality of service provided and identified areas for improvement. A clear complaints procedure was in place that was effective.