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Inspection Summary


Overall summary & rating

Requires improvement

Updated 3 May 2018

We carried out a comprehensive inspection of Ashdown Lodge on 8 and 9 February 2018. The inspection was unannounced.

Ashdown Lodge is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Ashdown Lodge is registered to provide personal care and accommodation for up to 13 older people and people who have dementia. At the time of the inspection there were 13 people living at Ashdown Lodge.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

This was the first inspection of the service since it was registered with the Care Quality Commission (CQC) in August 2017.

We had received information prior to the inspection that people had been subject to abuse and placed at risk of avoidable harm. People told us they felt safe and we did not find any evidence that people had been subject to abuse.

However, we identified medicines were not always safely managed. Systems processes and practices to safeguard people from abuse and the assessment of risks, monitoring and management of people’s safety require improvement.

Quality assurance and information governance systems at the service were not yet fully operational. There was no on-going development plan in place to help the service continuously learn and improve. This meant quality, safety issues or potential risks were not always recognised or identified and action was not always taken when needed.

Care homes and other health and social care services are required by law to notify the Care Quality Commission, (CQC), of important events that happen in the service. This enables us to check the action the service took and if necessary request additional information about the event itself. However, not all of the relevant notifications had been submitted.

There was lack of adaptations inside and outside the home to support people with dementia to be comfortable and remain as independent as possible.

People had consented to their care and staff respected this. However, not all staff could explain their understanding of the Mental Capacity Act 2005 (MCA) and link the principles of this legislation with their everyday practice.

Staff knew people well and understood how people liked to be supported. However, people’s care plans did not contain enough information about them to enable staff to provide care in a person centred way. This meant there was a risk that people might not be supported in a personalised and meaningful way.

The service promoted a supportive, open and inclusive culture and staff told us that they felt supported. However, we found there was a lack of formal policies and procedures to protect and promote staff well-being and equality and inclusion rights in the workplace.

The above areas of practice have all been identified as requiring improvement.

Staff received an induction and had on-going training, supervisions and appraisals. However, some staff told us they felt they needed more training in order to be able to effectively meet some people’s specific individual needs. This meant people were at risk of not achieving the most effective outcomes from their support. We have made a recommendation about staff training on the subject of dementia and behaviours that may challenge.

The service had enough staff to meet people’s needs safely and followed safe recruitment practices. Staff had received infection control and food hygiene training and followed best practice guidance in these areas. Regular health and safety check

Inspection areas

Safe

Requires improvement

Updated 3 May 2018

The service was not always safe.

Medicines were not always safely managed.

Systems, processes and practices to safeguard people from abuse were not always safe.

The assessment of risks, monitoring and management of people’s safety required improvement.

The service had enough staff to meet people’s needs and followed safe recruitment processes.

Effective

Requires improvement

Updated 3 May 2018

The service was not always effective.

Staff required further specialist training for people with dementia and behaviours that may challenge.

Adaptations inside and outside the service to support people with dementia required improvement.

People had consented to their care. Not all staff could explain their understanding of the Mental Capacity Act 2005 (MCA)

The service did not discriminate against people’s assessed needs or decision relating to their protected characteristics under the Equality Act 2010.

Caring

Good

Updated 3 May 2018

The service was caring.

Staff were kind and compassionate.

People’s privacy, dignity and confidentiality were respected.

People could express their views and were involved in decisions about their care.

People were encouraged to be as independent as possible.

Staff communicated with people in ways they understood.

Responsive

Requires improvement

Updated 3 May 2018

The service was not always responsive.

People’s care plans were not person-centred.

There was a complaints policy and people felt confident to do raise concerns.

People had support to follow their interests and take part in meaningful activities inside and outside the service.

People’s end of life care was managed sensitively and effectively.

Information about the service was available in accessible ways for people with a disability or sensory loss.

Well-led

Requires improvement

Updated 3 May 2018

The service was not always well-led.

Quality or safety issues or potential risks were not always recognised, identified or acted on.

Statutory notifications about important events at the service had not always been submitted.

People and staff were involved in the development of the service.

The service shared information and worked in partnership with other agencies.