Ashdown Lodge

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained unchanged.

This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider fostered a culture of safety based on openness, learning and continuous improvement. Staff listened to and acted on safety concerns, and learning from incidents and feedback was used to refine and improve practice. The provider was receptive to learning and guidance from healthcare professionals and adapted practice to help staff recognise changes and deterioration in people's health needs. A staff member told us, “We have changed the way we monitor bowels as a result of this training”.

As a result of this learning, monitoring tools were introduced to support oversight of people's health and to help ensure timely responses to changes in health. For example, when a person showed symptoms of a suspected stroke, staff acted promptly, sought medical assistance and ensured the person was transferred to hospital within 10 minutes, resulting in a positive outcome.

Other examples demonstrated how learning had been embedded into practice, supporting timely escalation of health concerns and improved outcomes for people.

The provider did not always ensure safe systems were in place to support people`s care transitions between services. We identified an example where information relating to a person returning to the service following a lengthy hospital stay had mainly been shared verbally and was not formally documented, which reduced oversight of the discharge planning process. This created a risk that changes in the person's needs may not have been fully identified or planned for prior to their return to the service. We fed back to the provider who acknowledged the need to strengthen their processes including admission assessments and discharge planning processes, to ensure people's needs were fully understood and could be safely met when moving between services.

Feedback about people’s experiences of transitions between services was mixed. A relative described the process of arranging a care home placement as a stressful time. However, they told us the service supported the transition well by coordinating transport arrangements and maintaining communication throughout the process. This helped reduce pressure on the family and supported a smooth transition into the service, resulting in a positive outcome for the person.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff supported people to live safely while respecting their rights and promoting independence.

Safeguarding concerns were reported appropriately, with clear records maintained of actions taken and outcomes achieved. Staff had completed safeguarding training and understood their responsibilities in protecting people from abuse, avoidable harm and neglect while upholding safeguarding principles.

The provider did not always identify and respond promptly to risks relating to people's health and well-being. External healthcare professionals shared examples where deterioration in people's health had not always been recognised at an early stage, which resulted in delays in escalating concerns and seeking appropriate support. Additionally, this presented a potential risk that people may not always receive timely treatment, which could have a negative impact on their health outcomes.

Healthcare professionals told us their guidance and ongoing involvement had improved staff awareness and approaches to managing risks. A healthcare professional told us, “In the last few months there does seem to have been some improvement, which I am pleased to see and hope this continues”.

Records showed some examples where staff had recognised deterioration and escalated concerns appropriately resulting in people receiving prompt medical treatment.

A relative told us, “Mum was unwell, and they kept an eye on her and told me they were going to ask the doctor to check her over. They were concerned, they called the doctor, and she was given a course of antibiotics. She had a urine infection. They acted quickly.”

The provider continued to work closely with the GP, NHS professionals including emergency services where necessary. This supported a collaborative approach to identifying, monitoring and managing risks relating to people`s health and well-being.

The provider identified and managed environmental risks to support the delivery of safe care. For example, regular environmental and safety checks were completed with actions monitored through the provider`s service improvement plan. Day to day maintenance issues were dealt promptly by a designated maintenance person who also carried out weekly safety checks. Staff had completed health and safety training to safe working practices.

Personal emergency evacuation plans were in place to support people in the event of fires.

The environment was accessible for people using wheelchairs including the use of a lift which promoted people`s independence and safe mobility around the service.

Specialist equipment was obtained following assessments by healthcare professionals to help meet people`s individual needs safely. We observed staff using equipment appropriately to support people's comfort and safety. The provider had sensitively adapted some dining chairs using a device, which enabled staff to support people to sit safely and comfortably at dining tables while reducing physical strain for both people and staff.

The service, including garden areas, was clean, well maintained and provided a pleasant comfortable and safe environment for people.

A visiting professional told us, “It’s always so clean, never any unpleasant smells unlike some of the other care homes I visit.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

Staff described a supportive team culture that benefitted them and people using the service. A staff member told us, “We are a team, we work together and support each other, it works well for everyone”.

Recruitment processes were thorough with appropriate pre-employment checks completed, in keeping with recommended guidance. Staff received training relevant to their roles and were supported through supervision and appraisal. The service rotas indicated consistent arrangements and low use of agency staff, with permanent staff working flexibly to meet people's needs. This helped promote continuity of care and enabled people to receive support from staff who knew them well and understood their individual needs and preferences. A relative told us, “The staff are more than capable. when mum had covid, they called us in the evening and kept us informed and looked after her.”

We observed there were enough staff available to support people safely and it was evident staff took time to support people in a calm and timely manner.

A person told us, “They are lovely, like my own family. Oh, you couldn’t ask for better staff, they are the best.”

The provider assessed and managed the risks associated with infection prevention and control (IPC). Staff had completed IPC training and were observed using appropriate protective personal equipment (PPE), when supporting people. PPE stations were accessible across both floors of the service.

Safe infection control practices were followed throughout the service, including within the laundry area where designated staff managed the safe handling of soiled linen.

We observed the premises were clean and equipment used to support people was cleaned between use. These measures helped reduce the risk of infection spreading and supported the safety people, visitors and staff.

A relative told us, “Infection control wise, everything is very good. It's always clean, beds are always freshly made, wash basin is always clean and the toilet, the lady who does it is good. It smells nice.”

The provider made sure medicines were managed and administered safely in line with people`s needs and preferences. Systems were in place to monitor medicines, including secure storage arrangements and temperature checks to maintain the stability and effectiveness of medicines.

There was evidence of partnership working with the GP and external healthcare professionals, with people and their relatives involved, where possible, when changes to treatment were discussed or made. The service was supported by the NHS medicines optimisation for care homes (MOCH) pharmacists, who completed annual audits which identified any areas for improvement, prompting the provider to take appropriate remedial actions.

Staff had completed medicine training and competency checks and demonstrated a good understanding of the medicines people received. We observed staff supporting people with their lunchtime medicines in a safe and person-centred way. Staff knew how people preferred to take their medicines and adapted their approach. For example, a staff member told us, “[Name] likes it in her hand”, as they knelt beside the person to assist them with their medication.

People received their medicines safely in a way that respected their choices, including their right to refuse, which helped support their health and well-being.