Archived: Ashton Lodge

The service provides accommodation and support for up to twelve older people. Accommodation is arranged over two floors. A passenger lift provides access between floors. Ten bedrooms are single occupancy and one bedroom is shared. There were ten people living in the service when we inspected.

A registered manager was in post and was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. 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.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. At the time of the inspection, the registered manager had applied for DoLS authorisations for some people living at the service, with the support and advice of the local authority DoLS team. The registered manager understood their responsibilities under the Mental Capacity Act 2005. Mental capacity assessments and decisions made in people’s best interest were recorded.

The registered manager provided leadership to the staff and had oversight of all areas of the service. Staff were motivated and felt supported by the registered manager and staff team. Staff told us the registered manager was approachable and they were confident to raise any concerns they had with her.

People were treated with kindness and respect. People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. People were encouraged to be as independent as possible. Detailed guidance was provided to staff about how to provide all areas of the care and support people needed.

People told us they felt safe. Staff had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s safety had been assessed and measures put in place to manage any hazards identified. The premises were maintained and checked to help ensure people’s safety.

Staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained. People told us that they had no complaints and if they did they would speak to the registered manager or staff.

There were enough staff on duty with the right skills to meet people’s needs. Staff had been trained to meet people’s needs. Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

People received their medicines safely and when they needed them. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.

People had access to the food that they enjoyed and were able to access drinks with the support of staff if required. People’s nutrition and hydration needs had been assessed and recorded. People were asked for feedback on their food and action was taken if required.

People participated in activities of their choice within the service. There were enough staff to support people to participate in the activities they chose. A volunteer also spent two afternoons a week with people participating in various activities.

Processes were in place to monitor the quality of the service being provided to people.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were supported in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available at most times of the waking day, and was available by telephone in case of emergencies.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. The manager described the processes that would be followed if capacity to consent were absent, and the steps that would need to be taken to lawfully deprive a person of their liberty.

Is the service effective?

People were fully involved in their assessment and care planning. This meant that their true voice was heard and that all care and support was planned with their consent. We saw that the family and other people who the person that received support wanted involved also had a voice. This meant that the person received the right level of support to remain as safe and as independent as possible.

Is the service caring?

People were relaxed and happy in the company of staff. The manager introduced us to 10 of the 12 people at the home. All looked delighted to see the manager, and were confident to speak about the service provided. The manager provided us with time alone to speak with people in confidence. However two people were keen to tell us how the manager had helped them personally with potential difficult relationships. A person told us 'I had a problem with a (staff) I did not like. I told (the manager) and she made sure that it was sorted out. Now (the staff) and I get on fine'.

People were supported to come to terms with loss of independence, one person described that although they were very sad to leave their own home, they felt safe and were getting used to residential life. One person said 'I do feel safe, but it will take me a long time to adjust. But, since living here, I have not fallen over'.

Is the service responsive?

Records showed that the manager and team work together to keep people's health and support plans up to date. We saw records confirmed medical professionals had been consulted without delay. The action taken and what the outcome was were noted. During our visit, the manager was assessing a person to find out if, with a very small environmental adjustment, their independence could be considerably increased. We saw that various hand rails had been positioned to respond to the people's individual physical stature.

Is the service well led?

The people we spoke to said that the home was run very well. Several people said 'I have no complaints, the food is good, the staff are nice'. Two people told us they had made complaints, but they also told us that the manager had been able to sort out the issue 'before it was a problem'. One staff team member told us that they have supervision with the manager formally, but informally, the manager works alongside the team to support and role model 'good care'. The staff member said that it had been possible to provide people with trips out to the local hotel for cream teas, and occasional trips to a local park. We were told, and saw evidence that staff contribute to the review of support plans.

People were treated with respect and their privacy and dignity was protected.

People received care and support that was well planned and sensitively delivered.

People received the medicines they needed when they needed them.

Robust recruitment procedures ensured that people were cared for by staff who were suitable to work with them.

Effective quality assurance procedures ensured that people were provided with a good service.

Overall we found that this service was safe, effective, caring, responsive and well-led and had achieved compliance with all the standards we inspected.

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service. This was confirmed by our observations and in discussion with the people and a relative.

Care records showed that people had been supported to make decisions about their care. We saw that people had been involved in planning their care and had given clear consent where needed. When people's needs changed, we found that records had been updated to reflect this.

Staff spoken with demonstrated a good understanding of how to safeguard people from harm. Records showed that regular training was in place. Training records also showed that staff were suitably trained and supported in their role, with training specific to the people living in the service for example, diabetes care and medication management.

Records showed the provider regularly assessed and monitored the quality of the service. We saw that people and their relatives were asked their views about the home in surveys.