Archived: Ashbourne Lodge Rest Home

We asked the service to provide us with an action plan demonstrating what they had done to address the issues of non-compliance. We received an action plan from the registered manager. This detailed the procedures put in place to address the concerns. This inspection was to see what actions had been taken.

On this inspection, these areas of concern had improved and the service was compliant. We spoke with a range of people about the home. They included people who lived at Ashbourne Lodge, staff, and a professional working with the home. We also observed how people were supported by staff.

People we spoke with told us they were satisfied with the care being provided. They told us they felt well cared for. One person said, "The staff are very good with us. If we want anything we always get it. We get the help when we want it.' Another person told us, 'The staff are cheery. They know their jobs and look after us.'

We saw care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. People were assisted with personal care as needed, in a timely manner. We found care plans had been modified to ensure all information was accessible.

We observed the home was clean with no unpleasant odours. Actions had been taken to ensure flooring and furnishings were clean and protected people from the risk of infection. Personal protective clothing was accessible to assist with infection control.

Staffing had increased and was meeting people's needs. The home was calm and relaxed. Staff had enough time to support people with personal care. Staff were also able to spend time chatting to them and involving them in leisure activities.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us that the staff were very good and that they received care and support when they wanted it. They also told us they felt safe. One person said, "We are so lucky to have such good care. The staff look after us well.'

We saw that most people were receiving safe and appropriate care which was meeting their needs. However we saw from observation and care records that some people did not receive the care they needed. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to meeting their care needs.

Staff were knowledgeable about the foods and drinks people liked and disliked. They were also familiar with dietary needs of people. This meant that people received appropriate nutrition.

The home had policies and procedures in relation to the Mental Capacity Act and best interests meetings had been carried out to assist with particular decisions. Staff were aware of Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made. This meant that people would be safeguarded as required.

Some areas of the home were safe, clean and hygienic; others were not and did not consistently follow safe practices around infection control. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to infection control and hygiene.

Staffing levels did not take people's care needs into account. The service does not regularly review staffing to respond to people's changing needs. This meant that people's needs were not always met. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staffing the home.

Service contracts were in place. Maintenance records we looked at showed that regular safety checks were carried out. Any repairs were completed quickly and safely. These measures ensured the home was maintained so people were safe.

Is the service effective?

People's health and care needs were assessed and reviewed with them. We saw that care plans were up to date and reflected people's current individual, dietary, cultural and religious needs. Some records had information about their childhood, work and family life and about their likes and dislikes but this were not consistent in all care records.

People confirmed and records showed that they were able to see people in private and that friends and relatives could visit whenever they wished.

The individual needs of people were taken into account with the layout of the home enabling people to move around freely and safely. The premises were suitable to meet the needs of people with physical impairments.

Is the service caring?

People were supported by kind, attentive and informed staff. We saw that staff showed patience and gave encouragement and guidance when supporting people.

Most care practices observed were good, although some care practices had been affected by low staffing. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to care practice and staffing the home.

People told us that they were happy at Ashbourne Lodge. They said staff were caring and supportive. One person told us, 'I am happy here. The staff are lovely.' A relative said, 'Mum is so happy here and I know they look after her well.'

Care plans had been maintained, and regularly updated, recording the care and support people were receiving. However they sometimes needed additional information to provide a complete picture.

People using the service, their relatives, friends and other professionals involved with the service could discuss their views or concerns with the manager or staff. One person said, 'We can always discuss anything with the manager and staff and they will always listen.'

Is the service responsive?

We saw that staffing levels had not increased in relation to the higher care needs of people or to additional people being admitted into the home. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to providing sufficient staff to meet the care needs of people

We saw potential risks to people's health and welfare had usually been identified, but these were not always communicated to the appropriate senior staff or other professionals. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to acting on people's changing care needs.

People knew how to make a complaint if they were unhappy. They said they had no complaints but indicated that if they had they would be dealt with quickly. A relative told us, 'I am always kept involved and if I am not happy about anything, even if it is only a niggle, it is soon put right.'

There were some social and leisure activities in place to stimulate people and maintain skills. People said they enjoyed these.

Is the service well-led?

The service had a quality assurance system in place. Records showed that any identified problems were addressed. We were usually notified of any incidents or issues relating to the home in a timely manner.

Staff had a good understanding of their roles and responsibilities and of the ethos of the home. They felt that they worked together effectively. Staff also received regular training to assist with their development.

There were occasional staff meetings and staff had received an annual staff appraisal. There were plans to introduce formal supervision. This means staff had some involvement in decisions about the home.

People usually received the care they needed to be safe but staff did not always have the time to be flexible or to respond to people's changing needs. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to staffing.