CQC report explained · a residential care home
What the CQC found at Ash Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, robust recruitment and infection control procedures. Medicines were generally managed safely, but some records had missing signatures when people refused medicines.
- Effective?
- Good
- Staff received training, supervision and yearly appraisals. People's health, dietary needs, choices and rights were assessed and monitored.
- Caring?
- Good
- People said staff were kind and respected their privacy and dignity. Staff understood people's individual communication needs and involved them in decisions.
- Responsive?
- Good
- Care records were personalised and regularly reviewed. People were supported with activities, relationships, complaints, health needs and end of life care.
- Well-led?
- Good
- The registered manager and provider used audits, meetings and feedback to monitor the home. Inspectors found that earlier weaknesses in quality monitoring and management had been addressed.
What inspectors found, September 2018
Ash Lodge Care Home was rated Good; inspectors found safe, kind and personalised care, with minor medicine recording issues addressed.
The inspection was unannounced and took place on 28 August 2018. One inspector spoke with people living at the home, staff, managers and directors. They also observed care, checked records, reviewed medicines and toured the building.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable training, person-centred care records and systems for monitoring quality.
Some missing signatures were found on medicine records. The home said these related to people refusing medicines, and managers investigated and addressed the issue. Inspectors found that problems from the June 2017 inspection, including staffing, cleanliness, quality monitoring and the lack of a registered manager, had been addressed.
Staffing and cleanliness
Inspectors found enough staff to meet people's needs and keep the home clean. Infection control checks were carried out and issues were corrected promptly.
“There were enough staff to keep the service clean.” from the report
Kind and respectful care
People said staff were caring and respected their privacy. The inspector also saw patient and kind interactions.
“During the inspection we observed staff treating people with patience and kindness in the communal areas of the service.” from the report
Personalised support
Care records described people's likes, dislikes, life histories, communication and goals. Staff used this information to guide individual support.
“People's care records were person-centred and detailed their likes, dislikes and preferences for their care and support.” from the report
Quality monitoring
The management team used audits, feedback and meetings to identify and correct problems. This was an improvement since the previous inspection.
“We found quality monitoring checks and audits were in place to assess all aspects of the service provided.” from the report
Medicine records
minorSome medicine administration records did not have signatures. The home investigated this and said the missing entries related to people refusing medicines, with daily audits used to check records.
“We found there were some missing signatures on some people's MAR's.” from the report
Tired decoration
minorSome areas of the home looked tired. A redecoration programme was in place to improve the environment.
“A programme of re-decoration was in place to improve décor that looked tired.” from the report
- 01How are refusals of medicines recorded now, and how are missing signatures prevented?
- 02What progress has been made with the programme to improve tired decoration?
- 03How are staffing levels reviewed when people need escorts to appointments or go out?
- 04How are people's mental health changes, triggers and support plans reviewed with them and their families?
- 05How can relatives see the results of feedback, complaints and quality checks?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home, with improvements since the June 2017 inspection noted in Safe and Well-led. This explanation was written from the published report of 28 September 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, July 2017
Rated Requires Improvement; inspectors found kind, effective and responsive care, but concerns about staffing, cleanliness and management checks.
Inspectors visited the home without warning on 2 June 2017. They spoke with people, staff and managers, observed care, checked records and medicines, reviewed recruitment and training documents, and toured the building.
People said they felt safe, were treated well and had choice and control. Medicines were well managed. Staff supported people with health appointments, meals, activities and links with family and the community.
The home was not consistently safe or well-led. There were too few domestic and catering staff, some areas needed cleaning, and recruitment checks were incomplete before some staff started. There was also no structured system to identify and act on problems.
The overall rating was Requires Improvement. Effective, caring and responsive were rated Good. Safe and well-led were rated Requires Improvement. The previous inspection in June 2015 had rated the service Good in all assessed areas.
Kind and respectful care
People told inspectors that staff were caring and respected their privacy. Inspectors observed good relationships and a patient, attentive approach.
“We observed staff were patient, attentive to people and had a caring approach.” from the report
Choice and independence
Staff encouraged people to make their own decisions and do what they could for themselves. People chose their routines, meals and activities.
“Staff supported people to be independent and ensured they gained consent prior to carrying out tasks.” from the report
Activities and community links
People could take part in activities, pursue hobbies and visit local facilities. Staff also supported people to maintain family relationships.
“There were activities for people to participate in and staff encouraged people to pursue their own hobbies and interests” from the report
Medicines managed well
Inspectors found that medicines were obtained, stored and given safely. Staff who administered medicines had received training.
“We found medicines were well-managed.” from the report
Staffing and cleanliness
seriousThere were not enough domestic and catering staff. Inspectors found unclean areas, untidy outside spaces and some bedrooms needing attention.
“Insufficient domestic staff had impacted on the cleanliness of the environment” from the report
Weak quality checks
seriousThe home did not have a structured system to find problems, record them and make sure they were fixed. This meant cleanliness and furniture issues had not been identified by the home's own checks.
“There was no structured approach to quality monitoring which meant that although checks may have been carried out, there was no record of this and no action plan to address any issues.” from the report
Incomplete recruitment records
needs fixingReferences were not always in place, dated or verified before staff started work. The provider said these issues would be addressed.
“We found some shortfalls with the recruitment process which meant that full employment checks were not always in place prior to staff starting work at the service.” from the report
Care records needed updating
minorSome care plans did not contain all the required information or clearly describe the support staff should give. The manager said these would be updated during the move to computerised records.
“Some minor amendments were required to ensure all the information was included in care plans” from the report
- 01How many domestic and catering staff are now on duty, and how do you check that staffing is enough for people's needs?
- 02Have the dining room, bedrooms, toilets, bathrooms and outside areas identified in the report been cleaned and kept clean?
- 03What quality checks are now completed, how often are they recorded, and who checks that problems are put right?
- 04Have all staff recruitment references been obtained, dated and verified before staff start work?
- 05Have the care plans and monitoring charts mentioned in the report been fully updated?
This was an unannounced inspection of the overall service, including all five key questions; the previous inspection on 11 June 2015 had rated all assessed areas Good. This explanation was written from the published report of 11 July 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Ash Lodge Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 31 March 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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