CQC report explained · a residential care home
What the CQC found at Ashbury Lodge Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2022
Rated Good overall; inspectors found safe, kind care, but the home needed to improve its records and quality monitoring.
This was an unannounced focused inspection on 22 and 28 June 2022. Inspectors spoke with people living in the home, relatives and staff. They reviewed care records, medicines records and other documents, and observed a medicines round.
People told inspectors they felt safe and received kind, respectful care. There were enough staff, medicines were given safely, the environment was safe and people had access to food, activities and healthcare. Staff understood people's needs and supported their choices.
The main weakness was how the home was led and monitored. Some care records were out of date, and important information was kept separately from the electronic care system. The overall rating improved from Requires Improvement to Good, but Well-led remained Requires Improvement. Caring was not inspected during this visit.
People felt safe
People and relatives told inspectors they felt safe. Risks were identified and steps were taken to reduce harm.
“People told us they felt safe living in the service and their relatives confirmed this.” from the report
Kind and respectful staff
Inspectors saw positive interactions, and people said staff knew them and responded to their needs.
“Staff treated people with kindness and respect, and spent time getting to know them and their specific needs and wishes.” from the report
Safe medicines and staffing
There were enough staff to meet people's needs. Medicines were stored and given safely, with no gaps found in the medicines administration records.
“There were no gaps in medicines administration records (MARs) and when people were prescribed 'as required' medicines, there were protocols in place” from the report
Activities and relationships
The home offered varied activities and supported people who preferred individual activities. Families and residents were given opportunities to share their views.
“Activities were varied and planned based on people's interests.” from the report
Improvement since the last inspection
The overall rating improved from Requires Improvement to Good. The report says the home had made significant progress since the previous inspection.
“There had been significant improvement in the service since our last inspection.” from the report
Care records were not always current
needs fixingSome care plans contained information that was out of date or did not include changes following professional advice. This could make it harder for staff to find the right information.
“People's care plans were not always up-to-date.” from the report
Information was not always shared effectively
needs fixingImportant end of life information was held in a separate folder rather than the electronic care system. Inspectors were not sure that all staff, including agency staff, would know where to find it.
“We recommend the provider introduces an effective system to record and share information about changes in people's needs.” from the report
Quality monitoring needed improvement
needs fixingThe systems used to monitor the quality and safety of care were inconsistent. An external audit had identified problems, but a full action plan was still to be produced.
“Systems in place to monitor the quality and safety of people's care were inconsistent.” from the report
- 01How will you make sure every person's care plan is updated promptly when their needs or professional advice changes?
- 02How do staff returning after a long absence learn about changes in people's needs?
- 03Where is end of life information recorded, and how will agency staff find it quickly?
- 04What action plan has been put in place after the external audit?
- 05How will you check that improvements to record-keeping and quality monitoring have been sustained?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and the overall rating partly used ratings from the previous inspection. This explanation was written from the published report of 28 July 2022 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, June 2021
Rated Requires Improvement; inspectors found safe care, but concerns about consent records, staff training and management checks.
This was an unannounced focused inspection on 7 April 2021. Inspectors checked Safe, Effective and Well-led. They spoke with seven people, three staff members, two managers and seven relatives, and reviewed care, medicine and management records.
The home was rated Good for Safe. People said they felt safe, staffing levels were sufficient, medicines were managed safely and infection control arrangements were suitable. Staff understood safeguarding and risks were regularly reviewed.
The home was rated Requires Improvement for Effective and Well-led. Records did not always explain people's current needs or how people lacking capacity were involved in decisions. Management checks had not identified all these problems, and one incident was not reported to the CQC at the time.
The overall rating fell from Good at the previous inspection in 2018 to Requires Improvement. The CQC said it would continue monitoring the home and could inspect sooner if concerning information was received.
Safe staffing
Inspectors found enough suitably skilled and experienced staff to meet people's needs. Recruitment checks were generally thorough, although gaps in three employment histories were corrected during the inspection.
“People, their relatives and staff told us there were enough suitably skilled and experienced staff deployed to meet people's needs.” from the report
Medicines
Medicine records were clear and accurate. Staff were trained and medicines were administered in a compassionate and person-centred way.
“We observed part of a medicines round. This was managed in line with best practice guidance but also in a compassionate and person-centred manner.” from the report
Food and nutrition
People's dietary needs were met, their nutritional needs were monitored and they had varied food choices.
“People's dietary requirements were met, and nutritional needs monitored.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for visitors, protective equipment, testing, hygiene and managing infection outbreaks.
“We were assured that the provider's infection prevention and control policy was up to date.” from the report
Consent and capacity records
needs fixingRecords did not always show that people lacking capacity were involved in best-interest decisions. Inspectors recommended consulting medical professionals where possible about treatment decisions.
“the records did not confirm that the person had been provided with all the relevant information to make an informed decision about the medical treatment.” from the report
Incomplete care records
needs fixingCare records did not always contain enough detail about people's current needs. Best-practice processes were known to managers but were not consistently reflected in records or care delivery.
“Care records did not always contain sufficient detail about people's current needs.” from the report
Staff training
needs fixingStaff had not been trained about one person's specific health condition. Inspectors said this could mean staff were unclear about how the condition affected decision-making.
“Staff were not trained on this person's specific health condition, therefore, they may not be clear of the impact of this on person's decision making as their condition could fluctuate.” from the report
Management checks
needs fixingAudits did not always identify problems with recruitment files and mental capacity records. The home also failed to notify the CQC about one incident involving police and paramedics at the time.
“There were systems in place to monitor the service. However, these had not always been effective at identifying where improvements were needed as identified during our inspection.” from the report
Communication with relatives
minorSome relatives said communication and information about incidents and care were inconsistent. One relative also felt staff had been defensive when questions were asked.
“Communication and provision of information are areas of concern.” from the report
- 01What has changed since the inspection to make sure care records contain enough detail about each person's current needs?
- 02How do you record capacity assessments and show that people are given relevant information before treatment decisions?
- 03What training do staff now receive about residents' specific health conditions and how these may affect decision-making?
- 04How do you check that audits identify problems with consent records, care records and recruitment files?
- 05How will you keep relatives informed about incidents and respond to their concerns?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed, and their ratings were not given in this report. This explanation was written from the published report of 11 June 2021 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 Ashbury Lodge Residential Home
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- July 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Ashbury Lodge Residential Home →
- June 2021Requires improvementdown from GoodSafe: GoodEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Ashbury Lodge Residential Home →
- September 2018Goodup from Requires improvementSafe: GoodEffective: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementstayed Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2014Inspected but not rated
- November 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 26 November 2010.
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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44 live-in carers within about an hour of Swindon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £990 to £1,280 a week. 34 can care for a couple. 12 years' experience on average.
“Linet became her carer and all changed, my daughter started eating, taking her medications and more important her happiness came back.”
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.