CQC report explained · a residential care home
What the CQC found at Ashdown Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2019
Rated Good overall; inspectors found safe, kind, personalised care, but the building and dementia-friendly environment needed improvement.
This was an unannounced inspection on 9 April 2019. One inspector and an expert by experience spoke with people living at the home, relatives, staff and professionals. They observed care and reviewed care plans, medicines, accident records, complaints, recruitment records and quality checks.
The home was rated Good overall. It was rated Good for Safe, Caring, Responsive and Well-led. Inspectors found that people felt safe, received their medicines properly, were treated with kindness and had personalised care. Staff were trained and the home had improved its systems since the previous inspection.
Effective was rated Requires Improvement. The communal toilets were not accessible to people with mobility problems. Inspectors also found that people living with dementia did not have enough help to know the day, date and time or enough stimulation. The provider was getting quotes to redesign the communal bathrooms and had an improvement plan for a more dementia-friendly environment.
Safe medicines
Inspectors found that medicines were managed safely, with regular audits, staff training and competency checks.
“People received their medicines safely and on time.” from the report
Kind and respectful care
People and relatives spoke positively about the care. Inspectors observed staff offering reassurance, encouragement and choices.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans included people's physical, emotional, mental and social needs. Staff used hand-held devices to update records while spending time with people.
“People received personalised care that was responsive to their needs.” from the report
Improved management
The home had strengthened its quality checks, incident reporting and care plan audits since the previous inspection.
“At this inspection we found scheduled audits in place to ensure good quality care was maintained.” from the report
Toilet access
needs fixingThe communal toilets could not be used easily by people with mobility issues. The provider was obtaining quotes to redesign the communal bathrooms, but the report did not confirm the work was complete.
“the communal toilets were not accessible to people with mobility issues.” from the report
Dementia-friendly surroundings
needs fixingThe home did not provide enough help for people with dementia to know the day, date and time. Inspectors also said more stimulation and support for independence were needed.
“there was nothing for those living with dementia to orientate themselves regarding the day, date and time.” from the report
Small en-suite toilets
minorSome bedroom toilets were very small, with doors that could make movement difficult for people with mobility issues.
“It was not clear if people with mobility issues would be able to pull the door across once on the toilet.” from the report
- 01Have the communal toilets been redesigned so that people with mobility issues can use them safely and independently?
- 02What changes have been made to help people with dementia know the day, date and time?
- 03What activities and environmental features are now available to provide stimulation throughout the day?
- 04How do you check whether the small en-suite toilets and doors are safe and usable for each person?
- 05How have the improvements from the previous Requires Improvement rating been kept in place?
This was an unannounced scheduled inspection that considered the home, the care provided and all five CQC questions. This explanation was written from the published report of 23 May 2019 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, May 2018
Requires Improvement; inspectors found kind care, but serious problems with medicines, risk management and oversight.
This was an unannounced comprehensive inspection on 8 and 9 February 2018. It was the first inspection since the home registered with the CQC. Inspectors looked at the care, records, medicines, staffing, premises and how the home was managed.
People said they felt safe and inspectors found no evidence that anyone had been abused. However, medicines were not always managed safely. Risk assessments did not always match the support staff were giving, and some safeguarding concerns and incidents were not properly recognised or followed up.
Staff were kind and respectful. People were supported with food, drink, health care, activities and end of life care. However, staff needed more training for dementia and behaviours that may challenge. Care plans did not contain enough personal information, and the home lacked some dementia-friendly adaptations.
The overall rating of Requires Improvement means the home was not consistently meeting the standards expected. Four regulations were breached, covering safe care and treatment, safeguarding, good governance and notifications of incidents.
Kind and respectful staff
People described staff as caring. Inspectors saw staff take time to listen, communicate patiently and respect people’s dignity and choices.
“Staff were compassionate and took time to sit and talk with people and respected people's privacy and dignity.” from the report
Health, food and drink support
People were supported with health appointments, monitoring, eating and drinking, and a balanced diet. Staff knew people’s food preferences and support needs.
“People had support to meet their medical and health care needs and had were assisted to eat and drink enough, and maintain a balanced diet.” from the report
Activities and end of life care
People could take part in activities inside and outside the home. End of life wishes were recorded and staff sought appropriate health and social care advice.
“People had support to follow their interests and take part in meaningful activities inside and outside the service.” from the report
Medicines records and storage
seriousAllergy information was missing from sampled medicines records, there were unexplained gaps in administration records, and some medicines were not securely stored. Guidance for medicines given when needed was not always available.
“However, we sampled MAR sheets and found information about medicines people were allergic to was not recorded.” from the report
Safeguarding and incident follow-up
seriousSome staff were unsure who to contact outside the organisation about abuse concerns. Some concerns and incidents were not recognised, reviewed or shared with staff and relevant agencies.
“This meant there was a risk that necessary action might not always be taken to keep people safe.” from the report
Risk assessments
seriousThe support staff were giving did not always match the written risk assessments. In one example, extra staff support for challenging behaviour had not been formally recorded and reviewed.
“However, there were inconsistencies between the control measures staff were using to keep people safe and the information in people's risk assessments.” from the report
Personalised care plans
needs fixingStaff knew people well, but important information about people’s preferences, life history and support needs was often not written down. This could make personalised care less consistent.
“People's care plans did not contain enough information about them to inform staff about how to provide care in a person centred way.” from the report
Dementia training and environment
needs fixingSome staff said they needed more training for dementia and behaviours that may challenge. The home also lacked signs, landmarks and contrasting colours to help people with dementia move around independently.
“However, the provider had not considered how to ensure the environment met the needs of people living with dementia.” from the report
Management checks
seriousQuality audits were limited, some electronic records had not been reviewed and there was no functioning ongoing development plan. This meant problems were not always identified or acted on.
“There was no functioning on-going development plan to help the service continuously learn and improve.” from the report
- 01How are you now checking medicines, including allergy information, unexplained gaps, storage security and medicines given when needed?
- 02How do you make sure safeguarding concerns and accidents are recognised, reported to the right agencies and followed up?
- 03Have all residents’ risk assessments been reviewed so they match the support staff actually provide?
- 04What dementia and behaviours-that-may-challenge training have staff completed since the inspection?
- 05What changes have been made to care plans and the home’s quality audits and improvement plan?
This was an unannounced comprehensive inspection covering all five key questions and was prompted by information about possible abuse and avoidable harm, alongside the standard inspection process. This explanation was written from the published report of 3 May 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.
Every inspection of Ashdown Lodge
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2017
Registered with the Care Quality Commission on 31 August 2017.
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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