CQC report explained · a residential care home
What the CQC found at Ashton Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that medicines, risk assessments, staffing, recruitment checks, equipment and building safety were managed safely. They also found suitable infection prevention and control arrangements.
- Effective?
- Good
- This key question was not assessed during this focused inspection, so its previous rating was carried forward.
- Caring?
- Good
- This key question was not assessed during this focused inspection, so its previous rating was carried forward.
- Responsive?
- Good
- This key question was not assessed during this focused inspection, so its previous rating was carried forward.
- Well-led?
- Good
- Inspectors found regular audits, clear communication, supportive management and a positive culture focused on people's interests and wellbeing.
What inspectors found, July 2021
Rated Good; inspectors found improved safety, kind and person-centred care, but one staff member lacked confidence about safeguarding duties.
This was an unannounced follow-up inspection on 15 June 2021. The inspectors checked whether the home had acted on problems found at the previous inspection, especially around safe care and treatment. They reviewed care records, medicines, staff checks, safety checks and infection control arrangements. They also spoke with people, relatives, staff, managers and a health professional.
The home was rated Good overall, with Safe and Well-led both rated Good. Inspectors found that medicines were now managed safely, risks were assessed and reviewed, staffing was sufficient, and checks on the building and equipment were up to date. They were also assured about infection prevention and control arrangements.
Inspectors found a positive, person-centred culture. Staff supported people's interests, including people living with dementia, and relatives described improvements over recent years. One staff member who did not provide care did not understand safeguarding responsibilities, so the provider was advised to make sure all staff were confident about what to do if they suspected abuse.
Improved medicine safety
The previous medicine-related breach had been addressed. Inspectors found clear guidance, matching medicine stocks and checks of staff competence.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 12.” from the report
Person-centred activities
The home made efforts to understand and support people's current and past interests, including people living with advanced dementia.
“Real efforts had been made to promote and develop people's current and past interests especially those living with dementia.” from the report
Good staffing and recruitment checks
Inspectors observed enough staff and saw staff spending time with people. Recruitment checks included references and criminal records checks.
“We observed there was sufficient staff. We also saw staff spending time and chatting with people.” from the report
Open management
Staff said managers were present, listened to concerns and kept them updated about changes in people's needs. Regular audits and competency checks were completed.
“Regular effective audits took place in relation to the quality of the service.” from the report
Safeguarding knowledge was not consistent
needs fixingOne staff member who was not involved in care did not understand what to do if they had concerns about abuse. Inspectors recommended that the provider make sure all staff understand their safeguarding responsibilities.
“Despite this we did speak with a member of staff, who was not involved in the delivery of care, who did not have a good understanding about what they must do if they had concerns.” from the report
- 01How do you make sure every staff member, including non-care staff, knows what to do if they suspect abuse?
- 02What checks now make sure medicines remain safely managed, including as-required medicines?
- 03How do you review and update risk assessments when a resident's health or needs change?
- 04How will you continue activities that reflect my relative's interests, especially if they are living with dementia?
This was a focused follow-up inspection covering Safe and Well-led, including infection control; the other key question ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 16 July 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.
What inspectors found, March 2020
Rated Requires Improvement; inspectors found kind and responsive care, but unsafe medicines management and weak safety checks.
This was an unannounced inspection on 18 February 2020. Inspectors spoke with people, relatives and staff, observed care, checked records, counted medicines and reviewed safety and recruitment records.
The home had made important improvements since inspections in April 2018. People were treated kindly, their care plans were personalised, staff supported them with food and health needs, and the home responded to complaints and healthcare concerns.
However, medicines records were not reliable and medicine amounts did not always match what should have been given. Some pressure-relieving mattresses were set incorrectly, staff used a shared hoist sling, and checks by managers had not found these problems. The overall rating remains Requires Improvement, with Safe and Well-led also rated Requires Improvement.
Kind and respectful staff
People and relatives spoke well of staff. Inspectors saw staff being gentle, reassuring and respectful, including when people were anxious or in pain.
“We saw staff being kind and thoughtful towards people.” from the report
Personalised care
Care plans included people's routines, backgrounds, interests and important relationships. People were involved in creating and reviewing their plans.
“People had personalised care plans and assessments, which identified people's preferred routines, backgrounds, past achievements, their interests and who was important to them.” from the report
Food and healthcare support
People spoke positively about the food. Staff offered help with eating and drinking, acted on dietician advice and contacted health professionals when needed.
“When people were unwell and needed support from a health professional staff and the management team took action.” from the report
Medicines were not safely managed
seriousInspectors found problems in four of five people's medicines checked. Records did not always explain changes, and medicine quantities did not always match what should have been given.
“We found no evidence that people had been harmed however, people's medicines were not always being monitored and managed in a safe effective way.” from the report
Pressure equipment checks
needs fixingTwo of three pressure-relieving mattresses checked were set incorrectly. Management checks had not identified this risk.
“We checked with a member of staff whether a sample of three people's pressure relieving mattresses were set at the correct setting, two out of three were not.” from the report
Shared hoist slings
needs fixingA sling was moved from one person's bedroom and used for another person. Inspectors also noted a stain, creating an infection control concern.
“We observed a member of staff supporting a person to move using a sling which had been taken and later returned from another person's bedroom.” from the report
Uneven social engagement
minorSome lounges had good activities and interaction, but people in other lounges were not routinely engaged. Relatives also reported a lack of activities.
“However, in other lounges we saw that staff did not routinely engage with people.” from the report
Long staff shifts
needs fixingRelatives were concerned that some staff worked very long shifts and appeared tired. Inspectors recommended better monitoring of whether this affected staff practice.
“They are extremely tired and overworked but never complain but walk round like zombies sometimes.” from the report
- 01What changes have been made to medicine records, stock checks and audits since the inspection?
- 02How do you now check that pressure-relieving mattresses are set correctly for each person?
- 03Does each person who uses a hoist have their own sling, and how is cleaning checked?
- 04How do you monitor whether long shifts affect staff tiredness or the quality of care?
- 05What activities and social contact are available for someone who spends most of their time in their bedroom or in a quieter lounge?
This was an unannounced planned inspection covering all five key questions, including care, premises, medicines, records, staff and management systems. This explanation was written from the published report of 12 March 2020 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 Ashton Lodge
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- July 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2017Inadequatedown from Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- August 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- November 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 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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