Archived: Ashdown House

Following the comprehensive inspection on 5 August 2016 the provider submitted an action plan to the Care Quality Commission (CQC). This focussed inspection was carried out to ensure that the provider had implemented improvements in relation to how people were protected from known risks. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rockingham House on our website at www.cqc.org.uk.

This unannounced focused inspection took place on the 21 December 2016. This residential care service is registered to provide accommodation and personal care for up to 22 people some of whom may be living with dementia. There were 19 people living at the home during this inspection.

This inspection was carried out to check that the provider had implemented improvements in relation to how people’s ability to consent to their care and support was considered.

Ashdown House provides accommodation and personal care for up to 24 people some of whom may be living with dementia. There were 20 people living at the home during this inspection

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

People’s capacity to consent to their care and support was not always assessed. People were not free to leave the home because the doors to the outside areas were locked. People’s relatives had signed to consent to their care and support however, people’s capacity to consent to their own care and support had not been assessed. This constituted to a breach of the regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People were supported by sufficient numbers of staff that were experienced and supported to carry out their roles to meet the assessed needs of people living at the home. Staff had received training in key areas that enabled them to understand and meet the care needs of each person living in the home. Recruitment procedures were followed and people received care from staff that were suitable for their role.

People’s care and support needs were continually monitored and reviewed to ensure that care was provided in the way that they needed. People had detailed individual plans of care in place to guide staff in the delivery of their care and support. People and their representatives had been involved in developing these plans of care which meant that people received consistent and personalised care and support.

People’s health and well-being was monitored by staff and they were supported to access relevant health professionals in a timely manner when they needed to. People were supported to have sufficient amounts to eat and drink to help maintain their health and well being.

Staff took time to get to know people and ensured that people’s care was tailored to their individual needs. People had the information they needed to make a complaint and the service had processes in place to respond to any complaints.

People were supported by a team of staff that had the managerial guidance and support they needed to carry out their roles. The quality of the service was monitored by the audits regularly carried out by the registered manager and by the provider. There were effective safeguarding procedures in place to protect people from the risk of harm.

Summary

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

This is a summary of what we found-

Is the service safe?

People told us that they felt safe living at Ashdown House, individual plans of care were regularly reviewed and contained risk assessments to ensure their health, safety and wellbeing.

All of the people we spoke with told us that they had plenty to eat and drink One person said 'The food is very good, it's all home cooked and the cook comes round every day to ask us what we want. Another person said 'The food is really good, you can choose what you want and we have drinks and snacks in between meals'.

Bedrooms were fitted with appropriate safety devices such as low surface temperature radiators and window restrictors and no slip or trip hazards were identified within the environment.

Is the service effective?

People told us they thought there were enough staff who had the right skills to care for them safely and that the staff were kind and patient. One person said, 'The staff are lovely'. Another person said, 'I can't fault the staff they are very attentive'. We saw staff related well to people and knew how they liked to be supported. All of the people living at Ashdown House had an individual plan of care; these contained the right information. People looked comfortable and relaxed within their environment and looked well cared for. We also found that when required, staff ensured people had access to appropriate health care professionals and services. Staffing levels were maintained at safe levels and staff undertook appropriate qualifications and training.

Is the service caring?

People told us the staff were nice to them and that there were enough staff to meet their needs. All of the people we spoke with told us they were well cared for and the staff knew the care they needed and wished to be supported. One person said 'I am so happy here, it's beautiful, the staff are lovely' Another person told us 'I am very pleased to have got a place here; I have no concerns at all'. We saw that staff related well to the people who lived at Ashdown House, understood their needs and provided sensitive support.

Is the service responsive to people's needs?

We saw that people's routines were flexible; for example people were able to get up and go to bed when they wanted to. We saw that staff were mindful of people's privacy and that they treated them with respect. For example we saw that staff referred to people by their preferred name and knocked on bedroom doors before entering. We saw that people had access to general practitioners (GPs), district nursing services, specialist nurses, dental services, podiatrists and other NHS services when required.

Is the service well lead?

The provider had conducted a recent satisfaction survey which showed a high level of satisfaction with the service provided at Ashdown House.

Appropriate quality assurance systems were in place and the management conducted regular audits to ensure the health, safety and wellbeing of the people who lived at Ashdown House. Appropriate action was taken to address areas of non-compliance.

The provider sent us an action plan telling us about the action they had taken to make improvements. We conducted a further inspection on the 27 August 2013 to review the improvements to the medication systems. We concluded that the provider had taken appropriate action to ensure that medication systems were safe and effective.

Both of the people we spoke with told us that they were well looked after at Ashdown House and that the staff knew how they needed and wished to be supported. One person commented 'I am so pleased to be here, the care is excellent'. Another person told us 'this is my home; the staff know how I need to be cared for, it's very good here'.

People told us that they thought that the staff had the right skills to care for them safely. One person said 'The staff are excellent; I have no concerns at all'. Another person commented 'The staff are very good; they know how I need to be cared for'. People also told us that the staff were respectful towards them and that they felt safe living at Ashdown House. They also told us that they knew how to complain if they needed to.

However during our inspection we found that the provider was not meeting one of the essential standards of quality and safety in relation to medication.