Archived: Ashling Lodge

Updated 8 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a fresh rating for the service under the Care Act 2014.

This unannounced inspection took place on 14 September 2017and was carried out by a single inspector. Before the inspection we looked at the information we held about the service including information from any notifications the provider had sent us. A notification is information about important events that the provider is required to send us by law. We also asked the local authority commissioners for the service and the safeguarding team for their views of the home.

During the inspection we spoke with five people who used the service and two relatives. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not express their views of their care. We spoke with three care workers, the chef, an administrator and a representative of the provider.

We tracked four people’s care and their care records to check that the support they received matched their care plan. We also looked at five staff recruitment records, staff training records and records related to the management of the service such as minutes of meetings, records of audits and service and maintenance records.

Updated 8 November 2017

This unannounced inspection took place on 14 September 2017. At our last inspection of the home on 1 September 2016 we had found improvement was required in the key questions of safe and well led. Staff were not fully aware of how to use evacuation equipment in the event of a fire and aspects of the quality monitoring of the service did not always identify issues or ensure issues were promptly acted on.

Ashling Lodge is registered to provide residential accommodation and care for 11 people. Bedrooms are on the ground and first floor and there is a stair lift access to the first floor. At the time of the inspection there were nine people using the service. Prior to the inspection concerns had been raised with CQC about staffing levels at the home. We were also made aware of the uncertainty of the long term future of the home. The provider told us they had written to people and relatives in June 2017 to advise them about this. At the time of the inspection no final decision had been made.

Following the inspection the provider’s representative informed us a decision had been taken to close the home and that people, their relatives and relevant local authorities had been advised of this.

At this inspection there was no registered manager in post. The previous registered manager had left the home suddenly in June 2017. 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. The home had been managed by a representative of the provider since the departure of the registered manager.

At this inspection we judged there were sufficient staff deployed to meet people’s needs. However, we found breaches of regulation with the governance of the home and with recruitment arrangements. Aspects of the quality of the service were not well monitored to reduce risk. Previous fire safety recommendations on the gradual replacement of older smoke detectors had not yet been started. While legionella checks were completed arrangements for the assessment of risk from legionella did not comply with legal requirements. Audits did not always identify issues effectively. The provider did not regularly seek formal feedback from people or their families about the service or act on feedback to drive improvements. Recruitment systems were not always effective as we found employment histories for three staff had not been verified to ensure the provider had a full employment record as required under the regulations.

You can see what action we told the provider to take at the back of the full version of the report.

Some further improvements were needed. Most risks to people were identified and assessed but some risk assessments were not up to date to accurately reflect the level of risk or provide guidance to staff on how to reduce risk. Maintenance checks on a piece of fire safety equipment were not always effective. Staff knew people well, but people or their relatives, where appropriate, were not always consulted or invited to reviews of their care. People’s preferences about their care and support were not always recorded in their care plans.

The provider’s representative told us they had been busy with the day to day management of the home and had not had time to oversee the overall quality of the care provided. They took action to begin to address these issues described at or following the inspection.

There were some good aspects to the care provided. People told us they felt safe and well care for. Staff understood how to protect people from abuse or neglect. People‘s nutritional needs were met. Medicines were safely managed. People had access to health professionals when needed. Staff received sufficient training and support to carry out their roles.

People were asked for their consent before care was provided and were involved in the day to day decisions about their care. People told us that staff were kind and caring and we observed this was the case. Staff knew people well and interacted with them sensitively and with respect. People’s needs for stimulation and social interaction were met.

There was a complaints system that people had access to. People told us they thought the home was well run. Staff told us they felt the home was being well managed and that the provider’s representative was approachable.