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Care Services

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Ashbury Lodge Residential Home, Swindon.

Ashbury Lodge Residential Home in Swindon is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, caring for adults under 65 yrs, dementia, mental health conditions and physical disabilities. The last inspection date here was 12th September 2018

Ashbury Lodge Residential Home is managed by Coate Water Care Company Limited who are also responsible for 2 other locations

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2018-09-12
    Last Published 2018-09-12

Local Authority:

    Swindon

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

15th August 2018 - During a routine inspection pdf icon

This unannounced inspection took place on 15 and 16 August 2018.

Ashbury Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 44 people in one adapted building. At the time of our inspection 42 people were residing at the home. Accommodation is arranged over two floors which are accessed via a lift or stairs. There is a small garden to the front of the building and parking available.

At our last comprehensive inspection in May 2017 we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the service had not always obtained the appropriate consent from people and the care plans required improvement. We issued one requirement notice and a warning notice. We returned in November 2017 to do a focused inspection to check if the required improvement had been made. At that inspection we found enough improvement had been made to address the immediate concerns but further improvement was needed.

At this inspection we found the required improvements had been completed and therefore we have rated the service as 'Good' overall.

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 were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff had received Mental Capacity Act (2005) training and told us how it applied to their work.

People had their support and care needs assessed before moving to Ashbury Lodge. This information was then used to start an individual care plan. Care plans contained a good level of information that was clearly detailed, personalised and reviewed regularly. The service used an electronic care planning system which required an individual log in and password. This made sure information was held securely.

Risks had been identified, assessed and the most appropriate measures put in place to keep people free from avoidable harm. Risk assessments were reviewed monthly or sooner if needed.

Staff were trained in different topics and could ask for further training if they felt it was needed. Staff told us they felt supported and could approach the senior management at any time.

The service followed safe recruitment practice and all required pre-employment checks had been completed. There were sufficient staff deployed to meet people’s needs.

People were protected from potential abuse from staff who were aware of the different types of abuse and when to report any concerns. Staff were confident appropriate action would be taken. People told us they felt safe at the service and knew where to go to report or raise any concern.

Medicines were managed safely as safe systems were in place to order, store, administer and dispose of medicines. Staff were trained to administer medicines and followed safe practice. Where appropriate people were referred to healthcare professionals. The service worked in partnership with a range of professionals such as GP’s, district nurses and dieticians.

People had a choice of meals and where needed staff provided people with support to eat and drink. Mealtimes were relaxed and unhurried. Snacks and drinks were provided throughout the day.

There were activity workers in place who took the lead on providing activities at the service. People were able to participate in events based around their interests and abilities.

9th November 2017 - During an inspection to make sure that the improvements required had been made pdf icon

At the comprehensive inspection of this service in June 2017 we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We issued the provider with one warning notice and one requirement notice stating they must take action.

This inspection was carried out to assess whether the provider had taken action to meet the warning notice we issued. We will carry out a further unannounced comprehensive inspection to assess whether the actions taken in relation to the warning notice have been sustained, to assess whether action has been taken in relation to the requirement notice and provide an overall quality rating for the service.

This report only covers our findings in relation to the warning notice we issued and we have not changed the ratings since the inspection on 31 May, 01 June and 05 June 2017. We looked at the responsive domain and the well led domain. We have not changed the rating for the well led key question from ‘Requires Improvement’ because to do so requires a full assessment of all the key lines of enquiry related to this question. We will complete this assessment during our next planned comprehensive inspection. We have not changed the rating for the responsive domain as there remains areas of improvement to be made. The overall rating for this service is 'Requires Improvement'. You can read the report from our last comprehensive inspection by selecting the 'All reports' link for Ashbury Lodge on our website at www.cqc.org.uk.

At this inspection we found that the provider had taken the immediate action necessary to address the issues in the warning notice, but further improvements were needed.

A registered manager was in post at the service. 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.

Ashbury Lodge is a care home without nursing that can accommodate up to 44 people. At the time of our visit, 40 people were using the service. One person was receiving respite care with a view to moving to the service on a permanent basis. The inspection took place on 9 November 2017. This was an unannounced inspection.

The recording on people’s positive behaviour monitoring charts had not been completed appropriately and demonstrated a lack of understanding around supporting people positively during times of distress.

People and their relatives continued to raise concerns around the provision of activities. The service was in the process of reviewing the activities provided and recruiting a lifestyle and wellbeing co coordinator to support in this area.

Complaints continued to be managed appropriately within the service, however CQC had continued to receive a further five concerns regarding this service.

The service had started to use a system known as ‘Resident of the day’ to ensure that all aspects of a person’s care and support needs had been met and reviewed. Each person would be the ‘Resident of the day’ during the month and all staff roles would be involved in ensuring this person felt well supported.

There had been improvements to the monitoring charts that were in place. We saw that new food and fluid charts had been implemented which clearly identified why each person needed this chart in place.

A home manager had been recruited and people spoke positively about the management arrangements with one person commenting “We have two managers and can go to either of them, one is new but lovely, they always help me, they don’t say we haven’t got time.”

Systems were in place to monitor the service, however we noticed the review of some records did not always document when areas of improvement had been picked up. This was found in accident records and the review of positive behavioural

31st May 2017 - During a routine inspection pdf icon

Ashbury Lodge is a care home without nursing that can accommodate up to 44 people. The accommodation is arranged over two floors and the home is situated on the outskirts of Swindon. At the time of our visit, 41 people were using the service and one person was in hospital. The inspection took place on 31 May and 1 June 2017. This was an unannounced inspection. Feedback was given on the 5 June 2017 when the registered manager returned from leave so they had the opportunity to be part of this inspection. This inspection was brought forward in respect to concerns reported to CQC about the service. One further concern was received during the inspection. We did not find evidence of these concerns at the time of our inspection.

There was a registered manager in post when we inspected the service. 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.

At our previous inspection in April 2016, the home received a rating of requires improvement and were in breach of four Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection improvements had been made but we found that the service had one repeated breach of Regulation 17 Good governance and one new breach of Regulation 11 Need for consent was identified. You can see what action we told the provider to take at the back of the full version of the report.

Risks to people’s personal safety had been assessed and plans were in place to minimise these risks, however we found that people did not have moving and handling risk assessments in place and information in their mobility care plans did not provide staff with clear guidance. One person was on a behaviour monitoring chart as there had been several incidents of aggression towards other people and staff. We saw that this person had no risk plan in place to manage these behaviours and there was no clear guidance on what staff were to do to support this person.

Staff had received training in how to recognise and report abuse and were clear about how to report any concerns they had. Staff were confident that the registered manager would respond appropriately. People we spoke with knew how to make a complaint if they were not satisfied with the service they received.

The service had not always obtained the appropriate consent before taking decisions on behalf of people to ensure care was given in line with their preferences. Staff did not always demonstrate sufficient knowledge around the principles of supporting people who lacked capacity.

The service had remained in breach of the Regulation for ineffective recording in care plans. There was often inconsistent or conflicting information which made it hard to ascertain a person's most current needs.

There continued to be mixed responses from people, their relatives and staff about the activities provided by the service. We observed activities including board games and crafts during our visit and people being asked to participate.

We found that one notification of abuse had not been raised to CQC or The Local Authority Adults Safeguarding team. We raised this with the senior management team who submitted the necessary notification and conducted an investigation into this. The outcome of this event was that the recording did not accurately reflect the events and the person concerned was found to not have been placed at risk when this incident occurred.

Improvements had been made to the décor of the home including redecorating the bathrooms and installing new flooring.

18th April 2016 - During a routine inspection pdf icon

Ashbury Lodge is a care home (no nursing) for the elderly that can accommodate up to 44 people. The accommodation is arranged over two floors and the home is situated on the outskirts of Swindon. At the time of our visit, 40 people were using the service. The inspection took place on 18 and 19 April 2016. This was an unannounced inspection. The home had been part of the wave one new inspection pilot and a rating was not given in line with our methodology. This was the home’s first rated inspection.

There was a registered manager in post when we inspected the service. 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 registered manager was present and approachable throughout our inspection. Staff, relatives and people who used the service told us the registered manager was always available if they needed to speak with her and had confidence in her abilities to manage the service.

Infection control was not always managed safely or appropriately in the home. This included shared hoist slings with no recording they were being cleaned in-between different people using them. Communal bathrooms and toilets needed attention to make them fit for purpose. We observed a cracked mirror, cracked toilet cistern, a missing ceiling panel and marked floors and general disrepair.

Medicines were not always managed appropriately in the home. This included the recording of medicines, guidance for medicines taken as required and the management of people who needed their medicines covertly.

The home had sufficient levels of staff and they were seen to be visible for people to call on should they need support. The registered manager had a comprehensive recruitment process in place so people were supported by staff that had completed the necessary checks to be able to work with vulnerable adults.

People were given choices at mealtimes and fluids were encouraged throughout the day. However for people needing assistance with their meals this was not always completed in a dignified manner.

Staff had not received all the necessary training to be effective in their role. Only two people in the home had completed training to support people whose behaviour may challenge, yet we saw staff dealing with these situations throughout our inspection. The provider’s policy stated staff should have received this training.

Where people had been deprived of their liberty the registered manager had made the appropriate referrals to the governing body. This was implemented after a capacity assessment had been completed and a best interest meeting had taken place. Families were involved in the process.

People and their relatives spoke positively about the care and support they received. They said that if they had any concerns they could speak to either staff or the management team. They said they felt their concerns would be listened to and where required appropriate action taken.

Care plans were seen to lack detail and guidance for staff to follow. Risk assessments had not always been put in place and monitoring forms were not consistently completed.

Communication and participation in the development of the home was encouraged and feedback was considered and where appropriate acted upon. Relatives were welcomed in the home and involved in their loved one’s care.

The registered manager was approachable and available for people to see and worked alongside staff on the floor. People, their relatives and staff felt confident that the home was well managed.

The registered manager had quality monitoring systems in place to assess the service. Things that we identified on inspection had been identified by the registered manager as needing improvement and plans were in place.

We fo

5th June 2014 - During a routine inspection pdf icon

Ashbury Lodge Residential Home provides accommodation and personal care for up to 44 people many of whom were living with dementia. At the time of the inspection there were 37 people living at the home.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law like the provider.

On the day of the inspection we saw that people were well cared for and were appropriately supported. This included people being assisted to eat meals. We observed staff were good humoured, polite and caring when dealing with people.

People and, relatives of people who lived at the home told us they were satisfied with the care and support provided to people. Relatives told us the staff showed genuine warmth and affection towards people. One relative said of their relative who lived at the home, “The staff love her to bits.” Another relative told us, “The staff are good. You couldn’t get better treatment.”

We saw there was an activities programme from Monday to Friday facilitated by two activities coordinators employed for 25 hours per week each. Relatives said the activities provided were varied and were enjoyed by people who lived at the home.

Records showed that where people were able to, they were involved in the assessment of their needs and in contributing to decisions about their care. Where people lacked capacity to make decisions about their care we saw that for some people relatives had been consulted about this. We found that assessments of capacity as required by the Mental Capacity Act 2005 were not always carried out for everyone who did not have capacity to make a decision about their care and treatment. We also found where people did not have capacity and decisions were made for them that these were not always recorded to confirm this was done as a ‘best interests’ decision. We found the service needed to make improvements in this area. The action we have asked the provider to take can be found at the back of this report.

Health and social care professionals told us the home made appropriate referrals of those people who lacked capacity and needed to be assessed under the Deprivation of Liberty Safeguards (DoLS) procedures. This is legislation that restricts people’s freedom where this has been assessed as being needed to protect the person from possible harm. At the time of the inspection there was one person subject to a DoLS authorisation.

Staff were aware of their responsibilities to safeguard people from abuse and were provided with a handbook, which included details about safeguarding procedures and how staff could raise any concerns.

Each person’s needs were assessed and recorded so that the staff knew how to care for them. Care plans incorporated people’s preferences and routines so staff provided care in the way people preferred. These were reviewed and updated so staff had current information about people’s needs. We saw records of the home liaising with other health and social care providers so that people were referred for appropriate care. Health and social care professionals told us staff contacted them with any concerns and staff sought guidance and advice so that people were safely cared for.

There were sufficient staff to meet people’s needs with a separate staff team for each floor of the home. Relatives, staff, and, health and social care professionals told us they considered the home had enough staff to meet people’s needs. The registered manager and a member of the administrative team monitored and planned staff training so staff were trained and competent in areas considered essential to providing safe and effective care. In addition to this, staff had opportunities for professional development by completing recognised qualifications in care.

The home was well led and had systems in place to gain the views of staff and relatives about the service provided. Relatives confirmed they attended relatives’ meetings where they were able to raise any suggestions or issues they had. We saw records of reviews of accidents and incidents in the home plus action being taken to reduce the likelihood of any reoccurrence. Regular audits and safety checks were carried out, such as medicines audits and checks that equipment was safe and in working order.

23rd October 2013 - During a routine inspection pdf icon

At our previous visit in May 2013 we had identified shortfalls and required that improvements were made. At this visit we found that action had been taken to address these concerns and improvements had been made.

We observed that people were provided with the appropriate support to eat their meals. Peoples dignity was promoted. We saw that the service recorded information about peoples individual likes and dislikes with regards to food. Recording was completed that ensured that nutritional health was being monitored.

The provider was undertaking building work to provide a new larger kitchen and a new lounge-dining room.

21st May 2013 - During a routine inspection pdf icon

People who lived in the home we spoke with told us they were pleased with the care and support they received. We were told the staff were friendly and caring and treated them with respect.

We spoke with relatives who were visiting the home and they told us they were always made to feel welcome. We were told that the manager and staff were approachable and listened to concerns.

We found that people were provided with a choice of food and that the home had systems in place to monitor nutritional needs. However we found that improvements were required to some of the arrangements for the provision of the lunchtime meal. We saw there was a lack of choice over the timing of this meal for some people and that the required staff support was not always available.

The home was clean and hygienic and regular checks on cleanliness were undertaken by the senior staff.

Staff we spoke with told us they were receiving regular supervision and were well supported by the senior staff and managers. We found that improvements had been made to the planning and organising of staff training and that the majority of people were up to date with the required mandatory training.

The home had systems in place for monitoring and auditing the quality of care.

We saw that various improvements had been made to the environment and that more building work was being planned. A new summer lounge had been completed and was due to be put into use shortly.

27th June 2012 - During a routine inspection pdf icon

People who lived in the home told us they were well cared for and that staff were friendly and treated them with respect. We were told it was safe place to live.

Relatives said they were made to feel welcome in the home and staff communicated effectively with them.

Staff told us they worked well as a team and treated people as individuals. People tried to work with a person centred approach.

The new manager told us they were getting to know everyone who lived in the home and the staff who worked there. They were ensuring they were kept informed of all aspects of care.

5th August 2011 - During a routine inspection pdf icon

People described staff as ‘lovely’ and ‘very friendly, and very good too’. A relative told us that they had a good relationship with staff and that their family member was being well supported in the home.

We also heard that staff were very busy and one person commented that staff ‘did the best they can but were rushed off their feet’. We found that there were shortcomings which affected the quality of care that people received.

Relatives had completed surveys and there was an article in the home’s newsletter about the positive feedback that had been received.

People told us that they felt safe in the home. Staff said they had received training so they could recognise abuse and knew how to report any incidents they were concerned about.

 

 

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