Care service description

Ashford Lodge is a residential care home for nine men and women with learning disabilities ranging from the age of 20 to 60. Ashford Lodge is a detached property in the village of Chilham, on the outskirts of Canterbury. At the time of our inspection, there were eight people living in the main building, and one person living in the on-site annex.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities using the service can live as ordinary a life as any citizen.

Rating at last inspection

At our last inspection on 20 April 2016, we rated the service as Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Rating at this inspection

At this inspection we found the service remained Good.

Why the service is rated Good

People had been safeguarded from potential harm and abuse. Risks had been assessed and mitigated, and people were encouraged to take positive risks. Staff had been subject to the relevant pre- employment checks and there were sufficient staff to keep people safe. One person told us “I feel safe because the door is locked at night, and there is enough staff.” People received their medicines when they needed them. The service was clean and protected by the prevention of infection control. The provider ensured lessons were learnt and improvement plans put in place when necessary.

People received effective care, in line with best practice, that achieved good outcomes for them. Staff received training tailored to the needs of the people they supported. People told us they were supported to eat and drink sufficient levels and were encouraged to live healthy lives. People received coordinated care when they moved between healthcare services. The service had been adapted to meet the needs of the people living there. Consent to care and treatment had been sought.

People told us they were treated with kindness and respect, and were given emotional support as and when they needed. People were actively involved in making decisions about their care as far as possible. People’s privacy and dignity were respected and all documentation was held securely.

People received person centred care that was responsive to their needs. People told us they were involved in activities that were meaningful to them. All complaints and concerns were logged and responded to appropriately. People and their relatives told us they knew how to raise concerns and felt confident they would be addressed. The service was not supporting anyone at the end of their lives.

People, staff and relatives told us the day to day culture of the service was positive, inclusive and focused on good outcomes for people. There were suitable arrangements in place to ensure the regulatory responsibility was met. The provider sought feedback from people, relatives and staff and used it to learn, improve and ensure sustainability for the service. The manager had formed relationships with external agencies including safeguarding.

This inspection took place on 20 April 2016 and was unannounced. The previous inspection was carried out in July 2014 and there were no concerns identified.

Ashford Lodge is registered to provide accommodation and personal care for up to nine people who have a learning disability. Ashford Lodge is in the village of Chilham, on the outskirts of Canterbury. Eight people were living at the service, seven people lived in the main building, and each had their own ensuite bedroom. People had access to two communal lounges, dining room, kitchen, laundry room and a communal shower room and toilet. Adjacent to the main building is a self-contained annexe which has one bedroom, lounge, kitchen and bathroom facilities. There is a well maintained garden, with vegetable patch and outside area with off street parking within the gated grounds.

The service has a newly appointed manager, who was present throughout the inspection and is in the process of applying to be registered with the commission. 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 and associated Regulations about how the service is run.

People received their medicines safely and when they needed them. They were monitored for any side effects. If people were unwell or their health was deteriorating the staff contacted their doctors or specialist services. People’s medicines were reviewed regularly by their doctor to make sure they were still suitable. People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and received the care and support that they needed.

Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had attained the right skills and knowledge to be able to care for, support and meet people’s needs. When staff had completed induction training they had gone on to complete other training provided by the organisation. There was also training for staff in areas that were specific to the needs of people, like epilepsy and autism. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns both within the company and to outside agencies like the local council safeguarding team. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The manager and deputy manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The manager, their deputy and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Some people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the manager had applied for DoLS authorisations for people who were at risk of having their liberty restri

The inspection team was made up of one inspector. Time was spent in the home looking at care records, talking to staff and people who used the service. We looked at people's plans of care, staffing records and quality assurance processes. We set out to answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, the staff supporting them and looking at records.

Is the service safe?

The service was safe. People told us they felt safe and staff understood how to protect people's rights and safeguard the people they supported.

Systems were in place to make sure that the manager and staff learned from events such as accidents, incidents and concerns. People's care needs and the qualifications, skills and experience of the staff were taken into account when making decisions about staffing numbers required to the meet the needs of people who used the service.

Is the service effective?

The service was effective People's health and care needs were assessed with them, and they were involved in their plans of care. Specialist dietary, mobility and developmental needs had been identified in care plans where required. People who used the service said that they had been involved in the planning of their care and we found that the care plans reflected their current needs.

People's needs were taken into account with the layout of the service, which enabled people to move around freely and safely.

Is the service caring?

The service was caring. People were supported by attentive staff who knew them well. We observed that support workers showed patience and gave encouragement when supporting people. One person told us "The staff are good, they help me."

We found that people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. We observed that people were supported by staff who focused on person centred support.

Is the service responsive?

The service was responsive People regularly completed a range of activities of their choice both in and outside of the service.

The provider and the staff worked in collaboration with outside professionals such as speech and language therapists and dieticians, where necessary and staff followed the recommendations made.

Is the service well-led?

The service was well led. This was a responsive inspection to follow up on some concerns We did not substantiate these concerns. At the time of our visit the service had a new manager who had been in post for four weeks and who was in the process of applying to us to be the registered manager. The manager was being supported by the area manager who visited the home regularly.

The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continually improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home.