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Care Services

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Ashgold House, Whitfield, Dover.

Ashgold House in Whitfield, Dover is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, learning disabilities, physical disabilities and sensory impairments. The last inspection date here was 20th February 2019

Ashgold House is managed by Ashgold House Limited.

Contact Details:

    Address:
      Ashgold House
      Church Whitfield
      Whitfield
      Dover
      CT16 3HZ
      United Kingdom
    Telephone:
      01304823966
    Website:

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 2019-02-20
    Last Published 2019-02-20

Local Authority:

    Kent

Link to this page:

    HTML   BBCode

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.

30th January 2019 - During a routine inspection pdf icon

About the service:

Ashgold House is a residential care home for people with sensory impairment, learning disabilities and autistic spectrum disorders. Ashgold House can accommodate six people. At the time of our inspection there were five people using the service.

People's experience of using this service:

People were safeguarded from the risk of abuse. Staff were aware of what actions to take to ensure people were safe.

Risks associated with people's care and support had been identified and plans were in place to help minimise these risks.

There were sufficient staff available to meet people's needs and to ensure they could go out when they wanted to.

People were supported to manage their prescribed medicines. Staff had received training to ensure this was carried out safely.

Accidents and incidents were monitored to identify trends and patterns and the provider took action to minimise incidents occurring.

People received support from staff who were trained and supported to carry out their role.

People were supported to maintain a healthy diet which catered for their likes and dislikes.

People had access to health care professionals as required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service was compliant with the Mental Capacity Act 2005.

During our inspection we saw staff interacting with people who used the service. Staff and people had a good rapport and staff were kind and caring in their approach.

Staff maintained people's privacy and dignity and were respectful of their home.

People received personalised care which was responsive to their needs and preferences. Support plans were clearly detailed.

The provider had a complaints procedure and people felt at ease to raise concerns. No concerns had been received at the time of our inspection.

The service was well led and had a registered manager who was dedicated in providing high-quality care which promoted an open and fair culture.

Audits were in place to measure the performance of the service and to action any concerns as they arose.

Rating at last inspection:

The home was rated Good (report published in August 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

30th June 2016 - During a routine inspection pdf icon

This inspection took place on 30 June 2016 and was unannounced.

Ashgold House is a privately owned service providing care and support for up to six people with different learning disabilities. People may also have behaviours that challenge and communication needs. There were four people living at the service at the time of the inspection.

The house is a detached property set in its own grounds in a rural area. Each person had their own bedroom which contained their own personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.

There was a registered manager working at the service and they were supported by a deputy manager. 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.

We carried out an unannounced comprehensive inspection of this service on 9 and 15 June 2015. Four breaches of regulations were found. We issued requirement notices relating to the employment of staff, staff training and skills, person centred care and good governance. We asked the provider to take action and the provider sent us an action plan. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. We found the breaches in the regulations had been met.

There had been no new people at the service for a long time. But if a new person was thinking about coming to live at the service their support needs would be assessed by the registered manager to make sure they would be able to offer them the care that they needed. The care and support needs of each person were different and each person’s care plan was personal to them. People or their relative/representative had been involved in writing their care plans. The care plans recorded the information and guidance needed to make sure staff knew how to care for and support people in the safest way. People were satisfied with the care and support they received. Any potential risks were assessed and managed without restricting people. There were systems in place to review accidents and incidents and make any relevant improvements to try and prevent them re-occurring.

People had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and support and promoted continuity of support between the staff team. People knew who their key worker was and had a choice about the key workers who worked with them. People had key workers that they got on well with.

Staff were caring and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people. People were comfortable and at ease with the staff. When people could not communicate verbally staff anticipated or interpreted what they wanted and responded quickly.

Staff were kind and caring when they were supporting people. People were involved in activities which they enjoyed and were able to tell us about what they did. Planned activities took place regularly and there was guidance for staff on how best to encourage and support people to develop their interests, skills and hobbies. Staff supported people to achieve their personal goals. This was a shortfall at the last inspection but the breach in the regulation had now been met.

Staff assumed people had capacity and respected the decisions they made on a day to day basis. When people needed help or could not make a particular decision on their own, staff supported them. Decisions were made in people's best interests. The Care Quality Commissio

16th August 2013 - During a routine inspection pdf icon

There were five people living at Ashgold House when we inspected. We spent time with the people and observed interactions between the people and the staff.

We found that people were asked to give consent and were involved in the decisions about the care and support they received. People told us and indicated that they were asked for consent before any care took place and their wishes were respected. People who used the service told us and indicated that they were happy at the home.

People were relaxed and responsive in the company of staff. They were able to let staff know what they wanted and we saw staff respond in a caring and positive way. People said that there were enough activities and that they enjoyed going out in the local area and doing different things.

People's health needs were supported and the service worked closely with health and social care professionals to maintain and improve people's health and wellbeing.

People told us and records confirmed that medicines were given to people when they needed them and in a safe way.

There was enough staff on duty to meet support and meet people's needs. The staff we spoke with had knowledge and understanding of people's needs and knew people's routines and how they liked to be supported.

People indicated and told us they did not have any complaints about the service. Staff knew when people were unhappy about something from the way they communicated their body language and facial expressions.

1st November 2012 - During a routine inspection pdf icon

We spoke to people who use the service, specialist community services, the Registered Manager and to staff members.

There were five people living at Ashgold House when we did the inspection.

We spent time with the people and observed interactions between the people and the staff.

We saw that people were responsive in the company of staff. They were able to let staff know what they wanted and we saw staff responded in a caring and positive way. Staff listened to people and took their views seriously and always answered their questions in a way that they could understand. People told us and indicated that they received the care and support that they needed at Ashgold House.

People were involved in decisions about their care and support and their privacy and dignity was respected. They said they had been involved with planning their care and support and were happy with the care and support they received.

People told us or expressed that they felt safe and well looked after. People said they would talk to staff about any problems and the staff would sort it out for them.

People said that there were enough activities going on and said that they enjoyed going out in the local area. Some people went swimming regularly and others went bike riding.

The staff we spoke to had knowledge and understanding of people's needs and knew people's routines and how they liked to be supported.

7th January 2011 - During a routine inspection pdf icon

Some of the people using the service were not able to speak with us to share their views. We spoke with others and we also observed what life was like in the home and what people experienced. During our visit we saw that staff treated people that use the service with respect. We saw that staff listened to people and took their views seriously and always answered their questions in a way that they could understand. We saw that the staff were friendly with the people using the service and everyone seemed relaxed in the home.

People using the service told us that they liked living at the home and that the staff gave them the help they needed. We saw that staff delivered the support that had been agreed in the care plan and that they understood people's needs. People told us that they enjoyed their meals. We saw that people were offered a choice of meals and were given the support they needed to eat. People told us they are happy with their rooms and everything was in good working order.

1st January 1970 - During a routine inspection pdf icon

This inspection took place on 9 and 15 June 2015, was unannounced and was carried out by two inspectors.

Ashgold House is a privately owned service providing care and support for up to six people with different learning disabilities. People may also have behaviours that challenge and communication needs. There were five people living at the service at the time of the inspection. The house is a detached property set in its own grounds in a rural area. Each person had their own bedroom which contained their own personal belongings and possessions that were important to them. The service had its own vehicle to access facilities in the local area and to access a variety of activities.

There was a registered manager working 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.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager was aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. We received information from the service informing us that one person had an application granted to deprive them of their liberty to make sure they were kept as safe as possible. There were four applications still being processed by the DoLS office. There were records to show who people’s representatives were, in order to act on their behalf if complex decisions were needed about their care and treatment.

The care and support needs of each person were different and each person’s care plan was personal to them. People or their relative /representative had been involved in writing their care plans. Most of the care plans recorded the information needed to make sure staff had guidance and information to care and support people in the safest way. People were satisfied with the care and support they received. However, some parts of the care plans did not record all the information needed to make sure staff had guidance and information to care and support people in the way that suited them best and kept them safe. On the first day of the inspection potential risks to people were identified but full guidance on how to safely manage the risks was not always available. This left people at risk of not receiving the interventions they needed to keep them as safe as possible. On the second day of the inspection the registered manager had reviewed and re-written the care plans and risk assessments. There was now clear guidance in place for staff on how to care for people effectively and safely and keep risks to minimum. Staff were aware of the changes and knew what they had to do to make sure that people received the care and support that they needed.

Staff had support from the registered manager to make sure they could care safely and effectively for people. Staff said they could go to the registered manager at any time and they would be listened to. They said the registered manager was very supportive. Staff had received regular one to one meetings with a senior member of staff. Staff had not received an annual appraisal so did not have the opportunity to discuss their developmental needs for the following year. Staff had completed induction training when they first started to work at the service and had gone on to complete other basic training provided by the company. There was also training for staff in areas that were specific to the needs of people, like epilepsy and dementia. Some of the new staff had not received this training so there was a risk that they may not know what to do in certain situations. There were staff meetings so staff could discuss any issues and share new ideas with their colleagues to improve people’s care and lives.

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. However, all the checks that needed to be carried out on staff to make sure they were suitable and safe to work with people had not been completed by the registered manager. When staff had gaps in their employment history this had not been explored and recorded when the staff member was interviewed for the job.

Emergency plans were in place so if an emergency happened, like a fire the staff knew what to do. However, we found that the checks for the fire alarms which should be done weekly had not been done for four weeks. The registered manager had not identified this in their regular audits. There was a risk that the fire alarm system may not be working effectively to alert people in the event of a fire.

People had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and support and promoted continuity of support between the staff team. People knew who their key worker was and had a choice about the keyworkers who worked with them. People had keyworkers that they got on well with. Staff were caring and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff. When people could not communicate verbally staff anticipated or interpreted what they wanted and responded quickly. Staff were kind and caring when they were supporting people.

People were involved in activities which they enjoyed and were able to tell us about what they did. Some planned activities did not take place regularly and there was no explanation as to why some activities had not occurred. There was no guidance for staff on how best to encourage and support people to develop their interests, skills and hobbies.

People who were not able to use speech to communicate were given choices about the meals they received. They had a choice about what food and drinks they wanted. People were being supported to develop their decision making skills to promote their independence and have more control. People said and indicated that they enjoyed their meals. People were offered and received a balanced and healthy diet. If people were not eating enough they were seen by dieticians or their doctor and supplement nutrition was provided. If people were unwell or their health deteriorating the staff contacted their doctors or specialist services so they could get the support that they needed.

People received their medicines safely and when they needed them and they were monitored for any side effects. People’s medicines were reviewed regularly by their doctor to make sure they were still suitable.

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 safe guarding team. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the registered manager or outside agencies if needed. The registered manager monitored incidents and accidents to make sure the care provided was safe.

Staff were aware of the ethos of the service, in that they were there to work together to provide people with personalised care and support and to be part of the continuous improvement of the service.

There were quality assurance systems in place. Audits and health and safety checks were regularly carried out by the registered manager and the quality assurance manager from the company’s head office. The registered manager’s audits had not identified some shortfalls, like the fire checks were not completed. Shortfalls in care planning and risk assessments had not been identified. The registered manager told us that over the past year they had been overseeing the management of another service owned by the provider and had to spend time away from Ashgold House. She said that because of this she ‘had taken her eye off the ball’ at Ashgold House and that was why there were shortfalls.

The registered manager had sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service. Informal feedback from people, their relatives and healthcare professionals was encouraged and acted on wherever possible. Staff told us that the service was well led and that the management team were supportive and approachable and that there was a culture of openness within Ashgold House which allowed them to suggest new ideas which were often acted on.

The complaints procedure was on display in a format that was assessable to people. People, their relatives and staff felt confident that if they did make a complaint they would be listened to and action would be taken.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

 

 

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