Archived: Ashcroft Lodge - Doncaster

Updated 16 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 rating for the service under the Care Act 2014.

The inspection took place on 13 October 2015 and was unannounced. The inspection team consisted of an adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before our inspection, we reviewed all the information we held about the home including notifications the provider has sent us regarding significant incidents and the provider had sent us a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well, and improvements they plan to make.

We spoke with the local authority and Healthwatch to gain further information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

At the inspection we used a number of different methods to help us understand the experiences of people who used the service. We observed care and support in communal areas and looked at the environment in both the Lodge and the Cottage. We talked with people and observed their care and support being provided by staff. We met all of the five people who used the service. Some people had limited verbal communication. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with seven members of staff including the manager and the regional manager. We looked at documentation relating to people who used the service, staff and the management of the service. We looked at three people’s care and support records, including the plans of their care. We also looked at the systems used to manage people’s medication, including the storage and records kept. We looked at the quality assurance systems to check if they identified and addressed any areas for improvement.

Updated 16 December 2015

The inspection took place on 13 October 2015 and was unannounced. Our last inspection of this service took place in November 2013 when no breaches of legal requirements were identified.

Ashcroft Lodge is based in Thorne on the outskirts of Doncaster. The service is registered to provide accommodation and care for six people who have autistic spectrum disorders. It consists of two, linked houses. The Lodge is a four bedded house for people who have complex needs and who require one to one staffing for their care. The Cottage provides care and accommodation for two people who are relatively independent and working towards more independent living.

At the time of our visit there were three people living at the Lodge and two people living at the Cottage.

The service did not have a registered manager in post at the time of our inspection. 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. There was a new manager, who was completing the necessary tasks in order to apply to be registered.

Some people we spoke with had limited verbal communication. However, they very clearly indicated they felt safe and were happy living in the home, liked the staff and did the activities they liked to do.

People’s medicines were well managed generally, except that the temperature that people’s medicines were stored at was not monitored.

Staff we spoke with had a clear understanding of safeguarding people and they were confident their managers and the rest of their team would act appropriately to safeguard people from abuse.

The support plans we looked at included risk assessments, which identified any risks associated with people’s care and had been devised to help minimise and monitor the risks without placing undue restrictions on people.

We saw that the control and prevention of infection was managed well and that staff had been trained in infection control. Despite building alterations work being undertaken in the Lodge, everywhere was very clean and there were effective health and safety audits in place.

There were enough staff to keep people safe and to meet people’s individual needs, and the staff told us they received good training and support.

The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected. MCA assessments and ‘best interests’ decisions had been made where there were doubts about a person’s capacity to make a specific decision. DoLS applications had been made to the local authority.

There was good guidance for staff regarding how people expressed pain or discomfort, so they could respond appropriately and seek input from health care professionals, if necessary. People had access to a good range of health care services and staff actively advocated for people if they felt health care services were not as responsive as they should be.

People were supported to have a good, well balanced diet and people’s individual needs and choices were catered for.

Specialist equipment was provided to meet people’s individual needs. For instance, one person had a special, adapted bath in their en-suite. People were involved in choices about the décor of their homes.

Staff retention was good, and staff knew people well and had built good relationships. There was also a good mix of staff.

Staff spoke to people in a caring and positive way, treated people with respect and were mindful of their rights and dignity. There was a nice, relaxed atmosphere and people were relaxed and smiling in the staff’s presence.

There were very good care and support plans and information for staff about people’s likes and dislikes and we saw that staff were very good at monitoring people’s reactions and responses and responding to people in positive way.

We found that staff respected people’s spiritual and cultural needs. Staff were knowledgeable about this aspect of people’s needs and this information was also clearly reflected in people’s care and support plans. The care plans themselves were detailed and thoughtful and included pictures and photographs to enhance people’s understanding and involvement.

The people we spoke with who lived in the cottage said they liked living there and it was clear from our observation that the people who lived in the Lodge were happy and relaxed in their home.

People had very full lives, engaging in lots of activities, and this included in the evenings and at weekends. They were encouraged to keep in touch with the people who were important to them, such as their family members.

People and their close family members, were encouraged to make their views known about their care. An independent advocate had sometimes helped people with this. An advocate is someone who speaks up on people’s behalf.

The complaints process was clear and people’s comments and complaints were taken very seriously, investigated and responded to in a timely way. People didn’t have any complaints to tell us about and indicated they were happy living at Ashcroft Lodge.

The manager was very person centred in her approach. Person centred care is when staff understand what is important to the person and give them the right care and support to do the things they want. She was very keen to find more ways to seek people’s feedback, and use it to improve the service, particularly the people who had limited verbal communication.

The staff we met were very enthusiastic and professional, and were good communicators. They told us they were well supported by a very open management team.

There was a good range of quality and safety audits, undertaken by staff, managers and external verifiers.

People had a chance to say what they thought about the service and the service learned from its mistakes, using comments, complaint and incidents as an opportunity for learning or improvement.