We inspected Ashbourne Lodge on 13 February 2017. This was an unannounced inspection. The service is registered to provide accommodation and nursing care for up to 54 older people, with a range of medical and age related conditions, including arthritis, frailty, mobility issues, diabetes and dementia. On the day of our inspection there were 51 people living in the care home, including one person who was in hospital.

At our last inspection on 18 March 2015 the service was found to be fully compliant and was rated good in all areas and overall.

A registered manager was in post and present on the day of the 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 were policies and procedures in place to assist staff on how keep people safe. There were sufficient staff on duty to meet people’s needs; Staff told us they had completed training in safe working practices. We saw people were supported with patience, consideration and kindness and their privacy and dignity was respected.

People received care and support from staff who were appropriately trained and confident to meet their individual needs and they were able to access health, social and medical care, as required. There were opportunities for additional training specific to the needs of the service, such as diabetes management and the care of people with dementia. Staff received one-to-one supervision meetings with their line manager. Formal personal development plans, such as annual appraisals, were in place.

People’s needs were assessed and their care plans provided staff with clear guidance about how they wanted their individual needs met. Care plans were person centred and contained appropriate risk assessments. They were regularly reviewed and amended as necessary to ensure they reflected people’s changing support needs.

Thorough recruitment procedures were followed and appropriate pre-employment checks had been made including evidence of identity and satisfactory written references. Appropriate checks were also undertaken to ensure new staff were safe to work within the care sector.

Medicines were managed safely in accordance with current regulations and guidance by staff who had received appropriate training to help ensure safe practice. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were provided with appropriate food and drink to meet their health needs and were happy with the food they received. People’s nutritional needs were assessed and records were accurately maintained to ensure people were protected from risks associated with eating and drinking. Where risks to people had been identified, these had been appropriately monitored and referrals made to relevant professionals, where necessary.

The premises were well maintained and offered a pleasant environment for the people living there. The accommodation was spacious and provided a range of communal areas for sitting and relaxing, including several comfortable lounges, a reminiscence room, a bar (with snug) and a home cinema. Following consultation with people who used the service, a fully accessible sensory garden had recently been completed, which included raised flower and vegetable beds.

There were quality assurance audits and a formal complaints process in place. People were encouraged and supported to express their views about their care and staff were responsive to their comments. Satisfaction questionnaires

An unannounced inspection took place on 18 May 2015. There had not been a previous inspection as the home was first registered in August 2014.

Ashbourne Lodge provides care and support for up to fifty four people who require a range of needs, including nursing care. All rooms have en suites containing toilets and wash basins. People have access to a resident’s pub, cinema room, reminiscence room and sensory gardens.

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 and their relatives were satisfied with the care and support that was provided and felt that their needs were met. We saw that people were treated with dignity and respect and treated as individuals. People were well supported by staff who understood their individual needs and we saw that people were involved in the planning and delivery of their care. They were also supported to take part in activities that interested them.

Staff were aware of how to protect people from avoidable harm and of safeguarding procedures to ensure that any allegations of abuse were reported and referred to the appropriate authority.

Staff had a good understanding of people’s needs and had taken the time to form positive and caring relationships with those living in the home. Staff received training to help them provide effective care to people and were positive about their role and the organisation.

Medicines were stored safely though there were some out of date medicines that should have been returned to the pharmacist.

People received the care and support they required and their health needs were monitored and responded to. Assessments and care plans were in place to manage risks to people and provide guidance for staff to follow.

There were sufficient staffing levels to ensure the welfare and safety of people. People were responded to promptly and effectively by the staff team.

People’s nutritional and dietary requirements had been assessed and a nutritionally balanced diet was provided.

Requirements of the Mental Capacity Act (MCA) and Deprivations of Liberty Safeguards (DoLS) were known and understood.

The home was well maintained and offered a pleasant environment for the people living there. The accommodation was spacious and offered different areas for sitting and relaxing as well as a television lounge. A sensory garden was in the process of being built which the residents had been involved in planning. There was a cinema and films were chosen by the people living in the home.

People were confident about the management of the service and the registered manager was keen to develop and improve the home. There were effective systems in place to assess and monitor the quality of the service. This included gathering the views and opinions of people who used the service and monitoring the quality of the service provided. There was an effective complaints system in place.