This inspection took place on 23 and 30 August 2017 and was unannounced. This meant the staff and provider did not know we would be visiting.

Ashbourne Lodge Care Centre provides care and accommodation for up to 40 people, some of whom have a dementia type condition. On the day of our inspection there were 38 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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 last inspected the service in June 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the safe administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service, and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff.

Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Ashbourne Lodge Care Centre.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Care plans were in place that recorded people’s plans and wishes for their end of life care.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the manager. People who used the service, family members and staff were regularly consulted about the quality of the service.

Due to the physical and mental health needs of the people living at the home it was not possible to obtain some people's views. However we used a number of different methods to help us understand the experiences of the people using the service including Short Observational Framework for Inspection (SOFI) exercise. SOFI is designed to be used when inspecting services for people who had some difficulty in communicating their opinions on the services they receive.

We spoke to one person using the service who told us they were "happy”. We spoke to three relatives. One relative told us, “Staff are good.” Another relative said, “Staff do what they can.”

All of the people we spoke with confirmed that they thought their relative was safe.

We saw people were treated with consideration and respect. The home made sure people were protected from unsafe care.

At the time of this visit there were enough qualified, skilled and experienced staff available to meet people's needs.

People were made aware of the complaints policy. We saw the provider monitored the quality of the service, and asked people and their relatives for their views.

People we spoke with told us they were consulted about the care they received. Two people who used the service told us the staff always explained things to them and help them to make decisions. One person told us, “They don’t just do things for you. They explain it to you which is good”.

During the inspection visit, we saw a number of district nurses visiting people who needed a nursing service. This showed that people were receiving appropriate care and support from the NHS. One person told us, “I can’t fault the care here. The girls are really caring and very kind”. One relative we spoke with told us they had no problems with the care provided as Ashbourne Lodge. They told us, “Me and my family are happy with the care mom gets here. They keep us informed about everything”.

People we spoke with told us they were aware of the complaints procedure and would know what to do if they had any concerns. People felt confident about making any comments or raising concerns with the manager. One person told us,”I am very happy here. I have no concerns at all”.

We did not receive any comments from the people who used the service on staff training and support, and quality assurance.

This inspection visit was arranged to check on the improvements that the home had made following the last inspection visit in November 2011.

People living in the home told us that they were well treated by the staff and that they were happy living there. People told us that they found the staff very friendly and they were treated with respect.

We spoke with visiting relatives and they told us they were aware of the changes that had taken place, due to the home being taken over by another provider. People told us they had been kept informed about the change over of ownership of the home.

A relative told us that she agreed with the home to allow her to take her family member’s washing home and wash them herself. She said this made her feel involved in the care of her relative.

When we spoke with people about the number of staff in the home, they told us that they thought there were enough staff in the home. All said that their personal needs were always met promptly by the staff. A relative told us that her family member couldn't have been happier in the home. She said, “the staff are always there when you need them”.

This inspection took place on 29 June and 1 July 2015. The first visit was unannounced. We last visited the service in September 2013 and concluded the home was meeting all the regulations that we inspected.

Ashbourne Lodge Care Centre is registered to provide personal care for up to 40 people. At the time of our inspection there were 36 people living at the home, some of whom were living with dementia.

The home had a registered 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.

People told us they felt safe living at the home. One person said, “Yes I am safe, they are all wonderful.” Staff we spoke to were clear in terms of identifying signs of abuse and were confident to report any concerns. People and relatives told us they thought the home provided a high standard of care and there was a very welcoming atmosphere. We noted throughout both days of the inspection there were good relationships between people and staff at all times.

People told us they thought staff had the right skills to do their job. We noted the provider had a clear system in place for induction and regular training, as well as supervisions and appraisals. Staff told us they felt the yearly appraisals were useful as they had an opportunity to document their thoughts before the meeting. The provider ensured they employed suitable staff by following their recruitment procedure; this included ensuring everyone had two written references and a disclosure and barring service check.

We noted the menu for meal times was written on a board in each dining room. Choices were available and people told us they enjoyed the meal time. We discussed with the registered manager making the menu more visual for visiting relatives and considering pictures to support people making choices. The kitchen staff had a clear understanding of people’s dietary needs and this was communicated to the staff.

We saw that medicines were managed in a clear and structured way. The provider had a system for administering medicines and these were audited on a daily and weekly basis. Care plans were available to support people with safe administration of medicines and this included potential side effects and clear explanations as to why the medicine was prescribed.

People told us about the planned activities that took place on a monthly basis, these included entertainers and visits from an animal zoo. People told us that in-between these there were limited for them to do. The registered manager told us they had been looking into ‘rummage boxes’ to support people with dementia. We noted these were available on our second visit.

People and their relatives told us they didn’t have any concerns or complaints but would be more than happy to speak to the registered manager or staff if they did. They told us they knew they would listen and take any action they could.

Staff we spoke to told us they felt supported within their role, both by senior colleagues and the registered manager. We noted the home had a welcoming atmosphere and everyone seemed relaxed and happy in their job.

The registered manager and provider had clear systems in place for ensuring a quality service was provided on a consistent basis. We saw the registered manager completed a range of checks, from daily walk-around, flash meetings, to monthly audits. We saw that where required appropriate action was taken following these audits.