The inspection took place on 12 and 23 February 2018. The first day of inspection was unannounced and the second day announced. When we last inspected the home in December 2016 we found the provider had breached the regulations relating to assessing safe care and treatment and good governance because medicines were not managed safely, risk were not assessed effectively and the provider did not maintain accurate records relating to people’s care. We rated the home as Requires Improvement. Following this inspection, to reflect the improvements the provider has made, we have rated the home as Good.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions is the service safe, effective, responsive and well-led to at least good. We requested the provider supply the Commission with regular updates to enable close monitoring of progress. We found progress had been made and the provider was now meeting the regulations. Medicines were usually managed safely, although further improvements were needed to ‘when required’ medicines. People confirmed they received their medicines when they were due. Assessments to keep people safe were accurate and up to date. Care records now contained accurate information to account for the care provided at the home.

People, relatives and staff felt activities were not always available to keep people engaged throughout the day. We have made a recommendation about this.

Ashlea Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Ashlea Lodge accommodates up to 40 people across two separate units, each of which have separate adapted facilities. At the time of our inspection there were 33 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, relatives and staff said the provider and registered manager had made significant improvements to the home.

People and relatives gave us mostly positive feedback. They said the home provided good care and staff were kind and caring. People told us they were always treated with respect and staff promoted their independence. A person said, “They are always respectful towards me and I genuinely believe they care about the residents.” A relative commented, “There are none better because they really look after and care for [family member].” However, some people and relatives felt staffing levels could be improved.

The home was clean, well decorated and well maintained. People, relatives and staff told us the home was much cleaner now.

Staff did not have any concerns about people’s safety and knew how to raise concerns if required. The provider followed local safeguarding procedures when dealing with safeguarding concerns. These had been fully investigated and resolved.

The provider followed effective recruitment processes to ensure new staff were recruited safely.

Staff carried out health and safety checks to maintain a safe environment for people to live in. The provider also had up to date procedures to deal with unforeseen emergency situations.

People and relatives commented positively about the meals provided at the home. Staff supported people to have enough to eat and drink.

Management provided good support to staff and staff completed training to their role. Records confirmed training, supervisions and appraisals were up to date.

People were supported to have m

The inspection took place on 5 and 12 December 2016 and was unannounced. This was the first inspection of the home since the current provider took over management in April 2016 and the first rating inspection for this home.

Ashlea Lodge provides residential care for up to 40 older people, some of whom are living with dementia. At the time of this inspection there were 35 people living at the home. A new provider took over management of the home in April 2016.

The home did not have a registered manager. A new manager had been started their employment at the home three weeks prior to our inspection. They had applied to the CQC to become the 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.

During this inspection we found the provider had breached the regulations relating to safe care and treatment and good governance. We found the arrangements for managing medicines were not always safe. Medicines records were not always completed correctly, such as for the administration of medicines, application of topical creams, stock control and for the safe storage of medicines. We found medicines care plans were not always accurate or up to date. One person had received their medicines incorrectly on two occasions in the last month. Risks had not been adequately assessed as the assessments we viewed were inaccurate. Where measures had been identified to keep people safe, evidence was not always available to confirm these had been actioned. For example, some care plans had not been written or contained inaccurate and out of date information. We also found there were gaps in records and some essential records had not been kept, such as fluid charts. We observed an occasion where care workers did not follow a person’s care plan to reduce their anxieties.

The new provider took over management of the home in April 2016. They contacted the CQC to advise that due to the poor standards they had inherited an improvement plan was to be brought forward. When we inspected the provider had made significant progress against the actions identified in the plan. For example, actions to ensure all relevant people had the appropriate MCA assessments and best interest decisions, all staff had completed essential training, recruiting additional care staff and domestic staff and the appointment of a new manager. Other actions were still on-going at the time of our inspection. The provider submitted a revised action plan following our inspection which reflected the concerns we found during the inspection. The provider agreed to also submit a weekly progress update to ensure close monitoring of the outstanding actions and to meet the requirements of the regulations.

People, relatives and care workers told us there had been improvements made to the home since the current provider took over. They said the home was cleaner and the quality of meals had improved.

In May, August and November 2016 we received anonymous concerns relating to medicines management, moving and handling, high turnover of staff, cleanliness, people not being encouraged to eat their meals, people’s individual care, care plans lacking meaningful information and the management of the home under the previous provider.

People and relatives told us the home provided good care. They also told us care workers were kind and caring and knew people’s needs well.

Care workers understood the importance of treating people with dignity and respect and encouraging people to be independent. They gave us examples of how they aimed to promote this when caring for people.

We saw care workers used safe moving and handling techniques when supporting people to mobilise. Where concerns had