Astor Lodge

We completed this responsive inspection, as concerns had been raised about the operation of the service and staff practices. We found the provider had identified these issues and already taken action to address them.

People and relatives were consistently positive about the care and support provided. People told us they felt safe and said staff were knowledgeable, responsive and available when needed. Staff understood people's individual needs and risks and worked closely with healthcare professionals to support people throughout their rehabilitation. Visiting professionals were also complimentary about the staff team and their knowledge of people.

People received personalised care from staff who had developed trusting relationships with them. Staff involved people in decisions about their care and promoted choice, control and independence. People were encouraged to retain and regain everyday skills and were supported to take part in therapeutic, and rehabilitative activities. Staff adopted an empathetic and sensitive approach that helped people build confidence, broaden their opportunities and work towards greater independence.

Staff completed assessments with people and, where appropriate, their relatives before admission and throughout their stay. Care and treatment were tailored to individual needs and delivered in partnership with healthcare professionals, including a local NHS Trust clinical lead, nurse practitioner, physiotherapists, and occupational therapists. This range of local NHS Trust healthcare professionals worked at the home each day. Staff were skilled at identifying changes in people's health and took prompt action to seek clinical assessment and treatment when required. This helped people improve their health, regain skills and achieve the best possible outcomes.

There were enough suitably skilled staff to meet people's needs. The management team regularly reviewed staffing arrangements and monitored quality and safety through audits, oversight systems and partnership working with the local NHS trust. In recent months the provider had determined additional nursing cover was required and put this in place. Staff felt valued and supported and spoke positively about the leadership team. The management team promoted a culture based on transparency, inclusion, learning and continuous improvement. Both the provider and governance team from the local NHS Trust consistently monitored the service, used information to learn lessons and looked at how they could continuously improve.