Ashley House - Langport

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People’s needs were assessed and related care plans and risk assessments were developed. These care plans were reviewed involving people and their relatives as appropriate. Staff worked with health and social care professionals to make sure people received the care, treatment and support they needed. Our observations of the dining experience at the home was mixed, people were not always offered condiments or told what their meal was. On the second day of our site visit this had improved. The management team had systems and processes in place to meet people’s nutrition and hydration needs. Daily handover meetings were held and included discussions around people’s health and changing needs. People confirmed staff asked their consent before supporting them. Staff were aware of the principles of the Mental Capacity Act (MCA), MCA assessments and best interest decisions were in place for most decisions. We found 1 example where an MCA and best interest decision had not been completed. The registered manager addressed this during the assessment.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives were involved in a pre-assessment of people’s needs prior to them moving to the home. One relative told us, “They asked questions, and an assessment was completed.”

The registered manager completed preadmission assessments with people prior to their move to the home. They told us they gathered information from people, their relatives and social workers where required. Staff told us information was available in people’s care plans and they also spoke to people to find out their preferences. They confirmed if people’s needs changed, they would let the team leaders know, and care plans would be updated. Staff confirmed information was also shared via handovers. One staff member commented that they did not feel they were always given enough information about people when they moved into the home. We discussed this with the registered manager who described the processes in place for gathering information and they gave assurances that relevant information was available in these instances. They said however they would look into creating an information sheet for staff and ensure staff were aware of where this could be located.

People’s needs were assessed and related care plans and risk assessments were developed. There was an ongoing assessment process of people’s needs, and appropriate professionals were involved where required. People’s care plans were reviewed and updated where there were changes in people’s needs.

We did not receive any specific feedback from people about receiving evidenced based care and treatment. However, people felt staff had the right skills and knowledge, and people told us relevant health care professionals were involved in their care. This ensured people received evidence-based care and treatment. People told us they were happy with the food. One person told us, “It’s ok, there is always a choice.” A relative told us, “The food is excellent.” Our observation of the dining experience on day 1 of the assessment was mixed. People who were eating in the dining room were not offered to sit at the dining table, not always informed of what their meal was, not offered condiments and not encouraged to eat their meal. We discussed this with the registered manager who told us they were usually out supporting people at mealtimes and our observations were not their experience of usual practice. They told us they would address the concerns. Our mealtime observations in the dining room on day 2 of the assessment was positive with all of the areas we raised as a concern being addressed. Some people chose to eat in the lounge area of the home and our observations of the dining experience in this area was positive.

Staff were aware of people’s dietary needs and requirements. Staff told us people were offered choices daily about what they would like to eat. The kitchen staff had access to information relating to people’s dietary needs, they were aware of people with modified diets and those requiring additional calorie intake. The kitchen staff told us that they were in the process of redesigning the menus, this involved speaking to people about their preferences with a focus on healthy eating.

There were systems and processes in place to meet people’s nutrition and hydration needs. Care plans and risk assessments described what modified diets people were prescribed. Where people were at risk of dehydration or malnutrition this was identified in their care plans and management plans were in place. People’s weights were regularly monitored to identify any concerns regarding weight loss. The mealtime experience was monitored by the registered manager as part of the auditing process. Following our feedback regarding our observations of the mealtime experience the registered manager told us they would carry out more frequent observations.

People and relatives told us that staff knew them well and were able to support them with appropriate care, which met their needs. One person told us staff were, “Very good and friendly, they are helpful, can't do enough for you.” A relative commented, “They are very good with health appointments.” People confirmed staff worked with health professionals such as the GP and chiropodists when required.

Staff told us they worked with health professionals to ensure people got the care and support they needed. Staff told us they worked together well as a team. One staff member told us, “The nice thing is we all get on well, we can be honest and open about anything.” The registered manager told us they actively promoted teamwork through a variety of activities both in the home and socially. They told us they arranged staff ‘get togethers’ to go out for food and they were arranging a teambuilding evening. The registered manager also told us their door was, “Always open” and they were always “On hand” to work alongside the team if needed.

Health professionals told us there was a welcoming atmosphere in the home, staff were helpful and accommodating.

The provider had a clear process in place to escalate health concerns within a timely manner. Staff worked with health and social care professionals to make sure people received the care, treatment and support they needed. Where specialist health care professionals were involved in people’s care, their input and advice was included in people’s care plans.

People and relatives told us staff supported them to manage their health and they received good care. One person told us, “The staff are really good here.”

Staff knew people well and had a good understanding of meeting people’s changing needs. Staff told us how they encouraged people to move around and go outside in the fresh air. One staff member told us, “We encourage people to dance and go outside, we had a sports day, we also encourage balanced meals with plenty of vegetables.” The registered manager told us how they encouraged people to live healthier lives by ensuring homemade food was available with fresh vegetables and fruit. They also told us how they encouraged exercises through activities and people had the opportunity to walk into the local town.

There were systems in place to monitor people’s health. People’s needs were regularly reviewed, and referrals made to external healthcare professionals where required. The service had links with the local dementia team and referred people for a formal diagnosis if they did not already have one. Daily handover meetings were held and included discussions around people’s health and changing needs. Concerns were escalated where GP or hospital consultation was required.

People experienced good outcomes because of the support provided to them.

Staff described how they wanted to support people to achieve positive outcomes. One staff member told us, “We want to give the residents the best quality of life and care we can, keep them happy and safe and be as independent as they can. We are not restrictive and support people to take positive risks.” The registered manager gave an example of a person who was deemed unable to walk when they moved to the home. They described how they worked with professionals to support the person who was now able to walk short distances with a walking frame.

Care plans were in place which detailed people’s care and support needs, and care plans were outcome based.

People confirmed staff sought their consent before supporting them. One person told us, “Yes, they ask if I need help with anything. Another person commented “Yes they always advise on what they are going to do and ask if I need any help.”

Staff told us they asked people for their agreement before providing care and support. One staff member told us, “We don't push a person if they have decided they do not want something doing. We ask for consent before carrying out any activities.” Staff had an understanding of the Mental Capacity Act (MCA). The registered manager told us that people’s capacity was assessed in accordance with the MCA and assessments were stored within people’s records.

The service worked within the principles of the Mental Capacity Act (MCA). Care plans contained information about most decisions made in people’s best interests, and the reasons for this. We found one example where a person’s cigarettes were being stored in the office, the person’s health had deteriorated, and it was assessed that they would not be safe to hold their own cigarettes. The person appeared happy with this arrangement; however, they would not fully understand the potential fire risks. An MCA and best interest decision had not been made regarding this, the registered manager confirmed they would complete this during the assessment.