Ash Court Care Centre - Camden

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment, we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service. We will be requesting an action plan from the provider.
 

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was a positive culture and shared direction. Staff spoke to us about a desire to provide care with compassion and were able to expand upon what that really meant – treating people as individuals, taking time to listen and supporting people to keep both their bodies and minds active.
Across Forest Healthcare homes, there was a shared mission statement to provide a family feel to their care homes, with a focus on quality of life. Staff and leaders at Ash Court were able to share how they expected to deliver this and understood how their individual roles helped support achieving these aims.
Future plans for the service, as well as immediate changes, were communicated with staff during both team meetings and individual supervision discussions.
 

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. The registered manager had an extensive background in care provision having progressed through stages of their care career to their current provision. They told us they were passionate about empowering staff to also advance their skills, something staff told us they valued. A staff member commented, “[Registered manager] believes in me more than myself, [they] are the 1 pushing me to get my UK qualifications. [registered manager] really empowers us to be the best we can”
Staff also told us they felt informed about senior staff decision making.
People told us the registered manager was visible throughout the home on a day-to-day basis, and it was evident from our discussions and observation that they were familiar with individual people and understood people’s needs. One person said, “[Registered manager] is a friendly, happy person. I feel I could approach [them] if I wasn’t happy about something”.
The registered manager had support from senior managers as well as external partners. All expressed that the manager approached them for support and advice appropriately. They told us the registered manager was aware of their own limitations and confident in admitting this when required. One partner agency told us; “Opportunities to seek and offer feedback through visits are well utilised and the manager is quick to make contact when support is required.”
Relevant CQC notifications were submitted and done so in a timely way.
 

There were systems to support freedom to speak up. We saw a clear and easy to follow whistleblowing policy for staff. Staff we spoke with were familiar with the processes and understood when and why they might need to take this approach. Staff understood contact points for concerns and how these would be escalated. They also knew how to raise any such worries outside of the organisation if needed.
Staff also told us they were comfortable raising concerns, and senior staff were receptive of challenges. They told us they felt free to raise any issue without concerns of retribution.
Staff were encouraged to feedback regularly through staff meetings, individual supervision and anonymous staff surveys. Responses to anything raised and any actions taken as a result were shared openly with staff.
 

The provider promoted workforce equality and inclusion. Staff at Ash Court come from a diverse range of backgrounds and experience. Management told us they were keen to ensure all opportunities for development are available to the entire workforce. Increasing skills and knowledge is encouraged as relevant to all roles and tasks.
In similarity to the population in London Borough of Camden where Ash Court is situated, staff brought many different values, beliefs and languages. As such flexibility was applied to ensure staff were able to recognise important dates within their cultural calendars.
Results of the most recent staff survey (completed by 97% of staff) showed staff were positive about flexibility and work life balance.
The recruitment policy included ways to ensure the equality and diversity of the workforce. Equality monitoring forms formed part of the tools for analysing this. There was also specific information for considering overseas workers without discrimination.
 

The provider’s systems for monitoring and mitigating risk had not always been effective. Their audits had not identified where environmental concerns put people at risk.
We found a missing emergency pull cord, a potential trip hazard in the fire escape and doors displaying signage that they should be locked, open and accessible to all. There were also 2 emergency pull cords which had been gathered up rendering them unusable in the event of a fall. Despite audits aimed to identify such issues, they had not been addressed prior to our visit indicating such oversight was ineffective.
We saw evidence information and data are submitted to relevant bodies as required and in line with data protection and safeguarding protocols. This included CQC, local authority and healthcare agencies.
We reviewed quality assurance (QA) processes. These including internal QA reviews, those conducted by Forest Healthcare more widely as well as those undertaken by local commissioners.
Digital systems had been implemented to improve care. This included electronic recording of medicines and staff rota planning as well as the use of social media. This was used, with consent, to help keep families informed of what is happening at Ash court on any given day.
 

The provider worked with external partners. Partner agencies we spoke with gave us positive feedback about working with Ash Court. They were praised for open and transparent information sharing. Ash Court had been highlighted as a good example to other service managers and were engaged in local care managers’ groups to share examples of their own good practice and learn from the experience of others.
Ash Court engaged with the local community by welcoming local schools, visits to the local area and engaging local services for activities, such as transport providers and armchair exercise instructors.
Close working and engagement with the Veteran Friendly Framework had helped Ash Court to understand and celebrate veterans.
 

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Ash Court took part in various initiatives to continuously improve the quality of the service. The provider had taken part in a local authority initiative to adopt a strengths-based approach to care. This approach included an Occupational Therapist visiting the home weekly to work with people to become more independent and to take control. This encouraged people to retain independence and maintain their dignity for longer by continuing to carry tasks they are able to with support rather than on their behalf.

The service welcomed a weekly visit from a representative of Rethink advocacy services who spoke with people living at Ash Court and supported them to make decisions and choices, share feedback and have their voices heard. This helped promote people’s independence and ability to make choices.

Ash Court had achieved a Veteran Friendly accreditation. This helped them to better support people who were veterans. Partnerships which arose from this enable one person’s service records to be recovered and shared with them and their relatives. This enabled the relatives and others to recognise this person’s contribution to the country and to celebrate it. This brought a lot of happiness to the person and their relatives.
The provider also took part in a pilot to test a pain management tool as part of an IT App, PainChek. This tool supported individual pain management by integrating human input with artificial intelligence (AI). This supported care staff to recognise signs of pain, and monitor the levels in those with end of life care needs and less able to communicate and to tailor responses according to individual needs more accurately. The provider gave an example of how a person pain was being monitored which determined that they did not require to be on an end of life care pathway and could come off it. As a result the person had more control over their life, and together with their relatives’ were able to enjoy more quality time together.
The provider has adopted a sustainability approach and showed concerns about the quality of the environment. The service had achieved the Green Mark environmental accreditation to demonstrate the leaders’ and staff’s commitment to waste, pollution and carbon footprint reduction.

Feedback was welcomed and actively sought. This included thorough annual surveys and regular meetings of people and staff. Responses to points raised were communicated within those groups as well as shared with senior staff at Forest Healthcare. These included clear actions with measurable outcomes.
Staff were supported to develop their skills and progress in their careers. This meant the workforce was able to support the objective for continual improvement of the service by applying this same object to their own learning.
One partner agency told us, “Commissioners will approach Ash Court for support with pilot work in the recognition that they will embrace opportunities to innovate. For example, a planned trial of mealtime changes to explore the impact on falls.”