Ashurst

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People had care and personalised support plans which reflected both their physical and mental health needs. They were involved in the assessment of their needs, and support was provided to maximise their involvement. Assessments were completed prior to admission to ensure the service was suitable and staff had the information needed to provide safe and effective care and support.

The staff team involved people and relatives or carers, where appropriate, to prepare a plan of care. Care plans were reviewed at an MDT, monthly or more often should the person’s requirements change. Care plans demonstrated staff had a detailed understanding of people’s needs, which we observed during this inspection.

Health related information was identified and ‘hospital passports’ were in place; these were used by health and social care professionals to support people in the way they needed. There were staff champions for physical health, people’s involvement, equality and diversity, staff wellbeing and Safewards for Safehomes.

Staff understood the importance of promoting independence and knew about people’s capacity to make decisions. People were actively empowered to make their own decisions about their care and support. Consent was sought, and people were encouraged to make decisions for themselves, which we observed during this inspection. Staff documented successful outcomes and celebrated these with residents.

Support plans were focused around promoting quality of life, promoting independence, achieving goals and ensuring they remained in good health. Clinical assessment tools were in place where necessary and completed accurately. Nutrition and hydration needs were met. The provider was proactive in seeking ways to improve people’s experiences.

Leaders supported the health and wellbeing of staff, which was confirmed by staff we spoke with.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them; they did this in line with legislation and current evidence-based good practice and standards.

The provider’s aim was to support people to recover from mental illness, to prevent unnecessary hospital admissions and support timely and successful discharges from hospital. The provider implemented the Mental Health Recovery STAR which was goal orientated to aid recovery and rehabilitation. The clinical team reviewed STAR regularly which ensured staff were aware of current risks and how to work with them.

The provider ensured there was a range of evidence-based care and treatment which was suitable. This included psychological therapy sessions and sessions with the clinical nurse specialist.

Professionals used outcome measures to evaluate treatment effectiveness, track progress over time and support clinical decision making.

A person we spoke with confirmed staff told them about best practice and why they were providing the treatment they were.

Staff encouraged people to meet their nutrition and hydration needs. The provider had a weekly event in which staff and people cooked a meal from a randomly selected country. Staff told us how they often had their meals with the people.

A person confirmed they were supported with meal preparation and the food was ‘good’.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had access to the information they needed to appropriately assess, plan and deliver care, treatment and support. Plans for transition, referral and discharge considered individual needs, circumstances, ongoing care arrangements and expected outcomes.

The provider and leaders promoted an MDT approach when supporting people and care and support was developed and provided in partnership with people, relevant external professionals and clinicians. Regular MDT meetings were held to ensure care was tailored to meet people’s immediate or changing needs, and records were detailed. All necessary staff, teams and services were involved in assessing people’s needs to maintain continuity of care and information was shared between teams.

When people required support with accessing external professional involvement this was in place, for example, GP and Consultant appointments, reviews with social workers and treatment from external partners following incidents.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider ensured people’s physical health was monitored once a month. Trained support workers completed physical observations including blood pressure checks, weight, height and body mass index.

Staff, leaders and professionals worked closely with people to ensure their psychological wellbeing was reviewed consistently. The provider was proactive in engaging with healthcare services and professionals. People had access to mental health services, including crisis support, when they needed it.

The provider empowered people to maintain good health and wellbeing. We saw evidence of how the physical health nurse had focused in recent months on the importance of oral health and the intake of fluids.

Staff and leaders told us how people were encouraged to make positive choices regarding their health and wellbeing. The provider ensured wellbeing was taken into account by ensuring they had access to meaningful activities and wider community engagement.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

People were supported to set and accomplish goals, and where possible, achieve positive outcomes. A wide range of health and social care professionals were involved in the development of support plans and took part in regular support meetings where appropriate. Staff and leaders took a holistic approach to care and identified triggers for any negative behaviours before they reoccurred, which promoted positive wellbeing and a sense of feeling valued.

There were effective approaches in place to monitor care and treatment and their outcomes and continuous improvements were made to people’s care and treatment. Where applicable, relatives were kept informed. One relative told us, “I get to go to all meetings with the social worker, [staff name] is really good.” When asked about whether information was shared effectively with other agencies the same relative said, “They [staff] do this really well with the hospital incidents.”

Staff had a ‘handover meeting’ which provided a chance to discuss the events of the day before, and plan for the day ahead. People’s care and support were planned proactively in partnership with them. Staff used inclusive and individual ways of involving people, so they felt consulted, empowered, listened to and valued. For example, one person had been involved in discussions about managing their emotions each day and not really acknowledging their feelings; this person had agreed to do daily emotional check-ins with staff and an emotion chart with pictures was used to help assist with this.

Reflective meetings and staff meetings were held to discuss incidents and how to do things differently going forward. Leaders and staff discussed preventative measures to avoid the same reoccurrence. Risks were reassessed and changes made to care plans where necessary and cascaded to the staff team.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The provider and registered manager ensured people’s views and wishes were taken into account when their care was planned and people confirmed this, which was often done through an MDT approach. People understood their rights around consent and staff supported them to understand these. They received information about their care and treatment in a way they could understand and had appropriate support and time to make decisions. Capacity and ability to consent was taken into account.

Staff understood the importance of ensuring people fully understood what they were consenting to and the importance of obtaining consent before they delivered care or treatment. We observed staff seeking consent throughout this inspection. A staff member told us, “Consent is provided moment by moment; we are always asking people for consent and are trying to assist [person] to make decisions for themselves.”

The provider had robust systems in place relating to the Mental Capacity Act (MCA). Capacity assessments and decision specific best interest assessments had been completed. People were supported to make decisions, and there was information to show preferences had been considered. The provider was working in accordance with the MCA principles effectively.