Archived: Ashingdon Hall

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

At our last inspection to the service in December 2023, the provider did not ensure people's consent and best interest decisions had been obtained in line with legislation and guidance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Not enough improvement had been made at this assessment and the provider remained in breach of this regulation.

Staff did not demonstrate sufficient knowledge and understanding of the key requirements of the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS] and how this affected and involved people using the service. There was little evidence to demonstrate how staff were supported and enabled to keep up to date with best practice guidance, ensuring their skills and knowledge were maintained.

There was a positive dining experience at Ashingdon Hall. Information demonstrated the service worked with others and people had access to healthcare services when needed.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us they had enough to eat and drink and enjoyed the meals provided. Comments included, “The food is very nice, and I can go back for more”, “The food is good, and I can choose what I want” and “I have no faults with the food.” A relative told us, “X always gets a choice of food, and the food always looks nice.”

The provider had up to date policies and procedures and recognised formal assessment tools were used for the care and management of people’s needs, for example with skin integrity and nutrition. However, there was little evidence to demonstrate how the manager and senior members of staff were supported and enabled to keep up to date with best practice guidance, ensuring their skills and knowledge were maintained. As previously stated, a person using the service required a pressure relieving cushion to be in place whilst sitting to reduce the risk of pressure ulcers developing. During both days of our assessment the cushion was not used.

There was a positive dining experience at Ashingdon Hall. The atmosphere was very relaxed and allowed meaningful interactions between people and staff. Staff sat and ate with people using the service. This helped to create and encourage positive social interactions at mealtimes. People’s dietary needs were recorded within their care plan and people received meals that met their specific requirements. For example, a person using the service received a soft diet due to experiencing dental difficulties which could impact on their ability to chew harder food items.

Staff told us they had the information they needed to support people. The manager and staff confirmed handovers took place to discuss changes in people’s care and support needs.

Information demonstrated the service worked with others, for example, the local authority, healthcare professionals and services to support people’s care provision.

Relatives confirmed staff were responsive to their family member’s healthcare needs. Relatives told us they were kept up to date about their family members needs and the outcome of health-related appointments. A relative told us, “X gets better access to other professionals since they have been here [Ashingdon Hall]. X is reasonably healthy and can see healthcare professionals when they want.”

During the assessment we overheard staff talking to relatives on the telephone about their family members needs and the outcome of health-related appointments.

The service worked effectively within and across different organisations to deliver effective care, support, and treatment. People were supported to have access to a range of appropriate healthcare services and support as needed, such as, GP, chiropodist, continence nurse, district nurse, physiotherapist and optician.

The manager and staff confirmed that since our last inspection to the service in December 2023, an electronic software system had been introduced for care planning. Staff used handheld devices to access people’s care records and record the day-to-day support people received.

Staff worked closely with a range of health professionals to ensure people's health and wellbeing was maintained. Daily handover meetings were held so staff had information about the people they were supporting. People had healthcare passports in place which could be used by health and social care professionals to support them in the way they needed.

We could not be assured people were always consulted when decisions were made that affected them and their liberty. Whilst people were observed to be offered choices day to day, decision making where people lacked capacity did not follow correct processes to ensure decisions had been made in people’s best interests.

Staff did not demonstrate sufficient knowledge and understanding of the key requirements of the Mental Capacity Act 2005 [MCA] and how this affected people using the service. A person had an authorised Deprivation of Liberty Safeguards [DoLS] order in place with conditions imposed. The latter are restrictions that are placed on a person's freedom to ensure they are only deprived of their liberty when it's necessary and in their best interests. However, staff spoken with, including the manager were unaware of the conditions in place for this person and were unable to demonstrate these had been reviewed, monitored or met. This meant without knowledge of the conditions included as part of this authorisation staff would not be able to comply with the Mental Capacity Act 2005.

The Mental Capacity Act 2005 [MCA] provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguarding [DoLS].

At our last inspection in December 2023, the provider and then manager could not demonstrate they understood the requirements of the MCA and DoLS. At this assessment the manager confirmed only 1 MCA for a specific decision had been completed for 1 person and this was in September 2024. This was despite others having bedrails fitted, a sensor alarm mat in place and a keypad entry code system in use on the Dementia Suite. Where a person using the service had an authorised DoLS order in place with conditions imposed, there was no evidence to demonstrate these had been reviewed and actioned to ensure compliance with the Mental Capacity Act. Since our last inspection 3 people had been transferred from the residential suite to the dementia suite. Although staff told us consultation had occurred with people’s families regarding the move, no best interests decisions were recorded and no MCA was completed.

The provider did not ensure they were working in line with legislation and guidance with MCA 2005 and DoLS. This demonstrated a continued breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.