Ashridge Court Care Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Whilst the provider had made sure people were at the centre of their care and treatment choices; they had not always responded to relevant changes in people’s needs. Staff told us they had access to information about the people they supported and said any changes in people's needs were communicated during handovers. We asked staff about a persons’ health as they had not been identified to us as not being suitable to visit. We received differing information from staff regarding this person’s change in health. Staff said they had identified the deterioration of health to the nurse at the weekend, but this was not clearly documented or handed over. We checked the handover document which did not identify the changes, and the care plan had not been updated to inform staff of the important, required changes to care delivery. We discussed this with the registered manager and regional director and immediate actions were taken to address this. This was also taken forward as lessons learnt to all staff and further training arranged. The provider worked in partnership with people and, where appropriate, their relatives and individual needs. This enabled staff to provide care that was tailored to each person, to understand what was important to them, including their preferences, backgrounds. This was confirmed by people and families that we spoke with. People also told us they and their families were involved in reviews of care plans. This was reflected in peoples care plans. We were told that families could access care plans and daily notes when they wished to. As well as general information, care plans also included specific information about how conditions/medications affected people individually. Care plans included details of social and wellbeing needs alongside personal and health care.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People told us, “I have seen a doctor, and a chiropodist, the staff arrange my health checks, and I have been for a scan at the hospital.” One relative said, “They ring to let me know of appointments so we can attend if we can, if we can’t, they let us know of any outcomes.”
Staff told us that they worked alongside families and always inform families of any appointments and keep a record of the appointment and advice given.
A health professional told us, “Staff are generally very helpful, and know their residents well, I have noticed its very busy with call bells lately and staff seem quite rushed, but I don’t visit every day, it could be just a bad day.”
There was evidence of regular partnership working with health professionals such as specialist nurses, and therapy teams. These records could be better linked to the care plans, but they showed responsive co-ordinated care. Staff were able to discuss how they ensured people were treated equally and fairly no matter their age, sexuality or their health diagnosis. They told us of their knowledge of the Equality Act and how they used this in supporting people and decision making.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Information regarding people’s communication needs were documented in their care plans. A relative told us, “My relative is very deaf and that makes communication difficult, but staff manage well.”

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their carers. Staff responded to people’s communication needs. These were assessed and recorded within individual risk assessments. These included specific information on how people’s communication needs could be met and what aided their communication. For example, those who needed spectacles or hearing aids. Systems to support people to communicate with staff, relatives and friends had been assessed and promoted. For example, staff supported people to phone their loved ones as necessary.

The provider had systems for people to share feedback and ideas, or raise complaints about their care, treatment and support. There was an organisational complaints policy and procedure, we saw that concerns raised had been responded to promptly and thoroughly. However, we were informed by a health professional that they thought a recent investigation had not been fully investigated as they had not received a full report as requested. The regional director was taking this forward as a priority. The management team told us they had an open-door policy; however, we were told by people, families and visitors that they did not feel the registered manager was visible. Many visitors were not sure of whom the registered manager was as they had not met them. We received negative information from a regular visitor which we shared with the provider to investigate. However, despite some negative comments regarding the approachability of the registered manager, we did see relatives seeking out senior staff on the floor and were told of how approachable the deputy manager and senior staff were. Some people were able to tell us they were asked for their views and felt listened to. Relative, resident and staff meetings took place and there were opportunities to feedback regularly. Feedback and actions taken were then discussed at the next meeting.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People and families said there were no barriers to access care and treatment, and they felt it was done in a timely way. Relatives told us people were supported to continue to access the care and treatment they required outside the home. For example, for people with long term health conditions, the home worked with specialists and GPs to ensure care and support was provided.

All people had access to the communal lounges and garden. Those who were less mobile were supported to move around to these areas as they desired. Activities took place on all floors of the home to ensure those who preferred not to move to other spaces were still able to join in.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People living at Ashridge Court Care Centre had a range of needs relating to mobility, communication, cognition, health conditions and sensory needs. Staff were able to discuss and demonstrate an understanding of people’s differences. They told us how they adapted their approach so people could be involved in daily life and receive care in a way that worked for them. Care records included information about people’s individual needs and preferences, including how staff should communicate with and support them.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff worked closely with people to make plans about their future care. For example, people and their families were involved in planning how they would like to be cared for at the end of their lives. It was acknowledged by staff, that some people found these discussions difficult and so staff gathered information slowly and added important details after hospital admissions. Care plans identified people's preferences at the end of their life and the service co-ordinated palliative care in the care home where this was the person's wish. Care plans contained information and guidance in respect of peoples' religious and resuscitation wishes. During the inspection visit further holistic details were entered to care plans to guide staff in ensuring peoples’ comfort. People had ReSPECT forms. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment and ensures their personal wishes are followed. People also had a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decision, also known as a DNR (Do Not Resuscitate) order,which were accessible to all staff and health professionals should a situation arise. Relatives and friends were supported with compassion through this difficult time. For example, visiting for those people at the end of their lives was extended. DNACPR and ReSPECT forms were discussed with people and families, staff made sure people understood their options and what it meant to request withdrawing care, or not receiving care, to allow them a dignified death.