Ailwyn 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

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. We found the service to be in breach of the legal regulations person-centred care and of safe care and treatment; There was a limited variety of meals, snacks and drinks being offered when people were losing weight and at risk of dehydration.

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.

The provider did not always complete robust assessments of people’s needs. We reviewed 5 people’s care records and found they did not always fully reflect their care needs. We found several inconsistencies and contradictions in them. Risk assessments were not always reviewed when required and were not always accurate. However, all the relatives we spoke with felt the service assessed people’s needs appropriately and they were included in ongoing reviews and updates. Staff told us they could access people’s care notes when they needed through the devices provided. They explained that only senior staff or management reviewed the care plans.

The provider did not always ensure evidence-based care and treatment was provided. We spoke to the staff who confirmed they monitored people’s food and fluid charts on regular basis and their devices tell them when they need to be reviewed. This was good practice however the entries that we saw did not evidence how much an individual had eaten and if they were following the appropriate diet for them. When people had not reached their daily fluid target there was no escalation of this between teams. However, relatives we spoke with felt the service delivered care and treatment appropriately.

Staff teams did not always work together to ensure consistency of care and approach. The management told us they worked closely with a variety of different healthcare professionals. We spoke to external healthcare professionals, and they felt the communication could be improved and would find information about people in the service from other sources instead of the service itself. However, they felt there was a good working relationship with the service, they would refer people appropriately and listen to the advice given. The service was meant to have daily meetings with heads of departments, but these were not happening. The staff we spoke with said they did not attend as they were too busy. Staff said they relied on information being shared by other staff. This was not effective and meant people may receive inappropriate care or treatment. On 2 of the occasions, we attended site the management had no oversight with what was happening within the service as their office was located on the second floor and they spent all their time in the office and were not visible around the service. They relied on information being given over a walkie talkie. This impacted them not always being accessible for people or them seeing what was occurring day to day where people were. Handover was basic and did not tell staff much information. However, relatives and healthcare professionals we spoke with felt the service was responsive in referring people to ensure they received the most appropriate support promptly, staff knew there was weekly GP visits, and they would add people to it if they felt they needed a review.

The provider did not always support people to manage their health and wellbeing, people were limited on choices of meals and drinks and there was a lack of physical activity provided, and this prevented people living healthier lives.

When we observed the environment, we noted a lack of drinks and snacks being offered, we observed people were asking for drinks and when drinks were given, they were being finished instantly, there was no fresh fruit being offered. Speaking to staff there was not always adequate number of choices at mealtimes around breakfast and the evening meal and on the review of people’s meal records this showed a lack of nutritional variety around these mealtimes. Staff weighed people monthly, or weekly, they did not evidence that additional calories were offered where concerns around people’s weight had been identified, however the service escalated concerns to the GP and made sure they provided background information on the person, so the GP could submit suitable referrals. Relatives we spoke with said they monitored people’s weight closely and made sure they get the appropriate supplements where needed, an individual who was a vegetarian was catered for. Families were able to stay for meals if they wanted to.

The provider did not always ensure people's care was effectively monitored. They had not always accurately recorded people's fluid intake, social activity engagement or monitored risks to their safety and well being. However, relatives we spoke with felt the service monitored their relative’s health and that they were always kept updated with their health needs. Staff told us how they weigh residents once a month and there were some people who were weighed weekly also. The service analysed information monthly and noted where trends and themes of most common times of falls were and how they could try and reduce these.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The daily notes we reviewed in the service did not record that consent was always obtained before care and support needs were carried out. However, the staff we spoke with told us how they all gained consent before supporting an individual, this was echoed by speaking with relatives who said the staff gained consent from people and they told people, how they wanted to support them. One relative we spoke with said “she would have difficulty consenting but they do talk to her and explain what they need to do”