Ashlands Care Home

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 changed to requires improvement. This meant people’s needs were not always met.

This service scored 50 (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 make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We found that while staff were kind and respectful, care was not always person-centred. For example, one person was still wearing clothes with food on them from breakfast several hours earlier, and another was left in a hot room without support. We saw that some care practices were task-led rather than based on people’s choices, such as set shower routines without checking preferences. One staff member said, “I don’t know how often [they] would want a shower I just know [they] have to have one [shower] once a week.” This meant people were not always offered choice and provided with care in a person centred way.

Everyone living at Ashlands Care Home was on a fortified diet. There was no clinically assessed reason for this. For example, staff added cream and creamed cheese to mashed potatoes. This put people at risk of receiving fortified food they did not require, increasing the risk of excess sugar and fat in their diets.

However, staff did speak well of the people they cared for and showed passion for the work they did. One staff member said, “We have banter with residents and know how they like to be treated and what sense of humour they have and I respond accordingly – that’s true person-centred care and we want to be the best at it.” People felt that they were given good care. One person told us, “They [staff] ask what I like and what I don’t like I get on with other people we don’t argue which is rather nice.” The manager said “We talk to residents and see if there is anything they want to change. Everyone has the right to be included in their care.”

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Staff told us they used handovers and a communication book to share updates, which helped maintain some consistency. One staff member said “We work as a team, there are 15-minute handover meetings every day – 1 morning, 1 evening - so all know what’s happening. We also have a communication book to record things of note, like appointments and follow-up actions.”

However, we saw that care plans were often incomplete or inaccurate, which could affect the continuity of care. Some people’s communication needs were not clearly recorded, and there were conflicting instructions in plans. This meant people may not always experience continuity of care.

People using the service were not consistently supported to access information in ways that met their individual needs. The environment lacked dementia-friendly signage and tools, which are essential for supporting people living with dementia to understand and navigate their surroundings independently.

Signage throughout the home did not include clear visual symbols, appropriate contrast, or accessible language. This meant that people living with dementia were at increased risk of confusion, disorientation, and distress. For example, key areas such as toilets, dining rooms, and bedrooms were not clearly marked in a way that would support people’s independence or reduce reliance on staff. There were no pictorial menus to help people choose meals, and several people told us they did not know what food was being served.

This does not reflect best practice in dementia care, where accessible and tailored information is vital to promoting autonomy, dignity, and safety. The absence of dementia-friendly tools may also limit people’s ability to make informed choices and participate meaningfully in daily life.

Staff did not demonstrate an awareness of the importance of accessible information for people with cognitive impairments. There was no evidence that the service had assessed or reviewed people’s individual communication needs in line with the Accessible Information Standard.

We discussed with the provider the importance of adapting the environment to better meet the needs of people living with dementia. This includes implementing dementia-friendly signage, changing the decor, and reviewing how information is presented to ensure it is accessible, accurate, and supports people’s rights and choices.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

We heard mixed feedback from people. While many said they felt safe and well cared for, others reported delays in call bell responses, especially at night. One person told us, “Usually they [staff] do [respond], we have a buzzer in our room. They [management] have limited night staff so if you want something you have to wait.”

We saw that communal areas were sometimes left unsupervised, and staff interactions were often focused on tasks rather than meaningful engagement. Some people said they felt isolated or bored. One person told us, “We don’t get asked about our views much.”

There were systems and processes in place for people to complain. Formal complaints were recorded. Where complaints had been made, they had been investigated or were in progress. We heard repeated concerns about the laundry service. People said clothes went missing or got mixed up, and some personal items like nightwear and grooming tools were lost. One person said “I have all my own clothes, but I often get other people’s even though they are labelled I leave them in a pile saying they are not mine. Anything I treasure my [relative] takes it home to launder it.” This affected people’s comfort and sense of ownership. This indicated there were no systems in place to effectively ensure any lessons learnt from complaints or incidents were shared with staff to improve quality of care.

The provider did not always make sure that people could access the care, support, and treatment they needed when they needed it.

The service was accessible for people. There was a lift to reach the upper floor. People who used walkers, wheelchairs or adapted chairs were able to move about the service. However, people were only able to access the garden with the support of staff.

Most people had access to personal care and medical support. One said, “They get you a doctor very quickly.” Another person told us, “I have a bath or shower twice a week—it helps my arthritis.” However, some people told us access to dental care and activities was limited. We also found dry toothbrushes, indicating people were not being supported to clean their teeth and maintain good oral health

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. We found people’s experiences varied. Some felt well cared for, while others felt isolated. We saw one person sat alone for hours in the dining room. Another said, “I miss shopping and going to the theatre—it would be nice if we could do this.” While some people reported positive experiences, others did not feel included or meaningfully engaged, suggesting that barriers to equitable care remain unaddressed.

The provider was not proactively seeking out and acting on information or tailoring care, support, and treatment accordingly for people who are most likely to experience inequality.

The service supported people living with dementia, a group that may face additional challenges in expressing their needs and preferences. However, there was limited evidence that staff were supported to recognise and respond to these specific inequalities. The lack of proactive engagement with people’s individual backgrounds, preferences, and aspirations—such as the desire to go shopping or attend the theatre—suggested thatpeople’s rights to personalised, inclusive care were not being fully met.

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.

The leadership team understood the importance of supporting people with decisions about their future and were able to give examples of supporting people where they struggled to talk or think about the end of their life care and preferences. We saw details in care plans regarding people having advanced decision paperwork in place, for example Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) documentation and details of how people wanted to be cared for in the future such as when they were at the end of life.

There was information on people’s treatment choices such as if they wanted to go to hospital if they were unwell and what type of treatment they were happy to receive when there. Where people did not want to be resuscitated, in the event their heart or breathing stopped, this information was available to staff. The manager told us, “Nobody likes to discuss the end of their life, they are all scared. You do it with willingness to listen, compassion and kindness. We encourage everyone to have a plan in place. We try to do that with the residents and the family members.”