Ashley Court Care Limited

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 changed to inadequate.

This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The provider was in breach of the legal regulations relating to people’s capacity and consent.

This service scored 38 (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’s care and treatment were effective.
We received mixed reviews from people and relatives about their involvement with the assessment process. One person said, “I have not spoken to anyone about what support I need, I’m ok, I can look after myself”. Other people raised no concerns.
We saw there were assessments completed before people started using the service, however not all the assessments we reviewed contained sufficient detail. Some of the assessments we viewed showed people and those important to them were involved in this process, however others did not. The provider and deputy manager told us assessments were used to create a care plan that met people’s assessed needs; however, we could not be assured these assessments were always effectively used to deliver consistent care as some people did not always have care plans in place or accurate and up to date information available. This meant people were placed at risk of not receiving suitable/consistent care based on their assessed needs.
 

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.
We observed areas of the home had not been assessed or considered to ensure it met the needs of people who were living with dementia.For example, other than 2 which displayed a photograph, all bedroom doors were plain and were the same colour.They did not have information including information or pictures on that would help people living with dementia recognise it was their bedroom. Which may cause confusion or loss of orientation for people living with dementia.
People had tools in place that were used to assess their needs. Staff were able to explain how they delivered care to people and told us they understood people’s needs. However, as care was not always delivered safely, we could not be assured this feedback was always accurate.
 

The provider did not always work well across teams and services to support people.
We saw a person seated in a wheelchair who looked uncomfortable and other people who remained in bed for the duration of our inspection. Some people were able to tell us this was their choice however other people could not tell us about their experience. We asked to see the relevant professional input that related to the mobility and equipment needs for these people, as we did not always see suitable equipment was available for them. We did not see this information and again requested it after our inspection. The information provided was not always up to date or reflective of people’s current needs. For example, for 1 person we were provided with an assessment of how they were supported in hospital in 2022.
We viewed care plans for these people and where the system had requested to upload the relevant professional assessment, we saw these actions were not always completed. Furthermore, when a person’s needs had changed, the deputy manager had completed the assessment for this and had not sought advice from a qualified professional. This meant we could not be assured the support they were receiving was appropriate and safe.
People raised no concerns with how staff worked together to share information. Staff shared information about people through communication books and handovers.
 

The provider did not always support people to manage their health and wellbeing to maximise their independence, choice and control.
People and relatives confirmed people’s health needs were responded to. One person told us, “I saw the dentist last week and I have to go back on Monday, I had my new glasses yesterday, I haven’t seen the doctor, but I don’t need to”.
Staff were not always aware of people’s health needs. We were told no one in the home was living with a specific health condition, however records confirmed they were. People’s health needs were assessed; however, as care plans were not always in place or contain accurate up to date information about people this placed them at risk of not receiving the support they needed.
 

The provider did not always routinely monitor people’s care and treatment to continuously improve it.
We received mixed feedback from people and relatives about their involvement with their care and the reviewing of this. One person said, “I have not discussed a care plan with any of them, but I am ok” Another person told us, “I don’t know about my care plan, perhaps [relation] talked to them”. A relative said, “I am involved in [my relations] care, the home let me know if anything happens or if they have any questions about how [my relation] likes things, I visit nearly every day.”
We saw care plans and risk assessments were routinely reviewed and that some people had contributed to this however as people told us they were not always involved or aware we could not be assured this was up to date.
When people needed support with their communication or their first/preferred language interpreting there was no evidence to show this was completed or how people were involved. This placed people at risk of not receiving support they wished for based on their preferences and needs.
 

The provider did not work within the principles of The Mental Capacity Act 2005.
People did not always have capacity assessments and best interest decisions in place when they could not consent to their care. For example, in relation to CCTV and health interventions. Furthermore, we saw people’s relatives were consenting to this care when they did not have the legal authority to do so. In some instances when people did have capacity, we also saw relatives had consented to their relations care and records did not show how people were involved with this or their own decision making.
In other areas, when people were unable to consent to their care there were capacity assessments and best interest decisions in place. However, these capacity assessments were not always specific to the decision being made and covered multiple areas such as consent to care and treatment and medicines, meaning the principles of the Mental Capacity Act (2005) were not followed.
Staff had received training in this area and could tell us how they gained consent from people however leaders were unable to fully demonstrate they understood the process they needed to follow.