Ashley Court Care Limited

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate.

This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfall.

The service was in continued breach of legal regulations in relation to dignity and respect.

This service scored 30 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

Feedback from people and relatives was mixed. Whilst some relatives raised concerns about the care provided, others spoke positively about staff. One relative told us, "All of the care staff here currently are brilliant." However, another relative told us, "I'd say they do not go above and beyond; they do the bare minimum they have to do," and others raised concerns regarding personal care and hygiene.

During our assessment, we observed one person sitting in urine for a prolonged period before staff responded to provide support. We also observed staff did not immediately respond when another person became unresponsive despite staff being present in the same area. In addition, some people experienced significant delays before receiving their meals.These experiences did not promote people's comfort and wellbeing and did not provide assurance that people's needs were consistently met in a timely way.

However, we observed some positive interactions which promoted people's wellbeing. For example, an external exercise facilitator encouraged people to participate in activities and supported people to engage at their own pace.

Whilst some caring interactions were evident, people's dignity, comfort and individual needs were not always promoted consistently.

People were not always treated as individuals. Information about people's unique needs, preferences and communication requirements was not always clearly recorded or reflected in the care they received.

Feedback from relatives suggested some efforts had been made to support people's individual needs. One relative told us, "The language barrier is hard, they have bought a translator and cards."

However, we found a person's care plan did not include information about the communication aids they used, including cue cards and a communication pad, despite staff describing these as important tools used to support communication. This meant staff did not always have access to clear guidance about how to provide personalised support.

Care records were not always reflective of people's current needs and preferences. We found gaps and inconsistencies within care planning documentation, which meant staff did not always have access to accurate information about how people wished to be supported. This increased the risk of people receiving care that was task-focused rather than personalised.

However, staff were able to provide examples of how they supported people's individual cultural and religious needs. For example, staff told us one person was supported to observe their religious beliefs by having meals arranged around prayer times and being given time and privacy to pray three times a day.

The provider did not always promote people's independence, choice and control. People were not consistently supported to make informed decisions about their care, treatment and daily lives.

People were not always supported to maintain their independence, choice and control. Opportunities for people to make decisions about their daily lives were not always promoted consistently. One person told us, "Sometimes you have what you are given," and further said, "Menus do not appear every day."

Our observations reflected this feedback. During both site visits, we observed people were not offered visual meal choices or shown plated meal options before meals were served. This meant there was a risk that people living with dementia or other cognitive impairments may not have been able to make an informed decision.

Staff generally relied on choices recorded earlier in the day rather than checking whether people still wished to have the same meal at the point it was served. We also observed inconsistencies in the choices available to people. For example, people spending time in communal areas were offered a wider range of drink options than some people who remained in their bedrooms upstairs. This meant people did not always have equal opportunities to express their preferences and make choices about their meals and drinks.

Furthermore, one person told us they had been supported to get up earlier than they wanted and said, "I just wanted to have a lie in." This meant people were not consistently enabled to make decisions about how they wished to spend their day.

However, staff told us people were encouraged to make choices about meals, activities and aspects of their day-to-day lives. Whilst this was positive, our observations demonstrated people were not always supported to exercise choice and control in a way that reflected their preferences and individual wishes.

People's immediate needs were not always recognised and responded to in a timely way. Delays in care and support meant people did not always receive assistance when they needed it.

One person told us they frequently had to wait a long time for meals due to the location of their bedroom. Relatives also raised concerns about whether their family members received support in a timely manner. Our observations reflected this feedback. We observed delays in people receiving their meals, with some people waiting significant periods of time before being served. This demonstrated people's immediate needs were not consistently recognised and responded to promptly.

During the assessment, we also observed a person become unresponsive. Staff did not immediately recognise or respond to the situation despite being present in the same room. This demonstrated people's changing needs were not always identified and responded to in a timely manner. Following concerns raised during the assessment, the provider introduced additional guidance and provided assurances that staff would have clearer information to respond appropriately to future episodes.

These findings demonstrated staff did not always respond to people's immediate needs without delay, which had the potential to impact on their comfort, wellbeing and safety.

However, staff told us there should always be staff available to respond when people required assistance. Despite this, our observations demonstrated people did not always receive support when they needed it.

The provider did not always ensure staff were enabled to work effectively within a stable and supportive workforce.

Staff told us there were challenges associated with recruitment and maintaining a consistent workforce. One staff member said, "We are desperately trying to recruit," and another referred to wishing there were more permanent staff. A relative shared similar concern and told us, "We see a lot of agency staff." These findings meant people did not consistently received support from staff who knew them well.

During the assessment, we identified inconsistencies regarding staffing arrangements. On the day of our assessment, we were told there were 2 agency staff working within the service. However, rota records indicated there were 4 agency staff on duty. The rota identified agency staff only as agency workers and did not include names. This meant the provider could not readily demonstrate who was working within the service or provide assurance an appropriate level of skills, knowledge and experience was available to meet people's needs safely. Amended information was only provided following our enquiries.

We also received whistleblowing information during and after the assessment which raised concerns regarding staffing arrangements, staff turnover, staff knowledge and the use of agency staff and the quality of care provided to people using the service. These concerns were consistent with feedback received from relatives and our assessment findings. Taken together, this did not always promote a positive and open culture where concerns could be identified, discussed and addressed effectively.

However, not all feedback was negative. One staff member told us, "I feel well supported, I love it here."