Ashley Court Care Limited

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• 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 requires improvement. At this assessment the rating has remained requires improvement.

This meant people’s needs were not always met.

The service was in continued breach of legal regulations in relation to person-centred care.

This service scored 43 (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 make sure people were at the centre of their care and treatment choices and did not work in partnership with people to decide how to respond to changes in their needs.

We found care records were not always accurate, complete or reflective of people's current needs. For example,1 person's care record contained conflicting information regarding their dietary requirements. Whilst one section of the care record stated the person required a Level 6 Soft and Bite-Sized Diet and Level 0 Thin Fluids, another section referred to a Level 4 Pureed Diet. We also identified inconsistencies within another person's dietary records. These discrepancies did not demonstrate care records were person-centred, accurately reflected people's needs or were being effectively reviewed and monitored.

Feedback from people suggested their preferences were not always considered when care was delivered. One person told us their showers had become quicker, and staff had explained this was due to water shortages.

These findings demonstrated people did not always receive care and support that was planned and delivered in a way that consistently reflected their assessed needs, preferences and wishes.

The provider did not ensure care provision, integration and continuity were effective. People did not always receive coordinated care that reflected their changing needs.

Relatives raised concerns regarding communication and continuity of care. One relative told us, "It's all new faces now." Another relative said, "We are never told what is happening."

We found care was not always coordinated when people's needs changed. For example, 1person had experienced multiple seizure and unresponsive episodes requiring emergency healthcare intervention; however, there was initially no condition-specific care plan, risk assessment or guidance in place to support staff in responding consistently to their needs.

Care records were not always accurate or consistent. We identified conflicting information within records relating to people's dietary requirements, including differing guidance regarding modified diets. This increased the risk of people receiving inconsistent care from different members of staff.

These findings demonstrated people did not always receive coordinated and consistent care in response to changes in their needs. As a result, care provision, integration and continuity were not always effective in supporting positive outcomes for people.

People and those important to them did not always receive clear, accurate and accessible information about care and support.

One person did not speak English as their first language and used communication aids, including cue cards and communication boards, to support their understanding and involvement in care. However, we observed these tools were not consistently used by staff during the assessment. When we asked a member of staff whether they understood what the person was communicating, they responded, "Do you speak (persons first language)? ," and gestured to indicate they did not understand either. This meant people with communication needs were not consistently supported to access information, express their views or understand decisions relating to their care.

Relatives also raised concerns regarding communication and the availability of information. One relative told us, "Communication is a big issue." and another said, "I can't get the information how much they have had to eat or drink." This indicated people and those important to them were not always provided with the information they needed to understand changes in care and support.

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

People and those important to them were not always listened to or involved in decisions about their care and support.

Some relatives told us they experienced difficulties when raising concerns and did not always feel listened to. One relative told us staff had provided different information regarding incidents involving their family member and said they felt they were, "Talking to a brick wall." Another relative said, "We are never told what is happening."

Relatives also described occasions where concerns had not been addressed promptly. These experiences showed people, and their relatives were not consistently listened to, kept informed or involved in decisions about their care and support.

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

People did not always experience equitable access to choice and decision-making.

We observed people living with dementia were not routinely supported with visual meal choices or shown plated meal options before meals were served. This meant some people may not have received the support they required to make informed choices about their meals. We also observed people who remained in their bedrooms were not always offered the same range of drink options as people spending time in communal areas. This did not provide assurance people had equal opportunities to make choices about their care and support.

These findings demonstrated people did not always experience equitable access to the information and support required to make informed decisions about their daily lives.

People did not always experience equitable experiences and outcomes. Staff and leaders did not always identify and respond to the additional support some people required to achieve positive outcomes.

We found care plans and risk assessments were not always in place or reflective of people's current needs. This meant people did not always receive care and support tailored to their individual circumstances.

These findings demonstrated staff and leaders did not always recognise and respond to the additional support some people required, which meant people did not always experience equitable outcomes.

People were supported to plan for their future care and treatment.

We reviewed records and found people had opportunities to discuss and document their wishes for future care. Care records included information relating to end of life care, and advanced care planning where appropriate. Records also identified people's preferences, those important to them and how they wished to be supported should their health deteriorate.

We saw evidence future care planning was reviewed regularly and reflected changes in people's circumstances. For example, one person's end of life care plan included information about their spiritual beliefs, family involvement, preferred funeral arrangements and wishes for their care as they approached the end of their life.

The provider's own care plan audits also demonstrated checks were undertaken to ensure end of life wishes advanced care planning, preferred priorities of care and last days of life plans were in place where required.

These arrangements supported people to consider and record their preferences for future care and treatment.