Ashring House

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 remained Good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Whilst the provider made sure people were at the centre of their care and treatment choices, this was not reflected in the care documentation, daily notes or risk assessments.

The provider had not fully ensured people’s care was person-centred. People’s care plans were not sufficiently detailed to fully reflect changes to their health and well-being, what was important to them and their families and plans for the future. Daily care records were task-focused and did not always demonstrate how people’s social and emotional support needs were being met. This was fully discussed with the provider, who was already taking action to improve the care plan system and had introduced training in documentation for staff.

Peoples’ health needs were not always planned for or included in their care plan or risk assessments. For example, there was no guidance for staff to follow regarding managing the risk for people who lived with a catheter or those that lived with seizures. This had placed people at risk of harm. These were addressed immediately and both GP and district nurse involved.

There was a lack of personalised activities, and it was not clear how people were being engaged in meaningful activities which suited their individual preferences and met their expectations. Some of this was because of their changed health needs. This had been identified by the senior management team and plans were in place for a minibus, drivers and for more outings/trips. People who were going to clubs/day centres now lived with mobility changes and dementia so alternatives were being sought.

Peoples’ rooms were very personalised with picture boards and possessions that were important to each person. People were supported to wear clothes of their choice and choose accessories they liked.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Relatives told us they there had been a time when they felt communication was lost and that they were not always kept fully informed and their requests for seeking specialist advice were not taken forward. They said recent changes had improved communication and that their loved ones had seen the necessary specialist, and they were feeling assured. Relatives told us, “Health appointments arranged, we can go if possible but if we can’t staff will go and tell us what happened.” and “After some issues staff ensure I am fully involved in decisions for my (loved one)”
A health professional told us, “Staff seem to know people well, always polite.” Staff told us that they worked alongside families and always informed families of any appointments and kept a record of the appointment and advice given.
The director demonstrated an awareness of inequalities in accessing healthcare services and emphasised the importance of a holistic approach to care. Staff ensured that support was not narrowly focused on a single health condition. For example, when supporting individuals with a learning disability, staff did not assume all care and support needs were solely related to the learning disability. Instead, they considered the wider context of each person’s physical, emotional, and social needs such as dementia. However, despite staff knowing this, it was not included in care plans or risk assessments or activities tailored to those changes.

Care plans included evidence of regular partnership working with health professionals such as specialist nurses and therapy teams. These records showed responsive co-ordinated care. Staff were able to discuss how they ensured people were treated equally and fairly no matter their age, sexuality or their health diagnosis. They told us of their knowledge of the Equality Act and how they used this in supporting people and decision making.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Most people living at the service were non-verbal. Staff told us there was a range of different communication aids that could be used if appropriate but were not in use. Care plans referred to how people used various noises, moving their head and other behaviours to communicate and this was clear in their individual risk assessments and care plans. There was also input from the Speech sand Language therapist. (SaLT) team regarding communication.

Care plans did not include a Distress and Discomfort Tool (DisDat). These are charts accessible to people who cannot verbally communicate, on which they can indicate how they are feeling, for example, happy, sad, anxious or unwell. However, this is being introduced with the new care documentation.

All care plans were written on the computer, and this enabled them to be printed off for family, hospital appointments and transfers. They could also be enlarged for those that have sight impairment.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people/families in decisions about their care and told them what had changed as a result.

Relative, resident and staff meetings took place and there were opportunities to feedback regularly. Feedback and actions proposed and taken, were then discussed at the next meeting.
There was a complaints policy and procedure, and the management team kept a log that ensured the provider had an overview. Concerns raised had been responded to promptly and thoroughly. Relatives told us, “Communication has improved considerably, I feel reassured that I can talk to a manager.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People had access to health and social care professionals which meant that they received the best and most appropriate care and support when required. We spoke with professionals who said communication was good and that they were contacted for appointments, support and advice in a timely way that immediately addressed people’s needs.

A health professional told us, “The clients I have visited have involvement from the LD team and occupational therapy.” Accurate records of appointments and interventions were kept as part of care plans which then provided a complete medical history for people for future reference.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

We were told that activities were tailored to peoples likes and based on their interests. They were predominately 1 to 1 sessions at this time. We did see some positive interaction but it wasn’t consistent for each person. Activity timetables were flexible depending on people’s presentation on a daily basis. People were supported to go out for walks and visit the local pub or coffee house. A relative said, “They used to have a good social life, going on trips and parties, my relative used to go to a club, but that all stopped, but I have been told things are going to happen again, I think it never got going again after covid, which was a shame, my relative likes people watching so it will be good if they can go to a club again.”

There was a lack of personalised activities, and it was not clear how people were being engaged in meaningful activities which suited their individual preferences and met their expectations. Some of this was because of their changed health needs. This had been identified by the senior management team and plans were in place for a minibus, drivers and for more outings/trips. People who were going to clubs/day centres now lived with mobility changes and dementia so alternatives were being sought.

People and families 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.

Where appropriate, loved ones were involved in planning discussions, helping to ensure decisions reflected what mattered most to the person. Preferences for their care at the end of life, were documented in their care planning records. This included details about the preferred place of care, as well as cultural, spiritual, and personal wishes.

People had ReSPECT forms. ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment and ensures their personal wishes are followed. These were reviewed by the GP surgery.

Some people also had a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) decision, also known as a DNR (Do Not Resuscitate) order,which were accessible to all staff and health professionals should a situation arise.