Ashlong Cottage

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 remained good. This meant people's outcomes were consistently good, and people's feedback confirmed this.

This service scored 67 (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 because accurate records were not consistently maintained to reflect changes in people’s care needs.

Although records showed that people’s care plans were reviewed regularly, we found occasions where they did not accurately reflect people’s current support needs. For example, one person’s care plan did not record their preferences regarding access to the community. On another occasion, care records did not include a person’s preferences relating to grooming. The provider took prompt action to address this shortfall.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People received effective support with their nutrition. One individual living at the service told us they enjoyed the food, including being able to have burgers when they wanted. Weekly menu plans were used to involve people in planning their meals. Where individuals were not able to express their meal choices, staff used their knowledge of people’s preferences, alongside ongoing observations, to inform decisions.

Staff were knowledgeable about people’s nutritional needs and referred to individuals’ eating and drinking guidelines to ensure diets were followed safely.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Team meetings were held regularly and included discussions on health and safety, as well as updates relating to individuals living at the home. A diary and communication book were used to share information between staff members, supporting effective information sharing and continuity of care. A staff member told us, “Some residents might have a hard time, but we deal with it. We talk as a team.”

The provider supported people to manage their health and well being to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s healthcare appointments were well documented, with information clearly organised and easy to access. Each person had a Health Action Plan in place, which included important details such as family history, medical conditions, and records of attendance at routine healthcare check-ups. Individuals also had a Hospital Passport containing key information about them, including their likes and dislikes and communication needs. This supported staff to provide appropriate care, particularly in the event that a person needed to attend hospital.

However, we found that the support provided to people with hand nail care was not always effective, as we observed that some people had long hand nails requiring attention. Prompt action was taken by the provider to ensure that, going forward, people received appropriate professional support to maintain their nail care needs.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service had designated champions for key areas, including infection control, fire safety, first aid, kitchen safety, and medicines, to ensure ongoing monitoring of care delivery. Champions used checklists to complete weekly and monthly checks, supporting effective oversight and helping to maintain good standards throughout the service.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The Mental Capacity Act 2005 (MCA) was applied in practice to support people to make their own decisions wherever possible. A staff member told us, “We support clients who cannot make decisions in line with their care plan. We involve social workers and family members if clients are unable to make important decisions.” Mental capacity assessments were completed in relation to specific decisions, ensuring individuals were appropriately supported throughout the decision-making process. However, there was no well-established system in place for reviewing and monitoring these assessments. The registered manager advised that mental capacity assessments were considered as part of general care plan reviews, but there was no documented evidence to confirm that individual capacity assessments had been formally reviewed to determine whether they remained necessary or could be reduced. The provider has taken prompt action to address this shortfall.