Ashleigh Manor Residential Care Home

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 assessment in August 2019, we rated this key question good. At this assessment, the rating has changed to requires improvement. The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

The provider was previously in breach of the legal regulation in relation to person-centred care, dignity, and good governance. Improvements were not found at this assessment, and the provider remained in breach of these regulations.

This service scored 45 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People’s rights to privacy and dignity were not always protected, and staff and managers did not consistently recognise the impact of their actions on people’s dignity. For example, people’s dignity was not always upheld in practice. We observed bedroom doors left open with people visible in bed, and some practices had not been addressed since the previous assessment. Records showed inconsistent attention to personal care, with relatives raising concerns about hygiene, and care plans did not always guide staff clearly on maintaining dignity. While positive staff interactions were evident, these were not consistently supported by systems or oversight, and improvements are still required. This contributed to a breach of regulation relating to person-centred care, dignity and good governance.

However, people were supported by managers and staff who demonstrated kindness, patience, and respect. Staff showed an understanding of people’s individual needs and personalities, and they spoke about people with compassion.

People who wished to share their views with us said they liked living at the service and the staff supporting them. One person said, “The staff are lovely – kind and caring,” and relatives told us, “They are kind, caring and polite.” Staff knew people well and often reassured them during care, for example, encouraging people at mealtimes and responding gently when people were experiencing periods of emotional distress.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care planning was not consistently person-centred. Records often contained references to other people, and did not always reflect people’s current needs. Risk assessments were frequently generic and not tailored, and there was limited evidence of people or relatives being involved in care plan development. This meant staff did not always have clear and accurate information to support the delivery of personalised care that reflected people’s assessed needs, preferences, and wishes.

However, some care plans used personalised language such as “I am” and recorded individual preferences, including daily routines, hobbies and communication needs. Relatives described staff as understanding people well, with one stating, “They know what makes her happy.”

Although improvements had been made since the previous assessment, inconsistencies in care documentation and practice remained. The provider had introduced new processes, but these had not yet been fully embedded. As a result, further improvement was required to ensure care was consistently planned and delivered in a person-centred manner. This contributed to a breach of regulation relating to person-centred care, dignity and good governance.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

People were not consistently supported or encouraged to maintain or develop their independence. Although support plans identified what people were able to do for themselves, they lacked clear, detailed guidance for staff on how to actively support people to maintain existing skills or develop new ones where possible.

We found significant concerns in relation to how people’s rights were respected. Mental capacity assessments and best interest decisions were not always in place or correctly applied, and staff understanding of these processes was inconsistent. Restrictions, including monitoring, bed rails and supervision of visits, were sometimes imposed without clear evidence they were proportionate or in people’s best interests. In some cases, medicines were used to manage behaviour without clear evidence of least restrictive options being explored. This meant people’s freedom, autonomy and legal rights were not always protected. These concerns remain ongoing from the previous assessment and require significant improvement. This contributed to a breach of regulation relating to person-centred care.

While staff encouraged independence in some areas, such as supporting people to choose meals and activities, this was not underpinned by robust systems. Managers described how they knew people well and how people were supported to exercise choice and control over their lives and express their views about the care and support they received.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Although managers and staff demonstrated they knew people well the service did not always respond promptly or effectively to people’s immediate needs. People told us they generally felt safe, and staff would help when needed, although staff could be “very busy” and responses were not always timely. Staff recognised changes in people’s health and escalated concerns, for example, contacting GPs and other professionals when people became unwell. However, this was not consistent. Some health concerns were not identified until raised by relatives, and monitoring of people’s conditions was not always robust or clearly recorded. Care records showed gaps in guidance for responding to risks such as diabetes, falls or seizures, which meant staff were not always clear on escalation actions. While improvements had been made in recognising needs, systems did not consistently ensure people received timely and appropriate support. This contributed to a breach of regulation relating to person-centred care.

The provider cared about the well-being of their staff. However, they did not always support or enable staff to deliver person-centred care.

The service did not always ensure staff were well supported, trained and enabled to provide safe, person-centred care, although staff reported feeling valued and supported by management. Staff told us they felt supported and described an open-door management culture, stating, “Everybody is really supportive and happy to help.” However, records showed significant gaps in mandatory training, inconsistent induction processes and limited evidence of effective supervision and competency checks. Some staff had not completed key training such as safeguarding, infection control and health and safety, and others were not included in training records. Supervision processes did not consistently address performance concerns or training needs. These issues impacted staff knowledge and confidence, particularly in areas such as medicines, mental capacity and risk management. While staff morale appeared positive, improvements were still needed to ensure the workforce is fully equipped to deliver safe, consistent care.