Ashton Lodge of Sunbury-on-Thames

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 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff undertook assessments of people’s needs prior to someone moving into the service. This involved assessing physical and emotional care needs, preferences, social community needs and how to maintain current levels of independence. Records showed that relatives, healthcare professionals and other agencies were also involved in the process. For example, where a person was at risks of falls, the falls prevention team was involved by staff so that the appropriate equipment could be in place prior to the person moving in.

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.

Whilst we received mixed feedback from people about the quality of the daily meals, people told us they were able to request an alternative if they did not enjoy what was listed on the menu. One person told us, “I think the food is a matter that is definitely being watched – there is not the variety that there was before.” Another person said, “I am provided with different meals and if I don’t fancy something they will do something different if I request it.” A relative told us, “The food and drink offers have all been good. Everything is good and they (carers) check that [person] has eaten and had enough to drink”. Where we observed staff using cutlery to support a person to eat which was not in line with the person’s care plan, staff immediately updated the care plans to reflect the current needs and there was minimal impact as a result.

Staff worked well together with services to achieve positive outcomes for people in line with national guidelines. One relative told us, “[Person] is stable now. [Person] is cared for for twenty four hours. Since [person] has been properly diagnosed [person] has been weaned off a lot of [their] medication.”

Staff used nationally recognised tools such as to monitor skin integrity, body weight and health escalation tools. We saw staff had escalated concerns appropriately and followed healthcare professionals’ instructions, in relation to dietary needs for example.

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.

Staff undertook daily meetings to discuss general day-to-day activities and changes to people’s health such as when people have an infection or when they have had a fall. The daily meetings included all areas of the service, such as kitchen, laundry and housekeeping. Comments from staff included, “I believe in teamwork. We can deliver quality care if we have good teamwork”, and, “We can always increase the teamwork. If we keep doing this we can do anything.”.
A healthcare professional told us in relation to staff working well together so that people did not have to repeat themselves when they attended appointments, “They are receptive when we have referred people to the acute trust. They can articulate what’s going on and it’s helpful that they are able to communicate like that.”

The provider supported people to manage their health and wellbeing 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 told us staff encouraged and supported them to live healthier lives whilst respecting their wishes. Care records included information on the input from the person’s GP and highlighted the importance of good mouth hygiene. The provider was working with partners to locate a dentist who could visit people in the home due to recent changes in the local area in relation to dentist provision. One visiting healthcare professional told us, “They are in tune with what’s happening with the patients. When I ask them what’s going on, they are able to tell me.” Where people had healthcare appointments, staff supported them with this to ensure they were able to attend.

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.

Staff undertook regular clinical meetings to discuss progress in conditions such as pressure sores, when people were unwell or injuries. Care records included information on how staff should monitor people’s health in order to ensure treatment was effective. For example, we saw one person’s medicines were reduced as a result of staff looking at alternative ways to manage their health. One healthcare professional told us, “I taught them how to use [equipment] and the patient got better and improved. [Registered manager] will always come out [of their office] and I will always articulate to them what the clinical input is and what the plan is. They monitor it.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and their relatives told us staff sought consent prior to supporting people and respected their choices. Staff had received relevant training and understood their responsibilities in line with the Mental Capacity Act 2005. One member of staff told us, “It’s about doing an assessment on their capacity and if they lack capacity, how we decide for them.” Assessments were decision-specific and they were sent to the relevant authorities for approval. Where restrictions were placed on people, these had been assessed against less restrictive options to ensure they were proportionate.