Ambleside

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 changed to requires improvement.

This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 61 (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 they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We reviewed the care plan records for 4 out of 15 people residing at Ambleside. We found concerns about the language used in one of the initial assessments sampled.

The language used in the care plan was disrespectful, but also counterproductive to the goals of care. There was a risk that the language used would be adopted by care staff within the team, reinforcing negative stereotypes and developing a poor culture where people were not treated in a dignified manner. Service document recordings were incongruous with care plans. We found the language used in some documents and staff conduct was not always appropriate and person centred. Documents such as the Statement of Purpose (SoP) and the housekeeping files used outdated language.

We saw a staff member walk into the conservatory whilst people were eating, open a fire exit where people were eating and then spit outside the door.

We observed staff member’s standing with arms folded, watching people in silence with little or no interaction or conversation.

We were not assured that people were treated with dignity because aspect of human rights and well-being were not consistently respected. Dignity in care involves respecting and valuing individuals, supporting their independence, and showing compassion. It is essential for maintaining the self-worth and human rights of those receiving support, ensuring their physical, emotional, spiritual, and cultural needs are met in a compassionate, person-centred manner.

We found the provider had failed to ensure each person received appropriate person-centred care and treatment that was based on an assessment of their needs and preferences. As a result, a warning notice has been issued in relation to regulation 9, person centred care.

The provider understood the diverse health and care needs of people and their local communities. Care was flexible and promoted integration. Care provision was joined up to partner health and social care services in their local area.

The provider made provision of an informal coffee morning twice a week for relatives where they could meet with their family member, the staff and the management team. We received no negative feedback from people or their relatives regarding providing information.

Families, were able to visit at any time, but mealtimes were ‘protected times. Resident meetings were held monthly and recorded. Although meeting minutes were very brief, they included topics such as privacy, activities, food and news about the home.

People’s communication needs were assessed. Information about people’s speech, visual and hearing impairments was recorded which assisted staff in understanding people’s communication needs and their preferred method of communication. For example, staff were prompted to speak to people with cognitive impairments using short sentences and pictorial clues.

Staff comments included, “I make sure I know each person’s communication needs by reading their care plan and observe how they respond. I use simple language, speak gently and clearly and give them plenty of time to understand and reply. When needed, I also use communication cards to help them express themselves” and “active listening, clear and simple language, using visual aids such as pictures.”

The provider had recently updated their Accessible Information Standard policy, which aims to meet the information and communication needs of people with a disability or sensory loss.

The provider made it easy for people and their relatives to share feedback or raise any concerns or complaints. However, we saw the providers ‘concerns log’ which documented the concern but needed further development to evidence the outcome and whether the issue had been resolved.

Relatives were encouraged to give feedback via the coffee morning or during their visits. They told us they knew how to raise a concern and who to raise a concern with. There were no concerns reported by the family members we spoke with, and we saw compliments and thank you cards from relatives and people who had stayed for respite care.

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

People were supported to access health and social care services as needed. Staff worked collaboratively with people and their relatives to overcome barriers to access services in a timely manner.

The manager and staff were aware of the need to protect people from all forms of discrimination and for people to be treated equally. Staff who had undertaken the Care Certificate received training in anti-discriminatory practice and the Equality Act 2010. However, we did not see completed training in these subjects in the records of other members of staff.

We spoke with people and their relatives and did not receive any feedback about concerns around discrimination.

The provider sets out their values for ‘residents rights’ in their Statement of Purpose which included, the right to independence, the right to privacy, the right to receive care which was based on anti-discriminatory practices.

We found some improvements were needed to people’s care documentation to reflect people’s last wishes and future planning. During the inspection we reviewed one person’s record which stated they had a ‘do not attempt resuscitation’ form (DNAR) in place however this was not in the person’s file. This meant the persons wishes may not be respected at the end of their life.

Staff had received training in end of life and palliative care.

Following our inspection and the sharing of our concerns with the provider, care plans were reviewed which included reviewing last wishes and future care planning. However, time was needed to ensure these changes were embedded.