Ashton House

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 assessed and reviewed people’s health, care, wellbeing and communication needs to ensure care was personalised and effective. Pre-admission and multidisciplinary assessments helped staff understand people’s individual needs, preferences and desired outcomes. Information from people, their families and relevant professionals informed personalised care planning and effective partnership working. A relative told us, “I was involved in care planning. I signed a load of documents and saw the care plan. I was given a copy.”

Assessment processes were responsive to changes in people’s needs. Staff used recognised clinical assessment tools alongside their knowledge of each person to identify deterioration and respond promptly. For example, when staff identified signs of possible sepsis, they acted without delay and contacted emergency services. The person received timely hospital treatment, madea positive recovery and was successfully discharged back to the care home. This demonstrated effective assessment, timely intervention and positive outcomes for the person.

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. Staff knew people well and worked with them and their families to plan and review care.

People told us they were involved in planning their care and had opportunities to discuss their health and support needs. A person told us their wishes had been captured and the relevant documentation completed. Another person said, “They are always asking after my well-being and making sure I am OK.” A relative told us, “Knowing that staff are checking up on mum and know when to call the family in, is really important to us and to mum.”

People’s protected characteristics, cultural needs, and personal preferences were considered to ensure care was tailored appropriately. We reviewed care plans; these were regularly updated to reflect changes in people’s needs and any professional advice received. Throughout the inspection we observed staff checking people’s care and wellbeing and updating care records demonstrating how staff supported people in line with their assessed needs and planned care.

The provider worked well across teams and services to support people. They worked closely with healthcare professionals and other services to ensure people received joined-up, consistent care. Staff shared information and made timely referrals when people’s needs changed. Updates were shared through handovers, meetings, and care records.

Multidisciplinary working, regular review and appropriate interventions supported 1 person’s significant recovery and improved quality of life. They progressed from being cared for in bed with no oral intake to eating independently, communicating verbally and walking independently. This demonstrated the positive outcomes achieved through coordinated, person-centred care.

Treatment plans showed staff sought advice and guidance appropriately. A person told us, “The doctor is here once a week usually on a Wednesday. If staff feel I need to see him, they make the necessary arrangements. He tells staff what to give me, following my consultation with him.” This partnership working supported prompt responses to health needs and ensured people received consistent care.

The provider supported people to manage their health and wellbeing, promoting independence, choice and control. People had regular health checks and access to healthcare services, with outcomes from appointments recorded and used to inform their care and treatment.

People told us they were supported to maintain their mobility and manage their health needs. One person showed us their personalised exercise plan and said it was helping their mobility and strength. Staff also promoted good hydration and increased monitoring during periods of extreme heat. We observed hydration stations located around the building and staff constantly topping up people’s drinks and water jugs.

People received meals that reflected their individual dietary needs, including allergies, preferences, diabetic and cultural diets. Some people received fortified diets to support weight gain and maintain good nutrition. An advocate described the service as “amazing” in supporting 1 person admitted with a very low weight and dangerously low BMI to improve their nutritional health. This showed care was responsive to people’s changing needs and supported positive outcomes.

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. Recognised tools were used to monitor risks such as malnutrition and pressure damage, with appropriate interventions including repositioning and pressure-relieving equipment.

The service used the National Early Warning Score 2 (NEWS2) system to identify and respond to deterioration in people’s health. Staff recorded changes in people’s health and monitored vital signs. For example, following a head injury, appropriate monitoring was implemented that considered the risks associated with blood-thinning medicines. A relative told us staff recognised a possible infection by noticing a change in their loved one’s mood, showing they knew the person well and could identify changes in wellbeing.

Sensory-based care enabled a person with a learning disability and significant cognitive and communication needs to engage positively with staff. Previously, the person had resisted care, however this personalised approach had built trust improved engagement and increased their acceptance of care.

The provider did not always inform people of their rights around consent or fully respect these when delivering care and treatment. Staff and managers did not always work in line with the principles of the Mental Capacity Act 2005 (MCA). People were not always supported to have maximum choice and control over their lives or to receive care in the least restrictive way possible.

Decision-specific capacity assessments, including those relating to restrictive practices, were not always in place or up to date for people who lacked capacity or had fluctuating capacity. Some people had not been consulted about restrictions on their movement and freedom. As a result, the provider could not always demonstrate that decisions were made in accordance with MCA principles.

There was evidence that MCA assessments and best interest decisions were undertaken appropriately. Conditions attached to DoLS authorisations were managed in line with requirements. Where medicines were administered covertly, appropriate capacity assessments and multidisciplinary best interest decisions were in place, ensuring people’s rights and individual circumstances were considered. We observed staff knocking on people’s bedroom doors and seeking consent before providing care or support.