Ashton House

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 remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 ensure people were at the centre of their care and treatment choices. Some observed practices did not demonstrate a consistently person-centred approach. This included medicines not always being administered in a dignified manner, the use of restrictive practices within the environment, and limited opportunities to support people living with dementia make choices, remain engaged and navigate their surroundings safely and independently.

People said they and, where appropriate, their relatives were actively involved in the planning and reviewing their care. Records contained information about people’s backgrounds, likes, preferences and how they wished to be supported. Care plans for people with a learning disability and autistic people were developed in partnership with them and, where appropriate, their representatives. A person with a learning disability who was new to the service had a one-page profile in their room. It provided clear information about their personality, what mattered to them and how best to support them. This helped staff provide consistent, personalised care and reduced the need for the person to repeatedly share their life story with new staff.

People told us they were happy with the support they received, and we observed warm, compassionate interactions between staff and people, reflecting positive and trusting relationships.

The provider understood people’s diverse health and care needs and worked with other services to support joined up, flexible care and continuity. Care records showed regular involvement from health and community partners including GP and community nursing. Referrals were made appropriately and professional advice was reflected in care plans. People’s needs were assessed following significant changes in their health and well-being and care plans updated.

People living in the main house told us there was a varied activity programme, providing opportunities for group engagement and one-to-one activities. Some people told us about day trips and social events they had enjoyed. However, most people felt there were limited opportunities to go out and said this was something they would like more of. One person was enrolled in a ‘Adopt a grandparent scheme’. We saw photographs of them chatting through video technology to a young person they had been matched with.

People were supported to maintain relationships with friends and family and to engage in activities. One person with a learning disability proudly showed us photographs displayed in their room of important people and special memories. Pointing to a photograph, they said, “That’s my mum. She is great”, demonstrating the importance of these relationships and memories to them.

People received information in formats that met their individual needs. Visual signage, pictorial information and environmental reference cues supported people living with dementia and a learning disability to understand and navigate their environment. The registered manager told us information could be provided in alternative formats, including large print and visual aids. Easy read information was available to support people to make decisions about end-of-life care, raise complaints and seek support with communication.

People had mixed experiences of verbal communication. We observed staff did not always use clear, simple language making it more difficult for some people to process information and engage in the conversation. For a person whose first or preferred language was not English, we observed some staff communicating with them in their native language. Key words and phrases in the person’s native language, supported by sign language, were provided to all staff to support effective communication.

People had access to personal devices, including mobile phones and voice-activated technology, which supported their independence and helped them stay connected with others. These devices enabled people to independently play music, listen to the news and contact relatives. Relatives told us communication was good and they were kept informed and up to date about their loved one’s wellbeing and matters relating to the care home.

People were able to share feedback, raise concerns and make complaints about their care and support. Feedback about whether people felt listened to was mixed. Some people felt comfortable raising concerns and were kept informed about actions taken in response.

However, others did not always feel listened to. Concerns included access to outdoor spaces, staff responsiveness and occasional language barriers. For example, one person said they did not receive timely reassurance when their health suddenly deteriorated, while another said staff often promised to return but did not. One person commented, “You have to ask, am I as important as the next person?”

A range of methods were used to gather people’s views, including resident and relative meetings, one-to-one discussions and annual surveys. Feedback and suggestions shared during these forums were discussed with the wider staff team through regular team meetings and used to inform improvements in practice.

The provider ensured people had equitable access to healthcare, with support tailored to their individual needs and preferences. Systems were in place to help people access a range of community and specialist services, including specialist clinics, investigative scans and routine health checks. This helped ensure people were not disadvantaged in accessing the care and treatment they needed.

Records demonstrated staff recognised changes in people’s health and sought appropriate medical advice promptly. People were supported to access the older people’s mental health team, diabetic nurse and GP, enabling timely assessment, treatment and positive health outcomes.

The provider had systems in place to promote equality and identify people who may be at greater risk of inequality. However, these were not always effective in ensuring equitable experiences and outcomes. Staff and leaders did not consistently demonstrate sufficient understanding of the specific needs of people living with dementia. People’s care and the environment were not always adapted to meet their individual needs, which limited some people’s independence, engagement and opportunities for meaningful activity. For example, a person told us, “It can get boring sometimes” another said, “I would like to do baking, but I can’t here because there are too many people.”

Staff had received equality and diversity training. They demonstrated an understanding of the health inequalities experienced by people with a learning disability and tailored care and support to their individual abilities, needs and lifestyle choices.

We were provided with examples of people celebrating significant milestones and enjoying activities linked to their personal interests, including travelling in a Rolls-Royce car and watching Second World War aircraft in flight. This showed how staff supported people to enjoy experiences that mattered to them.

People were supported to plan for important life changes, including their wishes and preferences for end-of-life care. Personalised end-of-life care plans reflected what mattered to people, and anticipatory medicines were available to support timely management of symptoms and maintain comfort. Information was available to guide staff in responding to emergency medical situations.

Care records showed people had been involved in discussions about their future wishes, which staff understood and respected. End-of-life care was provided with compassion, dignity and sensitivity, and families spoke positively about the support provided by staff at this important stage of people’s lives.