Ascend Support (Ealing)

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

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. This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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 make sure people’s care and treatment remained effective because they did not always formally review people’s health, care, wellbeing and communication needs in a timely way.

One person’s placement had not received a formal review for 2 years, despite staff making day-to-day adjustments to their support. This created a risk that changes in health, communication, mobility or support needs would not be formally identified and incorporated into current care planning.

Staff used care plans, observation and their knowledge of people to understand how support should be delivered in practice. Following our feedback, the provider updated the records.

The provider did not always ensure care was planned and delivered using complete, consistent and evidence-based guidance.

Diabetes guidance contained conflicting information about the person’s diagnosis and treatment and did not specify when staff should act on blood glucose readings. This increased the risk of delayed or inconsistent responses to changes in the person’s health. Following our feedback, the provider revised the relevant documentations including protocols.

Fluid guidance also contained conflicting information. One plan prescribed a minimum fluid intake, while another warned of excessive drinking without a clear clinical basis. This risked staff providing inconsistent support. The provider later confirmed there was no clinical target or restriction and instructed staff to offer drinks and report significant changes or signs of dehydration.

Mobility guidance was also inconsistent. One plan stated the person walked unaided and had no risk of falls, while other records documented the use of walking aids, rest breaks and a risk of falls. This could have resulted in staff providing unsafe or inconsistent assistance. Following our feedback, the provider clarified the correct equipment, staff support and escalation arrangements after a fall or suspected injury.

We found no evidence that these shortfalls had adversely affected the person’s health or wellbeing, as staff understood their needs and delivered appropriate care in practice.

Staff used positive behaviour support guidance to recognise triggers, adapt communication and adjust support using information about the person’s behaviour. This reduced distress and improved the person’s wellbeing. A relative said staff’s understanding of autism had made a significant difference.

The provider supported effective teamwork and communication with relatives and professionals.

Staff described detailed handovers, prompt escalation and communication with managers and healthcare professionals. A relative said the service kept the family informed about appointments, reviews and important changes.

A professional told us the service responded to professional recommendations and implemented support amendments across the staff team.

Care needs assessments showed that multiple professionals and services were involved in people’s care. These included general practitioners, pharmacies, social services and family support networks. Records clearly identified individuals involved and what support they provided, which helped coordinate care delivery.

The provider supported people to manage their health, access healthcare and develop healthier routines while maintaining independence, choice and control.

People were supported to access community activities, maintain routines that were important to their wellbeing and engage socially. Staff contacted the general practitioner (GP) when they identified a health concern.

Staff described booking and supporting people to attend appointments, communicating with health professionals, following medicines procedures and encouraging exercise. Staff also gave examples of swimming, fitness and yoga. A relative said staff supported diabetes care while balancing healthier choices with quality of life.

Staff identified health concerns and sought clinical advice when needed. This supported timely access to healthcare and healthier day-to-day choices.

The provider monitored care and supported people to achieve outcomes that mattered to them.

Relatives described consistent support and positive change. One relative reported “a huge reduction in a person’s distress and frustration,” with the person calmer, more settled and less reliant on medicines.

One person wanted more opportunities to go out and continued encouragement to make progress. This feedback provided a clear area for future outcome planning and review.

However, goals were not always supported by clear milestones, timescales or documented progress reviews. This limited the provider’s ability to measure progress, identify when support needed to change and demonstrate that positive outcomes were sustained.

As people were achieving meaningful positive outcomes and staff adapted support in response to their needs, this shortfall did not outweigh the overall evidence of good care.

The provider did not always ensure that decisions about care and treatment were supported by accurate, decision-specific Mental Capacity Act 2005 records.

Some capacity records contained errors, and the basis for a decision about where a person lived was unclear. This reduced assurance that the person’s capacity had been properly assessed for the specific decision and that any best-interests decision was clearly evidenced.

Staff had completed Mental Capacity Act 2005 training and understood the presumption of capacity, accessible decision-making and that an unwise decision did not in itself indicate a lack of capacity. Staff sought consent, respected privacy and escalated concerns about specific decisions.

A relative confirmed the person was involved in discussions about their care, preferences and future wishes, with choices presented in an understandable way. Following feedback, the provider corrected the medicines capacity assessment and best-interests record and aligned the guidance for when-required medicines. However, the initial recording shortfalls meant the provider could not demonstrate consistently robust application of the Mental Capacity Act 2005.