Ambleside

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. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (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’s care and treatment were effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. We saw people’s care plans were developed from an initial assessment of their needs. Care plans were reviewed monthly under a ‘Resident of the Day’ scheme or when a change in people’s needs had occurred. However, the process to review care plans had not always identified inconsistencies in information or that inaccurate information had not been removed. For example, we saw 2 people’s eating and drinking care plans said they were weighed weekly in one part and every month in another part. One care plan also said the person was at low risk of choking and low risk of malnutrition. However, their risk assessments had identified they were high risk of choking and high risk of malnutrition. A review of the care plan on 4 March 2025 had not identified these discrepancies in information.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s comments showed they were not always involved or aware of their care plan. One person’s comment was, “I haven’t had a review, I only see anybody when I ask to see them, and I don’t remember them discussing a care plan at all.” Another person told us, “No reviews as such, nothing annual. Only sometimes they do follow up on something particular and they didn’t ask what support I needed when I first came here. I haven’t seen a care plan.” Most of the care plans we reviewed although recently updated, did not always accurately reflect people’s current and changing needs. Catering staff had the information they needed about people’s nutritional needs, allergies and modified diets. Specialist advice in relation to people’s diets was shared with the kitchen staff and updated on a weekly basis to ensure it remained accurate and up to date. Staff serving people’s meals had accessible information about each person’s individual dietary needs. However, records did not always accurately reflect for people assessed at nutritional risk, what and how much they had consumed.

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 supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff told us the information shared during the handover between shifts enabled them to meet people’s needs and respond to any changes in their health or wellbeing. One staff member told us, “We get told about changes in handover and we have handover sheets we fill in throughout the day so the next people (on shift) are always in the know. They go quite in depth, sometimes they can take 20 minutes to get through, so they are quite detailed.”

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support. People said they saw other health professionals to help manage their care needs. Comments included, “There is a doctor here and the district nurse comes in as well” and “My daughter does my dentist appointments. She took me for an eye test as well.” People who required specialist support, such as seeing a Parkinson’s nurse received those appointments. Staff understood how to support and enrich people’s physical and mental health through exercise, increasing socialisation and activities. A programme of activities was displayed and during our visit, external visitors supported people in the home. People’s views were sought to ensure their hobbies and interests were known and supported.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Some people at risk of not eating and drinking well had their food and fluid intake monitored. Records did not evidence this was always being managed well. For example, on the first day of our assessment, 1 person’s fluid intake of 200mls was recorded at 5.30am and no other fluid intake amount was recorded until 16.12pm, some 11 hours later. At lunch time it had been recorded this person had eaten soup and chicken. There was no record of how much they had been offered and how much they had eaten. In other examples, staff wrote ‘pureed meal’ and ‘pudding’ with no description of what was actually given, portion size and what was consumed. This meant opportunities to encourage people to eat and drink more might not be identified. Some people required repositioning to maintain their skin integrity, but we found care records and what staff told us, did not match the assessed needs as directed by their care records.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Where consent was needed for people to be checked hourly at night, we did not see any records to confirm this. The manager and staff said this was done but this was not recorded. However, a relative confirmed they had not been consulted about the frequency of their family member’s checks at night. Following our feedback, this was reviewed by management to be more individual to the person.Records did not always evidence that decisions regarding people’s care and support were made with their consent, or in their best interests where people lacked mental capacity to make those decisions.However, people told us they were given a choice of what they wanted to eat and drink and what they wanted to do with their time. We observed staff asking people for consent before providing them with support. Staff told us they would respect people’s right to refuse support but understood the need to report any consistent refusals as they may need to act in people’s best interests. One staff member told us, “If any resident refuses to get up, they don’t have to get up. You just go away and try later; they may be tired or in a bit of pain and you just have to let them settle for a bit. I try talking them through it but it depends who it is. If it is going to affect them, then you may have to do it. You try and change staff members; a different face and you may be able to convince them that way."