Ash View

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.

This is the first assessment for this service. This key question has been rated requires improvement.

This meant people’s needs were not always met.

This service scored 57 (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 were at the centre of their care and treatment choices, and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Person-centred care was not consistently embedded across the service. Care records varied in quality and did not always contain clear, accessible information about people's preferences, routines and communication needs. Feedback from people indicated they did not always feel listened to, and the high use of agency staff impacted continuity of care and staff's understanding of people's individual needs. As a result, we were not assured that all people consistently received care and support tailored to their preferences and wishes.

However, the provider demonstrated some positive person-centred practices. Staff knew people well and supported them to pursue individual interests, maintain relationships and work towards personal goals.

Care provision was not always coordinated effectively to ensure continuity of support. Whilst staff worked in partnership with healthcare professionals and external agencies, and care plans and risk assessments were reviewed regularly, records were not always sufficiently detailed or consistently maintained. Information about people's routines, communication needs and support preferences was not always readily available, and handover processes were not consistently effective, resulting in a risk that important information may not be shared between staff. In addition, concerns regarding electronic call monitoring and inconsistent documentation meant the provider could not always demonstrate that planned care had been delivered as intended. However, there was evidence of collaborative working with external professionals to support people's health and wellbeing and respond to changes in need.

The provider generally supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider ensured people had access to information they needed to support their care and daily living. Most people were able to understand and communicate information verbally and did not require specialist communication aids. However, this was not consistent for everyone. For example, one person’s care plan identified the need for pictorial communication aids to support communication, but these were not available when requested during the inspection. This meant we were not assured the person was always receiving information in a format that met their assessed communication needs and supported their involvement in decisions about their care.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Systems to seek and act on feedback from people were not consistently effective. Whilst staff told us meetings were held with people using the service, records of these meetings were not available for review and staff could not clearly describe how often they took place. Several people told us they had raised concerns with management but did not feel these were acted upon. One person said, “We have told them how we feel but they don't seem to do anything.” As a result, we were not assured that the provider had effective arrangements in place to actively seek, record and respond to people’s views.

However, we saw evidence that managers responded to some concerns raised by people using the service. For example, concerns regarding the garden area had been escalated appropriately, and a meeting had been arranged involving tenants and the relevant local authority to discuss the issues and identify a resolution. This demonstrated that, on some occasions, people’s views were listened to and acted upon.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The provider took steps to ensure people had equitable access to care, support and services. People were supported to access healthcare services, community activities and social opportunities in line with their preferences and abilities. Staff worked with external professionals and families to remove barriers to participation and promote inclusion.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. Whilst staff understood the importance of meeting individual needs and there were examples of personalised support, we found inconsistencies in the quality of care people received. Several people told us communication was more difficult when agency staff were supporting them and reported that some agency staff did not always communicate effectively or understand their needs and preferences.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Where people chose to discuss future care arrangements, care records included end of life plans and information relating to funeral arrangements. Staff respected people’s right not to engage in these discussions, and records demonstrated that where individuals did not wish to discuss end of life planning, this was documented and their choices were respected.