Ashdown Nursing Home

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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 support effective care and treatment.

We asked relatives about their involvement when choosing Ashdown Nursing Home. They confirmed they were consulted and fully involved before their family member came to live at the home. One relative described how staff got to know their loved one through speaking with them, establishing what their wishes and preferences were through observing the person and communicating with them where they could. This initial information was used to build a picture of the person’s care needs and the things that were important to them. The relative added they were really pleased they did this rather than just taking the word of the previous care home which had not been a good experience for their loved one. The relative said, “Staff care with the greatest and biggest hearts, loving, kind, caring and super-professional.”

People’s care and support needs were assessed either in person or over the phone. The registered manager explained they could assess needs this way if the person was in hospital for example. Relatives would visit the home and have conversations with staff before their loved one was admitted, so they could establish whether the home would be suitable or not. We reviewed a completed assessment form for 1 person which was detailed and formed the basis of their care plan.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. Care and treatment were planned using recognised assessment and monitoring tools.

Relatives confirmed they were included in care planning with their loved ones, and their input was built-in to people’s care plans, including their likes and dislikes. Staff used assessment and monitoring tools to identify and review people’s changing needs. For example, the Malnutrition Universal Screening Tool (MUST) identifies people’s risk of malnourishment or issues with their weight. People’s risk of developing pressure areas was assessed. Risks were regularly reviewed and monitored through an electronic care planning system, and this enabled staff to have current and contemporaneous information. Information about people’s care within their plans provided guidance for staff which was followed.

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.

We asked some health and social care professionals for their feedback about Ashdown Nursing Home. One of them responded they always found staff friendly and helpful, that the nursing staff knew people well and were able to discuss what might work and what might not. The health professional added, “I believe the team are well skilled in dementia care, care for frailer people and end of life care, alongside general nursing care.” Records we reviewed showed systems were effective when people moved into or out of the home.

We saw staff worked alongside each other and were willing to help each other out. One staff member told us, “Our staff are very good and we work as a team, we can’t work without teamwork and always try and help each other. The nurses will also help if people get upset, to calm them down.”

The provider supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We observed people having their lunch in the communal lounge/dining room and the sun lounge. Dining tables were laid with tablecloths and napkins, with a pictorial menu showing alternative meal choices to the main menu. Lunchtime was busy with staff providing assistance when needed. One person became very upset and started shouting. A staff member came over and gave them a reassuring hug, rubbing their shoulder and they immediately calmed. Another staff member was providing support to another person with their meal, encouraging them to eat. The person was told what was on each spoonful as the staff member presented it to them. One person said, “It’s better than a restaurant. I can’t complain, there’s plenty to eat and it’s good quality.” A relative told us, “Food is gorgeous, home cooked, hot, and plenty of it. I hear people asking for other things or snacks and it’s never any trouble. Staff go and get whatever they want, although usually people have forgotten what they asked for by the time it arrives. Staff are so compassionate and never get cross or short with them for this.”

We spoke with the chef who was clearly passionate about his role and the significance that good quality, and how well cooked and presented food, supported people’s wellbeing and enjoyment of meals. The chef said, “If it was my father or mother, I would like this home for them. People choose what they want to eat half-an-hour before lunch. I try and satisfy the need in that exact moment.” We were shown a laminated book which depicted photos of plated-up meals, with writing underneath to explain what each meal was. This helped people to make their menu choice before their meal was served. The chef made food to order if people did not want what was on the menu. The chef said, “One person wanted fishfingers, he fancied them that day, so I cooked them. I try to accommodate people, so everyone is happy.”

People had access to healthcare support from external professionals. A relative talked about their loved one becoming anxious and upset and their conversation with a GP. “We discussed the concerns and agreed how [loved one] was feeling was out of character for him. The GP decided not to medicate for now and monitor to see if this continues. I was pleased with this and especially as he has not had an episode since. It would have been very easy to prescribe medicines, but the GP listened to me and the staff and it was the right thing to do. They are on the ball with everything.”

The provider monitored and reviewed people’s care and treatment to identify changes and respond to people’s needs. They met both clinical expectations and the expectations of people themselves.

The home sought to achieve good outcomes through the care and support people received. The registered manager explained, “We have a scheduled round with the GP and follow up from the week before. The nurses go around in the evening to see how everyone is, then we update families and call them with any outcomes. We categorise whether people need a GP right now or whether they can wait. We update people’s care plans and discuss at staff handover. We also write a report after the GP has visited.”

A relative told us they were involved in regular medical reviews, were kept up to date by the GP and the care home of any changes and treatments. They added, “I am always consulted about medical matters.” Another relative said, “I didn’t think [person] was drinking enough and always appeared thirsty in the mornings when I visited. He now has a plan with regular drinks that are monitored and staff are always popping by and reminding him to drink.”

The provider supported people to understand their rights and respected these when delivering care and treatment.

We observed staff routinely asked people for their consent before any kind of intervention was undertaken.

Staff completed training on the Mental Capacity Act 2005 and demonstrated their understanding of this legislation regarding consent. One staff member said, “When giving personal care we ask people for their consent. It is everything about them, their choices always.”

Records showed capacity assessments were completed for people regarding specific decisions such as consent to live at the home. Where people lacked capacity, records showed best interest decisions had been made and documented.