Ash Cottage

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to how people were not supported in a person-centred way.

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.Although we did witness very kind and positive interactions, we did observe a few occasions where people’s dignity was not always maintained. We witnessed a staff member repeatedly ask a person if they had finished their meal despite them still eating it. The food was then removed from the person whilst they were still eating. We also witnessed staff place dignity aprons on people who were midway through their meal and when people spilt food on themselves, staff did not offer to assist with a change of clothing and instead people were supported to the lounge in unclean clothing. We also observed a person walking around with no shoes or socks on and we had to alert staff of this. In addition, we observed a staff member talking to a person with their back to them and made no eye contact with the person throughout the duration of the interaction and another person requested a drink several times and staff did not respond. We asked staff to assist the person. The training matrix evidenced no staff had completed training on dignity.

People and relatives spoke highly of the staff and how their loved one was treated. Comments included, “The carers (staff) are really nice. They are always smiling. The care [person] receives is excellent” and “I do find staff caring here.” The registered manager told us they spent time in communal areas observing how staff interacted with people.

The service did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The service did not take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. We observed a high number of people were up quite early in the morning during an out of hours visit we conducted. People were sat in the lounge with no drinks and most people were asleep. The TV was playing a quiz show at a very high volume. When we asked staff if people chose to get up so early in the morning, they responded, “It is the night staff duty to get [person] up.” The staff member then went on to advise of how staff woke people up to ask them if they would like to get out of bed. We were not assured people were informed of the time or whether this was their own choice. We also witnessed people being taken to their bedrooms in the afternoon due to being tired. This may be due to getting up so early in the morning. Again, the person wasn’t asked and there appeared to be no choice. One professional felt people didn’t look well cared for. They said, “The patients (people) look unkempt and do not look cared for.”

When asked, staff were not aware of people’s specific religious or cultural preferences but did say they could find out more about a person by asking them. The registered manager told us protected characteristics were built into people’s care plans and we did see evidence of life history, preferences and cultural needs documented. Most bedroom doors had a picture and the name of the person, so it was easily identifiable to them.

The service did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing. We witnessed activities taking place during our visit. However, most people did not appear to be engaged in the activity. We observed an activity which involved people banging their hands on a table. No explanation was given to people as to what the activity was or why people were being asked to bang their hands on the table. People did not appear to be enjoying this activity. Care plans held a record of people’s preferred activities; however, we saw little evidence these activities were being carried out and some activity logs included a person having a lie down. We were not assured meaningful activity was taking place.

People and relatives held mixed views on activities and how people spent their time. One person said, “Sometimes they do exercises and we watch telly. We do sit about a lot though.” A relative said, “I’ll be honest I’ve never really seen activities when I’ve been there, but I have spoken to other relatives who assure me that things do happen.”

Staff told us they promote independence by observing people doing tasks and prompting this and the registered manager spoke of the importance of people maintaining relationships. They said, “We support visits, phone calls, video calls and community meet-ups. Relatives are welcomed into the service, and we adapt visiting arrangements to suit people’s needs.

The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment and act to minimise any discomfort, concern or distress. We observed on occasions people asking for assistance and staff did not respond. We had to alert staff of this. Some concerns were raised in relation to staff communication. One relative said, “The staff are friendly but sometimes there can be a communication barrier.”

People told us staff were responsive to their needs. Comments included, “The staff are brilliant here. There is a buzzer here on the wall and if we use it they (staff) are here within 2 minutes” and, “I have a call bell in my room if I need the staff and sometimes it’s a while but they always come and help me.” Staff told us how they would communicate with people who have specific needs including repeating questions in a way the person could understand.

The service cared about and promoted the wellbeing of their staff. Staff told us they liked working at this service and felt supported. The registered manager told us staff received a handbook which covers expectations, annual leave, breaks, wellbeing support and key policies. They said, “We take wellbeing seriously, we offer open-door support, reflective practice, supervision and access to external wellbeing resources.” Good practice was recognised through shout-outs, thank you boards, staff awards and by celebrating achievements.