During an assessment under our new approach
About the service
Ash House is run by Age UK Somerset. They provide a toenail cutting service for people in Somerset. This can be within clinics (which were not included in this assessment), or within their own home if the person is housebound.
Who the service is for
Ash House provides support to younger adults, older adults, people living with dementia, people with physical disabilities and people living with sensory impairments. At the time of the assessment, 159 people were being supported with the regulated activity.
Key findings
We carried out this assessment on 4 June to 15 June 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.
Safeguarding systems were in place to safeguard people from the risk of abuse; Toenail Cutting Assistants [TNCA] demonstrated awareness of safeguarding procedures and knew how to recognise and report concerns.
TNCA understood the process of recording accidents and incidents, including escalating concerns to leaders. Incidents were analysed to identify any themes or trends to improve people’s safety.
People told us when they first started using the service it was a positive experience. People were initially encouraged to attend a clinic to have their toenails cut, however for people that were housebound the service was provided within their homes to ensure people were still able to receive the service. People’s needs were not always adequately assessed, and whilst there were some risk measures in place, these were not always formalised into documentation or implemented consistently across the service. The risk was reduced as people’s toenails were cut by consistent staff who knew people very well. They demonstrated a good understanding of people’s needs and how to keep people safe. They were trained to be alert to health conditions which may pose a risk to people, and during the visit they completed observational checks.
TNCA told us they had received training and ongoing support from leaders to ensure they had the training and competence to carry out their roles safely and effectively. They told us they received sufficient induction and training and were able to shadow more experienced staff until they felt confident to lone work. We did find some gaps in recruitment records, however the provider rectified these during the assessment.
People received care that reflected their individual needs and preferences. Consent was sought prior to receiving the service and people were able to make decisions about when they received the toenail cutting service. People and TNCA told us they were able to build up a friendly rapport as they always seen the same toenail cutter. Although people we spoke with were extremely happy with the service, they told us they were not always aware of who they would contact should they have any concerns.
There was a positive culture within the service. TNCA spoke positively about the management and culture of the service, describing managers as approachable and supportive.
The provider’s mission was to help older people in the local area to live their best life. As well as the toenail cutting service, they provide several other services to support this mission. TNCA gave examples of how they had signposted people to other services provided by the provider which had helped improve people’s quality of life.
The provider demonstrated a commitment to continuous improvement. External audits of the organisation had been completed. The manager is also a member of Age UK national group on toenail cutting best practice.