Ashcroft Care 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 outstanding. At this assessment the rating has changed to 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 50 (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’s care and treatment were effective because they did not always check and discuss people’s health, care, well being and communication needs with them.

Assessments of people’s needs were not always consistently completed or fully reflected in care planning. While care plans contained a range of information about people’s health and wellbeing, some key areas were inconsistent or contradictory. For example, one care plan stated a person required an eye patch however staff told us they had now recovered and no longer required this.

This meant staff did not always have up to date and detailed information about people’s assessed needs. This placed people at risk of receiving inappropriate care and treatment.

This was fed back to the provider who told us they would take action to review all care plans to ensure they were relevant and conflicting information had been corrected.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Best practice tools were used to monitor areas such as skin integrity and nutrition, however inconsistencies remained. Some people’s care plans contained conflicting information about their dietary needs, including whether they required a modified diet at a specific IDDSI level (the International Dysphagia Diet Standardisation Initiative framework used to describe the texture of food and thickness of drinks for people with swallowing difficulties) or a normal food consistency. A relative shared examples of when their family member had been given food of the wrong consistency, placing them at risk of choking.

We observed a peaceful and supportive dining experience, and most relatives gave positive feedback about hydration and nutrition. For example, a relative told us, “[Family member] is on a fully blended diet and thickened water. Catering staff have worked hard to give them a varied nutritious diet and meals are of excellent standard.

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 knew people well and were seen to be contacting professionals and requesting the support of external health professionals when required. Staff spoke positively about teamwork and communication within the service and described a range of processes used to ensure staff remained informed about people's needs and any changes in their care. One staff member said, “staff are updated of any changes in the communications book on each floor, handovers, flash meetings that are held every morning with all heads of departments.” This demonstrated that systems were in place to support effective communication and information sharing across the home.

However, we did identify inconsistencies in care plans and assessments with needs not always accurately or clearly documented. Therefore, the provider would be unable to share an accurate assessment with other services, for example the hospital if this was required.

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

Relatives described to us how they had seen improvements in their loved one’s health since being at Ashcroft Care Home. A relative said, “The nursing staff are excellent and meet all of [family member] needs to an excellent standard.”

Staff described how they encouraged people to be more independent. For example, a staff member told us, “I offer encouragement and reassurance rather than taking over, I always work at the person’s own pace, respecting their abilities and preferences, and I praise their achievements to help build their confidence.”

The provider did not always have effective systems in place to routinely monitor people's care and treatment to drive continuous improvement. As a result, they could not always demonstrate that outcomes were consistently positive, met people's expectations, or reflected best practice.

Although we were informed, by relatives and staff, of some positive outcomes people had achieved, care records did not always provide an accurate and reliable account of people's needs and support. We found a number of records contained inaccurate, conflicting or inconsistent information, which reduced the effectiveness of care planning and limited management oversight.

We also identified inconsistencies in guidance provided to staff regarding the monitoring of specific health conditions. For example, documentation relating to blood glucose monitoring contained conflicting information about the frequency of checks required. This created a risk that people's health needs may not be monitored consistently.

Due to the inaccuracies and inconsistencies identified across care documentation, the provider was not always able to demonstrate effective monitoring of people's care and treatment or assure themselves that care was being delivered in line with people's assessed needs.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff understood the importance of gaining consent, saying “I always ensure that I choose the least restrictive option, ask the resident for consent, encourage independence, and report any concerns I notice.”

A relative told us, “Staff are very respectful, always asked if she is happy for them to administer medication, provide care for her, even the domestic team ask if it's okay to come in and clean her room.”

While staff demonstrated an understanding of the need to involve people in decisions about their careand that people had the right to refuse care, records did not always clearly evidence consent.

Mental capacity assessments had not been completed in accordance with the principles of the Mental Capacity Act 2005. In addition, assessments were not decision-specific and therefore did not provide sufficient information to demonstrate how capacity had been assessed in relation to a particular decision. They did not clearly identify the matter requiring assessment, nor did they provide guidance regarding the interventions staff should use to support people appropriately. Where restrictive practice was in place, for example door sensors, we found people had not been consulted, nor had capacity assessments been completed.

We raised this with the provider at the time of the assessment who told us they would review mental capacity assessments to ensure they were in line with law and legislation.