Ashill Lodge 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 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.

Previously the provider was in breach of the nutritional standards. This inspection identified they were no longer in breach in this area.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. We found peoples care plans evidenced that people’s needs were assessed frequently. For example, staff told us, “We had an occupational therapist out today and the persons care plan was updated straight away.” People and relatives informed us that they were involved in the reviewing of care plans and people knew their assessed needs. A relative told us, “I have a review every 3 months with the manager”

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. We found the staff used national clinical tools to monitor peoples care needs and could inform us what they are used for. They used a multi-universal screening tool (MUST) to assess the risk of malnutrition and a tool that was used to assess the risk of a person sustaining a pressure injury (Waterlow.) A staff member told us “We use MUST and Waterlow. Depending on their score we weigh a person monthly or weekly and then complete their Waterlow." There were sufficient food and drinks available for people, 1 person told us, “oh yes plenty, they fatten me up for Christmas I think.”

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. There was a good collaboration between healthcare professionals that supported people in the service and the staff. We spoke with several healthcare professionals, and all told us their guidance was implemented and followed by staff. 1 healthcare professional told us, “Any advice we do give, it is acted upon. We work really well together, I couldn't do it without them.” The service had handovers between each shift to ensure staff were aware of people’s needs in the service. The management held daily meetings which involved all departments to discuss daily updates within the service.

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. Peoples care plans clearly recorded what their healthcare needs were and the support they required from staff. There was a variety of nutritious meals available for people to choose from including a vegetarian option. Healthcare professionals felt staff knew people well. 1 healthcare professional told us, “I think they know people very well. When we ring and speak to staff and they talk to the [people] and they have always been very polite and caring and never heard anything that has caused a concern at all.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it and this posed a risk to people. Although we found outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The service did not consistently evidence that they monitored peoples care and support needs. Areas that posed a risk to a person that was recorded in their care plan did not always evidence it was being managed in their care records.

However, the service used clinical tools to monitor peoples needs. For example, people who were at risk of malnutrition were closely monitored and we saw evidence of improved outcomes. Staff could tell us how they monitor people’s conditions closely. A staff member told us, “If someone appears unwell, we take all their clinical observations and if someone is diabetic, we take their blood sugars. If we are concerned, we ring 111 or 999”

The provider did not always tell people about their rights around consent and did not always provide full information so people could understand the care and treatment being recommended to help them make an informed choice. The service had been using a messaging application to share images with relatives. However, people and relatives had not been informed staff were using their personal devices to capture and share this content. We also identified an instance where a video was used for a staff training purpose without appropriate consent. We raised our concerns with the provider, and this approach was stopped early in the inspection.

However, we reviewed peoples care plans and they had mental capacity assessments and best interest decisions in place for all other decisions. The service ensured they had a copy of peoples lasting power of attorneys or deputyships so they could be assured people had the legal authority to make decisions for people. The registered manager actively promoted advocacy to ensure people received appropriate support on decisions around their care and treatment when they had no representation.