- Care home
Ash Grange Nursing Home
Assessment report published 3 September 2026
Contents
Ratings
Our view of the service
About the service
The service is a nursing home which has 2 floors, each providing care and support to people with nursing needs. There were 35 people using the service at the time of the inspection.
Who the service is for
This service provides support to younger and older people with nursing needs, physical disabilities and dementia.
Key findingsWe carried out this assessment on 11 August 2026. This service was previously rated as good at our last inspection which was published on 19 March 2021. 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.
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives.
The provider’s systems ensured where people required a DoLS these were in place and individual care plans reflected the content. Not everyone was subject to a DoLS. The system ensured assessments were completed and applications were made. There was a process to track these to ensure any new applications were made in a timely way. Staff could describe who had a DoLS in place and what this meant for each person.
Systems are in place to review all incidents and learn lessons when things went wrong. The registered manager told us, “Learning from incidents report are completed following an event and we share the lessons learned with staff.” Staff confirmed they received information in meetings and supervisions about lessons learned. We saw incident analysis considered a range of factors to determine if there were any lessons to be learned. Where lessons had been identified relevant updates were made and staff were informed. For example, following a complaint being considered the registered manager had made changes to hospital admissions processes.
Staff understood how to recognise abuse and could describe the actions they would take to report any concerns. Staff had received training to support their practice and there was a whistleblowing policy in place. Where incidents had happened, the registered manager had reported these to the appropriate body, and we saw all incidents were monitored to track the outcomes and internal reviews were undertaken to identify any wider themes or learning.
There was a system in place to assess risks to people’s safety. Where risks were identified these were assessed and management plans were put in place. We saw people had different risk assessments depending on their assessed needs, these included risks relating to mobility, falls, skin integrity, eating, drinking and for specific health conditions such as diabetes and Parkinson’s disease. Staff could describe the support people needed to minimise the risks to their safety and our observations confirmed staff followed peoples plans. Risks relating to the environment were also considered and systems were in place to ensure the home and equipment were well maintained.
People received their medicines as prescribed. Medicines administration records were also in place and accurately completed. Guidance was in place for where people needed as required medicines and medicines were stored safely. Nurses were observed seeking consent from people to accept their medicines and administering these safely.
People had an initial assessment which identified their needs and outcomes. Staff told us they received information about people’s needs through the electronic assessment and care plan. We saw the system identified people’s individual needs and preferences and documented the outcomes they wanted to achieve. The system then produced a care plan to guide staff on how to meet these for each person. The electronic record also ensured people had regular reviews of their needs and outcomes, and evidence-based tools were included in the system. Staff told us they had a good summary included of people’s needs and the record was also used to document the care people received. A staff member said, “These are good and updated regularly we all know what is in place for people, it flags and tells you what needs to be done when. It is easy to record on the system when we deliver peoples care.” Where people could not consent to their care, we saw mental capacity assessments were completed and decisions were taken in people’s best interests.
Staff knew people well and could describe how they supported people to meet their needs. Staff were observed supporting people to remain independent. For example, people were given adapted cups to be able to drink themselves. Staff were consistently offering people choices throughout the day. People were given a choice of where to sit, what activities they wanted to do and what meals they would like. The registered manager told us they had various systems in place to check on how well staff engaged with people during their care. They described spot checks where observations were completed, regular feedback from people and their relatives and the nursing team having continuous oversight of staff practice. The registered manager also told us, “We have a culture of staff being able to share any concerns anonymously with me so these can be addressed in supervision with staff.”
People’s individual needs and preferences were understood by staff. Staff could describe in detail the information they needed to provide peoples care in the way they needed and preferred. For example, staff could tell us about preferences for how personal care should be delivered, preferences around frequency and which toiletries people liked to have and how they got these. Staff could tell when people needed support, they were observed being responsive when people needed help. A staff member told us, “Bedtimes are agreed with people and what time they get up. Some people decline on the day, and this is always respected. Personal care is done as the care plan tells us to and this gives us all the detail we need. All areas of protected characteristics are covered in peoples care plans for example, it will say about cultural needs or religion.”
Staff understood how to support people to raise concerns and told us they would have no hesitation in doing so. A staff member told us, “If someone made a complaint or anything else I would report this to the nurse in charge for action or the manager.” We saw there was a complaint log in place which detailed any concerns raised, the investigation undertaken and the outcome. The registered manager told us learning from complaints was in place and provided an example of how they looked for themes and trends when receiving concerns.
Systems to check people received their care were operating effectively and audits were in place to check medicines administration was done safely. The registered manager had systems in place which supported learning and there was a clear understanding of the providers vision for the service.
Some improvements were needed to safe staffing levels were maintained. For example, we observed staff were not consistently available in communal areas which meant people sometimes had to wait for their support. The registered manager explained the service had experienced staffing shortages on the day of the inspection and this had impacted peoples experience on the day. The registered manager confirmed action had been taken to prevent this from happening again.
Systems to ensure there were sufficient staff available to support people were not consistently effective. We found despite systems being in place to check and determine staffing levels based on individual dependency on the day of the inspection these had not been effective and there were not enough staff to meet people’s needs in a timely way.
People's experience of this service
We spoke to people and their relatives about their experiences of care during the inspection, we observed the care people received in communal areas and used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
People told us they felt safe living in the home. A person told us, “I love it here, staff are so friendly. They will help you in any way they can. I’m safe here. Nobody is allowed in here, so I know I am safe. I would tell [staff members name] if I didn’t feel safe, but that’s not the case, the staff make me feel safe.” A relative told us, “I do think [person’s name] is safe I do think they are safe with the staff. They move [person’s name] safely from their chair too, I have seen them do that.”
People told us they had support to manage their medicines safely and nurses administered these on time. A person told us, “I do get all my medicines, there’s no problem there.” People told us staff understood how to keep them safe and manage risks to their safety. People were able to describe how staff supported them to manage risks relating to mobility, falls and diets. A person told us, “The staff hoist me well. They keep telling me what to do so I don’t fall.” Relatives also felt that people were safely supported and risks were well managed. A relative told us, “They look after [person’s name] health. They were unwell and they got antibiotics quickly and it cleared up.”
People told us they were asked to give consent before receiving their care and were aware of their care plans and had been involved in their assessments. A person told us, “They ask me about what I like and don’t like and if I agree or not to what they are doing. I make my own decisions about what I do and what I wear.” A relative told us, “The staff always ask [person’s name] permission before doing anything for them. They always knock before coming into their room.”
People and their relative’s felt staff were kind and caring. A person told us, “The staff look after me and are very kind.” Another person said, “The staff are very caring. I love them all. They are like friends to me.” A relative told us, “The staff are all lovely, kind and caring and very helpful.” Another relative said, “They know [person’s name] pretty well now. They always call them by their name.” Our observations showed staff were kind, caring and responsive to peoples needs. For example, staff were observed to smile at everyone when they spoke to them, when entering the communal areas staff made sure to speak with everyone, calling them by name and having conversations. We saw staff were responsive to peoples needs, a person asked for a drink, and this was immediately bought to them.
People were asked about what activities they would like to do during the day and those chosen were observed to be on offer this included a quiz and dominoes. Staff also took time to go and speak with every resident during the morning to check on their wellbeing. We saw one person went out to a local shop and another was using the television to listen to their choice of radio station. The atmosphere in the lounge and dining area was lively.
People told us they understood how to make a complaint and relatives confirmed they also understood how to raise concerns and were able to share examples. A person told us, “I have had no reason to complain. I would again tell [staff members name] if something wasn’t right, even the food is lovely. There is a residents’ meeting, but I don’t go. Nothing could make it better for me.” People told us staff understood their needs and preferences. A person told us, “I can have a bath whenever I want one. I don’t have to wait long for anything. They ask me about everything.” A relative told us, “[Person’s name] just likes singing all of the old songs and the staff sing with them sometimes.”
People and their relatives were aware of the management team; however, some comments were made about the absence of management team during the weekend., “A relative told us, “The registered manager and the deputy are all really nice. I don’t know their names, but I spoke with them about [person’s name] care when they first came in.” A relative told us, “We wait at the door a very long time on a weekend. It’s because there are no office staff in on a weekend.”
We received mixed feedback about staffing levels with some people feeling there was not enough staff and others expressing staff were prompt in supporting and always around. Relatives also had mixed views about staffing levels. A person told us, “There’s always someone around. There’s enough staff and they answer my buzzer quickly. Another person told us, “My buzzer is not always answered though in the day.” A relative told us, “The staff are all lovely and try their upmost, but there just isn’t enough of them.” Our observations confirmed sometimes people had to wait to receive support with meals and occasions where there were no staff available in the lounge to assist people.