Ashgrove Care Home - London

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.

The last rating for this key question was 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.

We identified breaches of legal regulations relating to dignity and respect.

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not always treated with kindness or respect. During lunch on the day of our visit, we observed some people had a poor mealtime experience. A member of staff supported 2 people to eat their meals at the same time. This did not provide them with the dedicated attention and support they required. Other members of staff supporting people left them in the middle of the meal to attend to other tasks and then returned to them. Some people told staff they wanted to eat inside but this request was not met.

People waited a long time for their lunch to be served. Some people were seated and made ready for lunch over an hour before it was served. When people questioned staff about where their lunch was, staff did not respond or offer an explanation to the situation. People waiting for meals were seated alongside others who were served both their main courses and desserts before the other person were served any food.

Feedback we received about people’s care and experiences varied. Some people described interactions with staff which did not show them respect or consider their feelings. We discussed these with the registered manager who investigated these comments and raised an alert with the safeguarding team regarding feedback from 1 person.

However, some people and their relatives were positive about their care and experiences. Their comments included, “From what I have seen they are very caring and kind”, “Everybody is kind and happy to see you” and “They are pleasant but quite busy so do not spend a lot of time.” People were asked if they preferred a specific gender of workers providing support with personal care tasks. People told us the staff respected their privacy. Theor comments included, “They knock on the door and ask if they can come in” and “They pull the curtains and close the doors when providing care.”

Following our visit to the service, the management team sent us an action plan which outlined how they intended to respond to the concerns we identified. Their actions included implementing additional dignity training for all staff.

People were not always treated as individuals because the staff did not always respect their choices. Whilst choices were offered at mealtimes, in some instances these were not respected. For example, 1 person stated they did not want a specific meal. A staff member acknowledged this and took the meal away but then returned with the same meal a short time later.

At our last assessment, we found that people's communication needs were assessed and recorded but not always met. For the majority of people, staff who spoke their first language were available. However, we found continuing issues relating to communication for some people. A person who could not communicate in English was not appropriately supported. Their care plan stated they had, “no ability to understand or communicate [their] needs because there is a language barrier.” The person was able to communicate, however this was restricted because the staff could not speak the same language as them. We discussed this with the registered manager to ensure their care was planned in a more person-centred way. We also discussed how they could proactively find ways to enhance communication with this person.

Some people were cared for in bed or chose to stay in their bedrooms. During our visit, we saw that staff did not spend time with these people or ensure they had opportunities to engage or interact with something they enjoyed. For example, 1 person spent the majority of the day lying on their bed. They were able to move around with staff support, but this was not offered. The person’s care plan stated they enjoyed specific activities. These were not offered to the person and the only time we observed staff interacting with the person was when food and drink were brought to them.

People’s religious and cultural needs were supported. The provider organised for different religious groups to visit and offer worship opportunities. Different cultural meals were offered. Comments from people included, “Staff help me with prayers” and “They bring in someone from the Church to visit.”

At our last assessment, we found that care plans were not always recorded in a person-centred way. At this assessment, we found this was still the case. Guidance within care plans included generic statements and did not give enough detail about how individual needs should be met. We discussed this with the registered manager. They were arranging training for staff to help improve their care planning skills and ensure these documents were improved. The staff demonstrated a good knowledge of people’s needs. However, this information was not always clear within records.

During the day of our visit, the majority of people were escorted to the garden, where they spent the morning and had their lunch. Some people expressed they did not want to do this, but their requests to stay inside were ignored. In some cases, staff used persuasive language and offered rewards for people to go outside. This was not appropriate, and people were coerced into doing something they had expressed they did not want to do.

The provider employed a member of staff to plan and facilitate social activities. They organised a range of events and people were given opportunities to take part in these. Some people told us they were aware of activities but were happy doing their own things. Those who did take part in the activities told us they enjoyed these.

People were supported to be independent when they wanted and were able. They told us they were happy with the support they had with this.

Staff did not always respond appropriately to people’s immediate needs or requests for information or assistance. We saw occasions when staff attended to a task in a way which did not consider people’s feelings or other needs. For example, a person spilled their drink on their clothes. They had to wait for staff to support them following this and when a staff member supported them to remove wet clothing, they did so without checking on the person’s wellbeing or comfort.

However, most people and their relatives told us staff were attentive and responded well when someone became unwell or needed something. Their comments included, “They come and ask if I am well”, “The care here is excellent. [Person] is always clean and well dressed” and “If [people] need help, the staff help. There is always staff in lounge they monitor them at all times in the lounge.”

The provider ensured staff felt supported and valued. There were opportunities for promotion and career development through a range of training and mentoring. The staff told us they felt well supported. They had regular supervision and appraisals of their work. They liked the management team and were able to discuss their work with them. Comments from staff included, “We have regular staff meetings, and we can speak up if we have something to say”, “Managers listen to us and take action”, “I have supervision, and this is useful” and “We receive information from the organisation and senior managers through meetings.”