Ashgrove Care Home - London

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.

The last rating for this key question was good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

Assessments and care plans were not always person-centred. Whilst, staff assessed people’s needs and choices, some of the information within assessments was basic and did not give enough information about how people’s needs should be met. Often the same statements and information were used to describe the needs of different people. Care plans did not always state how people’s needs should be met or how outcomes should be achieved. For example, care plans for supporting people with oral care included statements such as, “requires oral care” and “needs support for mouth care every day” but did not specify the exact care, support or equipment the person needed. We discussed this with the registered manager. They had already identified this was an area for improvement, and felt the lack of detail was partly due to a change from paper based to electronic care planning. The provider showed us an action plan which included plans to make the required improvements.

Staff were familiar with people and their needs. They were able to describe how they would meet these needs. Relatives told us their views had been sought during assessments. Their comments included, “There have been assessments and reviews” and “They ask for my views.” However, some people using the service did not always feel they had been consulted. Their comments included, “I just have to go with the flow” and “They do not really ask me what I think.” We discussed this with the management team so they could think of ways to ensure people felt consulted and involved.

People received evidence-based care and treatment. The provider offered comprehensive training and guidance for staff to help make sure they had the skills and knowledge needed to care for people. Managers worked with the staff to identify training needs. Staff told us training was helpful and equipped them for their role. A staff member told us, “The training on dementia was very interesting and helped us to know what to do and why people behave a certain way.” Some staff took on extra responsibilities and lead roles. They accessed additional training and helped to inform and guide other staff about their area of expertise. Nurses were supported to retain their clinical knowledge and skills. People told us they felt the staff were skilled and well-trained. Their comments included, “They seem to know their jobs” and “They are good at what they do.”

The provider ensured people received support to meet their nutritional and hydration needs. Most people told us they liked the food and were given variety and choice. People’s comments about meals included, “The food is excellent, and the chef here is good”, “It would cost you an arm and a leg in the West End to get what [chef] gives you here” and “There is plenty of food and I am well fed.” The chef regularly met with people to discuss their preferences and to review menus. Alternatives to the main choices were offered and the chef catered for specialist diets, including cultural needs and high calorie diets. The chef had a good understanding about people’s individual needs. Food and fluid intake, as well as people’s weight were monitored and staff made referrals to healthcare professionals when they identified a concern relating to nutrition.

The provider had effective systems to enable the staff to communicate well with each other. These included daily meetings where they shared information. They also used electronic recording systems to update each other, managers and senior managers within the organisation about important issues. Staff told us they felt there was good teamwork.

The staff communicated well with external professionals. We spoke with visiting professionals who told us staff gave clear and timely information about people’s needs, made referrals when this was required and followed their guidance and plans.

The provider supported people with their healthcare needs. Relatives told us they were happy with the way people were cared for, and their healthcare needs were met. Some relatives told us about improvements in people’s health and weight. Relatives explained that any decline or health concerns were well managed, and they were involved in making decisions about people’s care.People told us they had regular appointments with healthcare professionals, and this was evidenced in their care records. One person explained, “The doctor comes straight away if I need them.”

Visiting professionals confirmed staff responded well to people’s health requirements. A professional explained, “I visit every week and can see the staff are good at meeting needs. This includes how they manage wounds and skin care. The staff empower people and provide good clinical care. I have seen improvements in people’s health.” Professionals told us that staff followed their advice and asked them for help when they were unsure.

Systems for monitoring people’s health and wellbeing were not always effectively implemented. For example, care plans and risk assessments had not always been updated to reflect individual experiences, including when people had become agitated or anxious. We discussed this with the registered manager who agreed to provide more training and support for staff about how they could use records effectively.

The staff responded to changes in people’s physical wellbeing and weight. They understood when people needed extra support and input, and they liaised with other professionals appropriately. Relatives told us they were consulted when people’s care was reviewed, and changes were made. A relative explained, “The care has been exceptional. Staff monitored [person’s] health and wellbeing, and this has led to improvements.”

The provider sought people’s consent for care and treatment. The staff carried out assessments when people lacked the mental capacity to make certain decisions. The provider involved people’s representatives to help make decisions in their best interests when needed. Relatives confirmed this had happened. We met a visiting professional who was supporting people with healthcare vaccinations. They explained that the provider had sought consent and provided evidence of this including consultation with people’s legal representatives when needed.