Ashley Grange Nursing 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.

The service was in breach of regulations for need for consent and meeting nutritional and hydration needs. At this inspection we have found the service is no longer in breach of regulations.

This service scored 75 (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.

Management completed all pre-admission assessments. Information from these assessments was used by nursing staff to then produce care plans. Assessments were also completed regularly to identify risks and changes to people’s needs.

People told us they were involved in their assessments and care planning. One person said, “They [staff] talked through my care needs when I came in, and they update it all the time. They ask me for my feedback on things; I will always tell them what I think.”

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.

People’s needs were assessed using nationally recognised tools for areas such as malnutrition and skin integrity. This helped staff identify people who may be at high risk which enabled measures to be put in place in a timely way. For example, people identified at high risk of pressure damage had equipment such as air flow mattresses and people at risk of malnutrition had fortified diets. Fortifying food enables people to have additional calories and nutrients.

Staff had been provided with training on the International Dysphagia Diet Standardisation Initiative (IDDSI). The registered manager told us this training was interactive, and staff had eaten modified food and drunk fluids that had been thickened. This helped staff gain an understanding of people’s experiences when eating modified diets.

People had mixed views about the quality of food available. Comments included, “It is cooked well but it is not to my taste, it is like school dinners. If I ask for something in particular, they will usually get it for me”, “I am most impressed with the food” and “The food varies, most of the time it is really good.” We found people had shared their feedback in meetings and actions were taken to improve their experiences. For example, the service had employed a new chef who had made some improvements for people.

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 worked in partnership with a range of healthcare professionals, many of whom visited the service regularly. Feedback we received was positive about the approach of the management and staff. Communication was timely and appropriate and referrals for people’s health needs were shared with the right health services. One professional shared that they had experienced delays trying to contact the service. We shared this feedback with the registered manager.

Staff had daily handovers and there was a daily head of departments meeting. Information was shared with staff on safeguarding concerns, complaints, changes to people’s needs and events such as new admissions.

People and relatives told us staff kept them up to date with any changes to people’s needs. One relative said, “They [staff] email me and send me information. I like to know how [relative] is getting on, so staff update me.”

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.

Staff worked in partnership with people to make sure their health and welfare was promoted. Staff were aware of people who were high risk of ill health and monitored their outcomes closely to identify early signs of deterioration.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

At our last comprehensive inspection people’s fluid monitoring was not consistent and people did not have access to sufficient fluids. At this inspection we found improvements had been made and staff were consistently recording people were being offered fluids. There was guidance for staff to know how much fluids people should be drinking per day. When monitoring showed people were not consuming enough fluids, nurses liaised with people’s GP.

Staff were supporting people to re-position regularly to help prevent pressure damage. People’s needs were recorded in their care plans and staff followed guidance to move people regularly. Records demonstrated staff were moving people within recorded timescales.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

At our last comprehensive inspection, we found staff were not working within the principles of the Mental Capacity Act 2005 (MCA). Capacity assessments and best interest decision making had not always been available in people’s records. At this inspection we found staff were now working within the principles of the MCA. People’s records demonstrated capacity assessments had been completed. There was also clear evidence of best interest meetings recording who had been involved and why decisions were being made.

Staff had been provided with training on the MCA and understood how this applied to their work. The registered manager said they had carried out the improvement needed and at times healthcare professionals had helped by reviewing MCA assessments. If more information was needed staff reviewed people’s records to make changes.