Ashley Grange Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

The service was in breach of regulations for person-centred care. At this inspection we found the service was 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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

At our last comprehensive inspection, we found people did not always receive care that was person-centred. Also, care plans were not detailed and did not reflect people’s current needs. At this inspection we found people now had personalised care plans which provided staff with guidance on how to provide people with individualised care and treatment.

Care reviews were regularly completed which meant care plans were updated with involvement from people and relatives if appropriate. One relative said, “Staff are aware I like to be involved in [relatives’] care. I am involved and have joined regular reviews too.” Another relative told us, “I was involved in the care plan when they [staff] wrote it. The nurse rung me after [relative] had been here a year and asked if I was happy with the care plan and how things were, or did I feel any changes were needed.”

We observed people being supported in a person-centred way. Staff knew people’s needs and were following guidance in people’s care plans. The registered manager told us, “It used to be quite regimented here, lots of people in bed all of the time. We did a lot of work to encourage staff to bring people downstairs if people wanted to. We discuss all new residents with the staff, and give them a clear expectation of their needs, make sure staff know their needs and wishes.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The registered manager gave us examples of how the service had joined up with local agencies to provide people with care. For example, they had worked closely with the local authority to provide a person in need with a short-term respite stay. This meant the safeguarding concerns for this person were resolved as they had a safe place to stay whilst their main carer was receiving hospital treatment.

People were receiving a continuity with their care as there was a long standing and consistent team of nursing and care staff. Care delivery was flexible and involved many different healthcare professionals such as tissue viability nurses, speech and language therapists and dementia specialist nurses.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were assessed and recorded with details of any specific communication needs identified. If people were visually impaired this was identified with details of how best to communicate. If people were hearing impaired staff had clear guidance on how to communicate with the person effectively.

Information could be provided in different formats if needed. This included a larger font or pictorial information.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider had a complaints policy, and we found all complaints were recorded. The registered manager investigated all concerns raised and provided the complainant with outcomes.

People and relatives knew how to raise any concerns and told us they would not hesitate to speak with the registered manager. Comments included, “If I were unhappy about anything, I would go straight to the manager” and “If I had any worries I would go to [registered manager] she has been excellent.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The service employed nursing staff 24 hours a day and the management team were also registered nurses. This meant people had nurses on site to manage their nursing needs consistently and at any time of the day or night. The service had established links with other healthcare services which enabled staff to make timely referrals when people’s care needs changed.

The premises was suitable for the needs of the people using it. People had access to outside space from the ground floor and there was a lift for people to use to access ground and first floors. We did find some toilets did not have pictorial signage which might help some people with dementia find them. However, the provider had already identified this and was taking steps to review all the signs at the service.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Management were aware of people that may face discrimination and made sure people had their care and treatment to meet their care and health needs. The registered manager told us that people’s care needs were shared with staff with clear guidance on how best to support people. Many people had nursing needs and reduced mobility. However, the ethos of the service was for people to be supported to get out of bed if they wanted to and spend time with others in communal areas.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

There was no end-of-life care taking place at the time of this inspection, however, it was an area of care that had been provided in the past. The clinical lead had completed training with staff on providing responsive, compassionate end of life care.

People could record their wishes for end-of-life care in their care plans. Some people had taken the opportunity to do this, but many care plans lacked details for this area of care. The clinical lead was taking action to make improvements with this area of care.