Ash Hall Nursing Home

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 provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

This service scored 50 (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 did not always treat people with kindness, empathy and compassion, or consistently uphold their dignity.

During our observations, staff interacted with people in a kind and reassuring manner. However, people did not always receive support in a timely way. We observed individuals requesting urgent assistance with personal care being told they would need to wait. This had the potential to compromise their dignity and meant their needs were not always met promptly.

We also found language used within the service was not always person-centred and, on occasion, did not uphold people's dignity. For example, some members of staff were referred to as 'toileting staff' and some people were referred to as 'feeders'. This language did not reflect a respectful and individualised approach to care. Following our feedback, the provider took action to address this practice.

People told us staff were kind and respectful, although some said staff were often rushed. One person said, "The staff are very good. Staff do what they can." Another person said, "The staff are very pleasant and nice. They do talk to you if they have time."

The provider did not always treat people as individuals or ensure care, support and treatment reflected their needs and preferences.

People's preferences, likes and dislikes were recorded in care records but were not always reflected in practice. One person described themselves as vegetarian and told us they were often served meat, which they pushed to one side. Dietary records showed the person regularly consumed steak, chicken and mince. Catering staff told us these were their preferred choices, and they often selected meat options. However, no records evidenced discussions about a change in dietary preference, and care plans had not been updated to reflect this.

People who remained in their rooms for most of the day had limited recorded engagement. Activities were often task-focused and did not consistently reflect individual interests, hobbies or preferences. This meant opportunities to provide personalised care and support were sometimes missed.

The provider did not always promote people’s independence or ensure they had choice and control over their care, treatment and wellbeing.

Bathing and showering arrangements were largely scheduled rather than led by people’s preferences. Records did not always show people had been given opportunities to choose when they wished to receive support, and where support was declined, reasons were not consistently recorded. As a result, people were not always supported to exercise choice and control over this aspect of their care.

People told us how staff encouraged their independence. One person said, “Staff ask you if you want help with eating, but you can do it yourself and stay independent if you want.”

Staff told us they tried to promote people’s choices as much as possible. One staff member said, “I try to encourage individuals to do what they enjoy. For example. if they want to come down to the communal lounge and join in with the church service then I will prompt them to do that. Or some people prefer their own company so I will ensure they have their TV or radio on if they enjoy that.”

Staff did not consistently respond to people's immediate needs or take timely action to minimise discomfort, concern or distress.

Staff interacted with people in a kind and caring manner. However, staffing arrangements did not always ensure people received timely support when they needed it. Two staff members were allocated to support people requiring assistance to use the toilet. During the inspection, we observed people requesting support to use the toilet and being told the allocated staff members were either on a break or assisting someone else.

We visited 1 person in their bedroom after they activated their call bell. The person urgently required assistance to use the toilet and remained waiting in their bedroom. After 10 minutes, they became visibly distressed, requiring us to intervene and alert staff to the urgency of the situation. This demonstrated staff deployment was not always effective in meeting people's immediate needs. As a result, people experienced avoidable delays and unnecessary distress while waiting for support.

People told us staff were approachable and listened to their requests but were often very busy. One person said, "They are all so busy so even if you were to ring the call bell, they probably wouldn't answer it."

Staff spoke positively about their roles; however, some told us staffing arrangements affected their ability to meet people's needs and preferences. One staff member said, "We would like to give people more baths and showers and bed baths, but we are just too busy."

Despite these concerns, we observed staff providing continuous oversight of people in a communal lounge area. One relative told us, "I think there are enough staff. I ask for something and they will deliver. There is always someone in the lounge."

We raised our concerns about staff deployment with the registered manager, who told us they would review current staffing arrangements.

The provider cared about and promoted the wellbeing of staff.

Staff told us they felt supported in their roles and were able to approach managers for guidance and assistance when needed. One staff member said, “I feel supported in my role, I have had supervision and I know I can go to the management or senior staff if I had concerns.” Another staff member told us senior staff and managers regularly recognised staff achievements and offered encouragement, particularly following challenging shifts.

Although some staff described the service as busy at times, they continued to speak positively about the support they received from managers and described a culture where they felt listened to, valued and respected.