Ashdown Lodge

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.

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 assessed and reviewed people's health and well-being needs with support from healthcare professionals. For example, one person receiving weekly dressing changes from district nurses was offered pain relief in advance to help reduce discomfort and distress associated with the procedure. The person was known to sometimes refuse dressing changes, therefore staff remained with them, monitored the effectiveness of the pain relief, provided reassurance and supported the person to feel comfortable with the district nurses completing the procedure.

People's health needs were reviewed through regular GP and paramedic practitioner ward rounds which provided clinical oversight and guidance to staff in assessing and responding to changing needs. A staff member told us, “If we have any concerns around a resident not being well or during end-of-life care, we have a lot of support from the local GP. They are really good.”

Daily handovers supported the sharing of information about people's care and well-being. This prompted staff to continuously discuss, assess, and monitor people’s needs and supported, consistent care.

The provider planned and delivered people's care and treatment in line with current legislation, evidence-based guidance and good practice taking account of what was important to them. For example, a person whose weight was low was regularly monitored using the Malnutrition Universal Screening Tool (MUST). MUST is an evidence-based tool used in health and social care to identify adults who are at risk of malnutrition or obesity and supports ways in planning their nutritional care.

The person's weight remained stable through staff monitoring using the MUST tool, regular weight checks, support with a varied diet based on the person's preferences and appropriate nutritional supplementation prescribed by the GP. This demonstrated staff used evidence-based approaches to identify and manage risks relating to nutrition, helping to maintain the person's health, well-being and quality of life.

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 collaboratively with external professionals and relatives, where appropriate, to understand and meet people's needs. This helped ensure important information about people's needs, preferences and histories was shared consistently and reduced the need for people to repeat themselves when moving between services.

For example, when people required admission to hospital, hospital passports accompanied them to provide healthcare professionals with important information about the person's care and support needs. The provider also encouraged relatives to be involved in discussions and work alongside staff, helping professionals gain a full understanding of the person without repetition. This approach supported, joined up and personalised care and reduced unnecessary anxieties associated with the change of environment, for example, from care home to hospital.

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.

For example, a person had lived at the service for several years after moving in with complex health needs and poor health outcomes. Despite changes in their health over time, they continued to receive consistent care and support in line with their wishes to remain living at the service that they called “my home”. Staff supported the person to continue living a fulfilled life in a familiar environment.

People were supported to maintain a healthy diet, with their choices and preferences respected and meals adapted to meet individual needs so they could eat safely and comfortably. This approach supported people to enjoy their food, maintain their well-being and remain engaged in daily life. A person told us, “They always get me what I want to drink. I am a fussy eater so it’s hard to please me, but they do alright.”

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.

There were several examples where people`s outcomes has improved or maintained, through the care and support provided. One relative told us, “She came from hospital and we were told mum would not be able to walk or get out of bed. Since being in Ashdown, she has been able to get up, sit out and do all the things they said she couldn't.”

This demonstrated how ongoing monitoring and care from staff helped people maintain and regain skills, improve their well-being, and achieve better outcomes than initially anticipated.

The provider respected people's rights around consent and promoted their involvement in decisions about their care and treatment. Staff understood the importance of gaining consent before providing support and recognised this helped people maintain choice, control, indignity.

In line with the Mental Capacity Act 2005, people's capacity to make decisions was considered where appropriate, and those with legal authority to act on a person's behalf were involved in decision making when needed, to ensure care was provided in the person's best interest.

Where people were subject to Deprivation of Liberty safeguards (DoLS), this was managed in line with Mental Capacity Act 2005. Restrictions were proportionate and applied in people's best interest. For example, appropriate safeguards were in place for a person living with dementia who lacked capacity to maintain their own safety. Their relative told us, “Yes, I feel mum is safe. They have doors that are locked so she won't be wandering out. They always ask if she needs anything, always somebody there. And they have their eye on her, which is reassuring.”

We observed staff seeking consent and explaining the support being offered before assisting people, which helped people feel involved, respected and reassured. A staff member told us, “I don’t just assume it’s ok to touch someone I always try and ask and explain what is going to happen.”