Ash House

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 of this key question, it was rated good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received support that was tailored to their individual needs.

One person described how they liked staff who shared their interests working with them and this was usually accommodated.

Staff told us improvements had been made to ensure people received care that reflected their individual needs. One staff member told us, “It is safe for [people] living here and improvements have been made in their quality of life. It’s so much more person-centred because you know what [people] want.” Another staff member explained how they could influence people’s care plans based on their knowledge of people. They told us, “You have to find out what works for them and expand [people’s] options.” A third staff member explained care plans were reviewed as people’s needs changed to ensure they continued to receive responsive personalised care.

However, some relatives felt people's emotional well-being would be further promoted if they had more opportunities for meaningful engagement outside the home. We have further reported on this in the well-led section of this report.

The provider was introducing a new electronic care planning system. The provider’s area manager explained how the new system would capture more social and background history about people. This would be presented in an accessible way to increase the involvement of people and their relatives to ensure support was tailored to people’s physical, social and psychological needs.

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.

Staff supported people to access health appointments and services in the community. Recruitment by the provider meant people received care from a consistent staff team who had time to get to know people well.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Records contained detailed information about people's preferred method of communication and any tools they used to support their communication. People were given information in a form that would support their understanding. For example, 1 person’s care plan was in a pictorial format. Another person had access to “mood boards” so they could use pictures to tell staff how they were feeling. Boards with photographs of staff informed people who would be supporting them that day. Important information like the complaints process was available in an easy read format.

The provider did not always make it easy for people or relatives to share feedback and ideas or tell them what had changed as a result.

Relatives told us they were involved in reviews of people’s care plans. However, some relatives felt improvements were needed to ensure their suggestions and feedback were captured and actioned. One relative told when they made suggestions, “They say yes, and I think there is hope and then nothing happens. I think they listen, but they don’t do anything.” Another relative told us they had not been consulted prior to a change in their family member’s personal living space.

The complaints process was available and in accessible formats to support people to raise concerns and complaints. The provider had introduced family forums to promote conversations and encourage ideas, however relatives questioned the value of these meetings as agreed actions had not been followed through by the provider.

Individual staff understood the importance of regular communication with relatives about people’s care. One staff member told us, “By maintaining that relationship with them it is making sure families are comfortable and getting updates and the people we support are not being socially isolated.”

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

Staff understood the needs of autistic people and people with a learning disability and ensured typical barriers faced by people were removed or mitigated against. For example, 1 person enjoyed bowling but did not cope with loud environments. A senior staff member explained, “We ask for a lane that is not right in the middle. Where they (amenities) are not learning disability and autism friendly, then we will try and make adjustments to make it as learning disability and autism friendly as possible.” Managers explained how they had sometimes struggled to secure reasonable adjustments when supporting people to attend medical appointments. We advised the managers to explore the reasonable adjustments digital flag which enables health and care professionals to share and view details of reasonable adjustments across the NHS.

Staff monitored people’s safety and health needs and identified when people wanted or needed support from other health and social care professionals. Care plans contained information about how people demonstrated pain or discomfort when they were unable to verbally inform staff how they were feeling.

Staff and leaders tailored care and support to ensure people did not experience inequality in experience and outcomes. However, improvements were required to ensure people had equal access to activities and engagement in the community.

People were reliant on support from their relatives who advocated for them. We found some instances where people did not always have equal access to a range of interesting things to do or learning opportunities. This meant people had varying levels of fulfilment and quality of life and some people spent a lot of time in their individual living areas.

If people were admitted to hospital, they continued to receive support from Ash House staff who understood their preferred communication style and typical responses. This ensured people’s needs were understood and promoted positive outcomes for them.

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.

One person’s commissioned hours were being reviewed with a view to providing them with a greater level of independence. The deputy manager explained the processes in place to support the person to feel comfortable with these changes.

People living at Ash House were in the younger age group so records of discussions around end-of-life care were limited. The provider needs to consider the appropriateness of developing end of life care plans to ensure people’s wishes were known and respected.

Health actions plans demonstrated there had been some discussions with relatives and those closest to people about future care needs if they became unwell.