Astley Hall Care Home

Updated 6 January 2025

Date of Assessment 25 June to 30 July 2025. This assessment included site visits to the service on 1, 2 and 8 July 2025.

Astley Hall is a care home with nursing providing accommodation and personal care to older people, including people living with dementia and physical frailty. The service is registered to support up to 83 people.

This assessment was prompted in part by concerns received about the leadership, people’s safe care and whether staffing levels and staff skill met the needs of people using the service safely.

At this assessment, there were 71 people using the service. We spoke with 19 people who used the service and 16 relatives. We spoke with 24 staff including the manager, the clinical lead, care staff, the catering staff, the activity staff, domestic staff, and the regional manager representing the provider. We also spoke with visiting professionals. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We looked at 11 people’s care records and multiple monitoring records including medicine records. We looked at 5 staff files and multiple management records including policies and procedures.

We found that whilst the service demonstrated some good practice, improvements were needed to ensure consistent delivery of high-quality care across all areas. We identified three breaches of regulation regarding safe care and treatment, staffing and governance. We have asked the provider for an action plan in relation to the concerns found.

The provider’s learning culture needed to improve. Whilst accidents and incident were analysed to identify themes so action could be taken to prevent recurrence, daily management oversight was not effective as risks were not always recognised.

Management oversight, governance systems and audits had not been used effectively to assess, monitor and improve the quality and safety of the service. Concerns were identified in relation to people’s assessed needs, health risks and inaccurate care plans and gaps in the monitoring records showed these were not fully effective. The provider’s management team were transparent and responsive to the concerns and shortfalls we identified. Their commitment was evident by some immediate action taken to reduce risks but further improvements were needed.

Staff were recruited safely. The oversight of staffing levels and staff deployment needed to improve. We were not assured staffing levels met people’s individual needs and this also compromised people’s dignity, independence and respect at time. Systems were in place to support staff, but most staff were not confident to speak up. Staff training was up to date and they understood their responsibility to protect people from abuse.

Staff treated people with kindness, compassion and supported their preferences. Staff were committed providing people they looked after and had development positive relationships with people and their relatives. People lived in a clean and well-maintained home. People had personalised their rooms to reflect their taste and interests. People maintained relationships with family and friends. The provider had plans in place to manage unplanned events and emergencies. Information was available in formats people could understand.

Updated 6 January 2025

People felt safe with the staff who provided the support they needed. People’s needs had been assessed and where required appropriate equipment was provided to promote their safety and independence. A relative said, “We have no complaints at all, staff are all great.” People and their relatives provided positive feedback regarding the standards of care and had no concerns with support with medicines and access to health care support when required.

People and relatives expressed concerns with the oversight of people’s needs and concerns about staffing levels. People who required little support from staff were happy with the support they received, however, others felt there were not enough staff and this increased risk and compromised their safety. They described the delays in call bell responses and personal care, led to loss of dignity and discomfort. Comments received included, “Staff numbers vary; at weekends they are often short” and “We do have some issues; the food is poor and we feel there are often too few carers, and we have told management over and over.”

People’s care and support records were not always an accurate reflection of their assessed needs and risks. Discrepancies contained within these documents increased the risk of people receiving poor care outcomes.

People told us they felt safe living at the home. People told us the care home was clean and they could move around safely. A relative described the care home as ‘comfortable and spacious’ and told us, “I think the home is heated by underfloor heating.”

People and relatives felt staff understood their roles and responsibilities in relation to providing people with emotional support, and tailored end of life care. A person who started using the service recently told us, “They all know my name already; it is nice and quiet, I have a lovely room and the food is lovely.” A relative said, “I am aware that I am being very positive, the carers, even the cleaners are remarkably pleasant and nice and talk to him. I find the ethos is good, the staff are nice to me and I am happy that Person is safe.”

Where people could not directly tell us about their experiences, we used observation to assess whether they received good care. People spoke positively about staff, and described them as ‘kind and caring’ and were ‘always polite and courteous’. At times, care delivery appeared to be task-oriented, which limited opportunities for meaningful engagement. As a result, staff missed chances to build rapport and connect with individuals in a more person-centred way.

People had the opportunity to participate in activities and some could go on outings. People stayed in contact with family and friends. Relatives also told us they visited their family member and friend at any time and were welcomed by the staff team. Most people enjoyed the meals and menu choices, and snacks and drinks were readily available.

People and relatives felt the changes in management had affected people’s quality of care. Most people and relative felt confident to raise concerns with staff as management did not always recognise or respond to individual concerns. People’s views were sought through surveys and meetings.