Ash Hall 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

Systems in place to monitor and review people’s care needs and to escalate concerns to external services were not always effective. The provider did not always give appropriate, accurate and up-to-date information in formats tailored to individual needs. The provider did not regularly ask people, their relatives and staff about their experience of the service. Care plans did not always include the required guidance for staff to identify when to escalate concerns to specialist services. People’s care plans did not always include information about their end-of-life preferences.

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.

People did not always feel their care was person-centred. One person told us, “Staff are not interested in what anyone wants.” Another person told us, “Staff do not always know what allergies I have and offer me things I cannot have.”

While staff generally felt they delivered person-centred care, we found people’s care plans did not always include enough information about their individual needs, risks and preferences. For example, some people’s care plans did not include their social histories or information about how they liked to spend their time. People’s end-of-life care plans did not always include information about their individual preferences. The registered manager was in the process of updating people’s care plans to ensure they were person-centred, however, improvements were still required.

While we observed staff generally making sure people were happy and comfortable, we observed some instances where people who remained in their rooms, were not always checked on or were not provided with meaningful person-centred activities. Care plans did not always include enough information about their care needs and risks and about their preferences. People fed back to us care was not always person-centred.

While people did not raise any specific issues about how the provider worked with other services to ensure their needs were met, we found care plans did not always include information to guide staff how to escalate concerns about people’s risks. Referrals to external services did not always include enough detail about people’s presenting risks, and outcomes and recommendations from professionals were not always recorded.

While staff told us they worked well with external services to ensure people’s needs were met, we found care plans did not always include information to guide staff how to escalate concerns about people’s risks. Referrals to external services did not always include enough detail about people’s presenting risks, and outcomes and recommendations from professionals were not always recorded. This meant people were at risk of not having their needs met.

Professionals supporting people at Ash Hall Nursing Home gave mixed feedback about how the care home worked with external agencies to ensure people’s needs were met. One professional working with the service told us, “The service did not update the GP when a resident presented with different symptoms following a previous referral about the same incident.” Another professional working with the service told us, “The home can refer direct to our team and do so on a regular basis. Referrals have been appropriate, and my recommendations have been put into practice on subsequent visits.”

While the provider had systems in place to monitor and review people’s care needs and to escalate concerns to external services, these were not always effective. Although the provider was working with the local authority and other agencies to make improvements in the quality of care they deliver, a number of actions were outstanding due to the provider prioritising specific pieces of work. Since our on-site assessment, the provider had put a service plan in place to ensure they were able to monitor the progress of actions more effectively.

People did not always feel they were given information about their care or involved in decision making about the service.

While staff did not express any issues with how people were provided with information, we found the provider did not always give appropriate, accurate and up-to-date information in formats tailored to individual needs.

The provider did not always give appropriate, accurate and up-to-date information in formats tailored to individual needs. People were not always provided with updates about their care needs. Some people’s bedroom doors had their names displayed however names were not always legible due the size of the writing.

People gave mixed feedback about how the provider listened to them and involved them. One person told us, “I don’t think they have meetings for residents.” Another person told us, “My views would get dismissed.” Another person told us, “I don’t get involved but my relative does.” Another person told us, “We have filled in a questionnaire before. They were left in residents’ rooms.”

The registered manager told us they would like to carry out surveys of people and staff experience every 6 months however it had been over 12 months since these surveys had been completed.

The provider did not regularly ask people, their relatives and staff about their experience of the service. For example, it had been over 12 months before our assessment since resident and relative meetings took place and over 12 months since questionnaires were carried out. This meant people were at risk of not being involved in the running of the service. When we told the provider about this, they put a plan in place to ensure people could complete a questionnaire about the quality of care they received, and a relatives meeting had been scheduled.

People gave mixed feedback about accessing the support they needed. One person told us, “I used to go to the communal area to try to socialise with the other residents but that was impossible as nobody spoke. I asked to come back to my room because I was in pain, and I was told by staff ‘hard luck’.” One relative told us, “My [relative] has moved rooms so that their mobility needs can be met. Carers contacted me [recently] as [relative] was complaining of pain. They called an ambulance. I’m very happy with the care.”

Staff told us people were able to access care, treatment and support when needed. One staff member told us, “We supported one person to access services as they were having problems with swallowing. They were on a modified diet, but their diet is normal now with our support and they have gained weight and are happy in themselves.” While staff knew how to involve specialist and emergency services in people’s care, care plans did not always include the required guidance for staff to identify when to escalate concerns to specialist services.

We did not receive any feedback from professionals supporting people at Ash Hall Nursing Home about equity in access.

Care plans did not always include the required guidance for staff to identify when to escalate concerns to specialist services. This meant people were at risk of not having their medical needs met when required. The building had adaptations to ensure people could access the premises. Mobility aids and specialist equipment was made available to people where required.

People did not always feel their needs were met in a timely way.

While staff generally felt people had good outcomes, not all staff felt people with incontinence needs were supported in a timely way.

Lack of guidance in care plans about people’s needs and risks meant people were at risk of not accessing services when needed.

While people did not express any issues with how the provider supported them with their end-of-life planning, people’s care plans did not always include information about their end-of-life preferences.

While staff told us they worked with health agencies to ensure people’s end-of-life needs were met, people’s care plans did not always include information about their end-of-life preferences.

While the care home worked closely with end-of-life services and had a palliative lead who delivered end-of-life training, people’s care plans did not always include information about their end-of-life preferences. This meant people were at risk of not having their end-of-life preferences met.