Ashview

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

At the last inspection, the provider was in breach of the regulations because they had failed to ensure staff were suitably qualified, competent, skilled and experienced, people received appropriate person-centred care and their nutritional and hydration needs were met. At this assessment, staff were suitably skilled and competent, people received person centred care which met their needs and provided them with a balanced diet. Improvements had been made and the provider was no longer in breach of the regulations relating to the question of Effective. People’s needs were assessed and monitored, and they were involved in the assessment process. Care plans were in place to ensure their care and support was person centred and effective. People were able to consent to their care and support as much as possible. Where people lacked the capacity to make decisions, these were made in their best interests, in line with legislation and best practice.

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.

People and their relatives had been involved in their assessments and regular reviews of their needs. A person told us, “I go out a lot and its written down in my plan, staff take me. I can look at my plan.” Another said, “I have helped write my care plan so I know what is in it and when it needs to be changed.”

Staff said they could easily read about people’s needs and choices as care plans were clear, accessible and up to date. A staff member said, “We have had a lot of training and discussion on making sure we write people’s daily records in a good and clear way. Also, we say how they feel and what choices they made.” We noted a good staff ratio, ensuring that they could adequately meet the needs of the people living at the service.

There was a system in place to ensure assessments looked at people’s needs and wishes. People's care plans were personalised, holistic and based on their strengths and aspirations. People’s care plans included an assessment of need, as well as risk assessments which included using equipment, going into the community, mobility, pressure care and eating and drinking. The manager explained how they assessed the needs of people, for example visiting a person in hospital to discuss if Ashview was suitable for them but also considered the needs and welfare of those already living at the service.

The provider planned and managed people’s care and support with them and they were supported to plan and achieve meaningful and relevant outcomes. People were supported to eat a healthy and balanced diet. We saw one person enjoying a bowl of fruit for their breakfast. People were involved in going food shopping with staff, preparing snacks and their lunches and helping to cook evening meals. Menu choices were discussed and agreed and there was a variety of food and dishes on offer. People could choose to eat as a group or individually.

Staff and leaders were encouraged to learn about new and innovative approaches that evidence shows can improve the way their service delivers care. Everyone who needed support with eating was assisted by staff who took their time to help people to enjoy their meal. Where needed, people’s food and fluid intake were recorded and their weight monitored.

People had been involved in the interior design and redecoration of the service. The service was homely and stimulating. The environment was clean, and equipment was stored correctly. People's bedrooms were personalised. Photos of people at events and celebrations were visible and flags were displayed everywhere to celebrate the Olympics.

People received personal and health care support which was coordinated to meet their needs.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support alongside other professionals.

Professionals were positive about the way the manager and staff worked with them.

Plans for transition, referral, discharge from hospital and admission to the service considered people’s individual needs, circumstances, and ongoing care arrangements. The manager communicated with external professionals and services for a coordinated approach and to maintain continuity of care.

People were supported to manage their health and wellbeing so they could maximise their independence choice and control. People’s health needs were discussed with them and their family members to ensure they lived healthy lives.

Staff were aware of people’s needs and recognised when something was not right. They told us they would always raise concerns with the manager as quickly as possible. One example showed how for one person staff had continually raised concerns with the GP that a particular treatment was not working. Through persistence, another test was completed and the problem for the person was resolved resulting in a better quality of life.

Referrals to health care professionals were made in a timely way and results of any intervention were recorded which evidenced good practice and outcomes for people.

People who used the service experienced positive outcomes in their day-to-day life with consistent staff engagement and support. There was clear evidence to show people were achieving their goals and aspirations.

Effective approaches had been developed around working with and supporting people. This included staff working to the defined values of the service which had been developed by the manager, staff and people themselves.

Processes were in place to monitor continuous improvements to people’s care, treatment and support.

People who could consent to their care and support told us their views were respected and they had choice and control in their lives. One person said, “I want to be able to make my own decisions. I know what I want or don’t want, and staff listen. This makes me feel my wishes are respected.” We observed staff engaging with people who had different ways of communicating offering them options and enabling them to make their own choices and decisions. People's mental capacity assessments were up to date and detailed. It was clear how people or those who were important to them had been involved in the process. People's care plans demonstrated how staff should empower them to make their own decisions about their care and support

Staff received training in the Mental Capacity Act which helped ensure they understood the principles of the act and put the training into practice. We observed where people lacked the mental capacity to consent to care and treatment the manager worked in partnership with key stakeholders to make decisions in people’s best interests. Staff told us how people were supported when they went out, to promote their independence and choice. A staff member told us, “We have people who are more independent than others when we go out. Some people need us to encourage and prompt them, but they always get there in the end. You must be patient and kind.”

People's risk assessments were up to date and sufficiently detailed to ensure people lived safely and free from unwarranted restrictions. Where restrictions were documented, for example around the circumstances in which people were able to safely go out, it was recorded if people needed a staff member to go with them. There was a process to make applications to deprive a person of their liberty, called the Deprivation of Liberty Safeguards (DoLS). People assessed as needing a DoLS authorisation had one in place and the manager was aware of when these needed to be reviewed.