Asquith Hall

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 service met people's needs. At our last inspection this key question was rated requires improvement. At this assessment, the rating has now changed to inadequate. Care was not person-centred and the provider failed to provide appropriate care to meet people’s needs and reflect their preferences. People’s health and care needs were not understood. Choice and continuity of care was lacking, and people did not have equity in access to care and treatment when they needed it. People did not receive accurate information adapted to their individual needs. Feedback was not always obtained from people who were most likely to experience inequality and their complaints were not always listened to. People were not supported to make plans for the future. We identified 1 breach of regulation in relation to person-centred care.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not supported in a person-centred way which was respectful of individual needs and choices. For example, 1 staff member shaved off a person’s beard that they had for years, causing upset and distress to the person’s relative. People’s care and treatment planning was not collaborative. Care records demonstrated that people and relatives were not involved in the care planning and risk assessment process.

Leaders and staff did not work in partnership with people to plan their care and incorporate their preferences. Language used by staff when speaking about people was not always person centred and respectful. For example, 1 staff member referred to a person stating, “He is a full hoist." Information in care records was inaccurate and conflicting and staff were unable to respond to any relevant changes in people’s needs.

Staff did not know people’s preferences and support was not provided in a person-centred way. The culture was task orientated and individual needs were not considered. The environment reflected a lack of consideration around individuals as people. Some people’s rooms did not have any personalisation or names on the outside of their door to indicate the room belonged to them. One person’s room had a sign stating, “Room Ready, Home”. Another person had a sign on the outside of their room which stated, “Room Ready”. People’s rooms in some instances were not fit for people to live in. For example, 1 person had a room which was stark, without any personal effects and only a wardrobe and drawers. Another person had a bare room, with no personal items and a wardrobe which was empty of belongings or personal possessions.

People were not supported and involved in their care provision and treatment. People’s care was not joined up, flexible or supportive of their choices.

Leaders and staff did not show understanding of the diverse health and care needs of people living at the service. As a result, people did not always have access to services they needed to meet their health and treatment needs.

Partner organisations expressed significant concerns that people were not receiving adequate support to meet their needs.

Systems and processes were ineffective in ensuring referrals were made to health and social care professionals, to support people in making sure their needs were met. There was a lack of partnership working which meant outcomes for people were poor.

People did not have any information available to them, in a format that was tailored to their individual communication needs. For example, easy read or large print. People did not have copies of their care plans and there was no evidence of any care or support information being shared with them.

Staff told us they were unable to communicate effectively with 1 person who was deaf. They said they were not using basic sign language, and nobody could communicate with the person.

Systems and processes were not effective in ensuring accurate information was available in adapted formats for people who needed it. Information in care records was inaccurate and did not always adequately address people’s communication needs. Some people were not communicated with at all.

People were not listened to, and their complaints were not always taken seriously and appropriately responded to. For example, a person told staff they had been assaulted by another person and they were told they had to put up with it. There was no evidence this had been recorded or investigated. People were not involved in making decisions about their care. Where feedback was obtained it was not clear what action had been taken in response. For example, it was documented during a resident meeting that 1 person had said they didn’t like living at the service. It was noted that they were advised to speak about this on a one-to-one basis. There was no evidence of a follow up with the person. Relative meetings were held however it was not clear what had been done as a result of identified actions.

Leaders and staff did not seek to obtain feedback from all people to make improvements. Documents reviewed suggested people were not encouraged to provide feedback during resident meetings. For example, a resident meeting was held with only 2 people in attendance. The minutes documented, “All other residents declined to attend or did not have capacity.” There was no further evidence of attempts being made to involve and obtain feedback from the other people on an individual basis or using a more flexible approach. Staff did not always listen and offer support appropriately. For example, we observed a person assault and swear at a visiting relative. Staff intervened however did not check if the relative was ok and said to the relative, “CQC are here."

Systems and process for involving people, obtaining their feedback and making improvements were ineffective. The approach was not flexible in ensuring people had equal opportunities to be involved and give their views.

People did not always have access to services when needed. For example, 1 person with significant weight loss had not been referred to specialist services for their involvement. One person told us they missed their appointments with other services, for example, the opticians.

Staff informed us that people did not always access services they required without delays. Monitoring of people’s health was not robust, and staff did not know people well. This meant people were not always able to access emergency out of hours input without delay, on occasions where staff had not noticed a deterioration in a person’s health.

Partners raised concerns regarding the involvement of appropriate services for people.

Systems and processes were not effective in ensuring people could access the care, support and treatment they needed when they needed it.

People were not involved or included in their care. People most likely to experience inequality, were not treated equitably or fairly. Those who were deemed harder to engage were neglected. For example, 1 person who was living in a squalid room was exhibiting increased mental health symptoms. Not only had a referral not been made for additional mental health support, but there had also been no attempts made to engage and support the person for a long period of time. They were predominantly left in their room, alone, on a daily basis.

Leaders and staff did not ensure people were placed at the centre of everything they did. They did not work together with people to support them and achieve good outcomes.

The provider did not actively seek out and listen to information about people who are most likely to experience inequality in experience and outcomes. Care, support and treatment was not tailored to people. People’s experience at the service was not considered and the standard of care contributed negatively to their outcomes.

People were not always supported to make important life changes and informed decisions regarding future plans. People were not collaboratively involved in care planning. Information regarding care, support, treatment and outcomes was not shared with people to enable them to understand, plan and make informed decisions.

Leaders and staff did not effectively support all people to make future plans.

Systems and processes were ineffective in ensuring people were supported to make informed decisions and plan for the future.