Archived: Aronel Cottage Care Home Limited

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This meant the effectiveness of people’s care, treatment and support in relation to their mental wellbeing was inconsistent.

People were not encouraged to be independent. While some people had high support needs, this was not true of everyone and a risk averse approach to care meant some people were unable to have the quality of life they required. People and their relatives told us people were not encouraged to be active. Consent for restrictive practices in care was not always gained from people or was poorly recorded. We spoke to the registered manager about this during the assessment and they told us they would change how this was recorded. After the assessment the manager told us he spoke to people to ensure they consented to any restrictions in their care and he uploaded evidence of this to people’s care plans.

Peoples’ needs were assessed on admission and continued to be assessed and updated in electronic care plans by staff who knew people well. Despite the lack of activity, people told us they were happy. Staff worked in collaboration with other healthcare professionals when needed. The use of an electronic care system made sharing information, when necessary, easy.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Peoples’ care was managed well and there were plans in place to maintain peoples’ health. A staff member told us people’s abilities were assessed on admission, such as mobility assessments. However, there were sometimes issues with communication, a relative told us, “Communication is a bit difficult because he’s so deaf, so they have to decide for him. They make a best guess at what he wants.” Despite this people were happy, a person said, “There’s nothing to dislike here, or anyone. It’s all pleasant.”

The provider planned and delivered people’s care and treatment with them or their relatives, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The registered manager planned care at admission with people and their relatives. The registered manager was clear about the care they could provide and only accepted people to the home with needs staff were trained to support. Care plans were completed and updated by staff who knew people well. Care was provided by care staff and registered nurses, and all care was overseen by registered nurses. Where people needed input from other healthcare professionals the staff were active in inviting them into the home. People told us, “They get the doctor quickly and they have fully qualified people here.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The electronic care system enabled the registered manager to print a care plan for anyone moving between services, for example going into hospital. People were asked on admission about themselves and there were sections within the care plan for both clinical and social care needs, along with a personal and family history.

The provider did not support people to manage their mental health and wellbeing, so people could not maximise their independence, choice and control. While the provider worked with other healthcare agencies to ensure people's physical health was supported, people's mental health was not prioritised.

People were not encouraged to be independent. We spoke to one of the registered managers about people being able to walk about the home and were told people could not walk unaccompanied. However, other staff told us some people at the service were able to walk alone, or with support. People were not encouraged or supported to walk, staff used wheelchairs to move people into the lounge. There was a lack of activity at the home that meant people sat all day in the lounge. A relative told us, “Never have I heard laughter or joy from the residents. They are brought into the lounge and unless they eat in the dining room, they are left in their chairs until bed, with nothing at all to do.” There were some activities organised, but not everyone was interested or able to engage with them. Activities were not tailored to people’s abilities or interests. Entertainment was predominantly passive, with no active element for people. A relative told us in the past there had been chair exercises for people to join in but these no longer seemed to happen.

People told us they wanted to have more exercise outside of the home. When asked what they would like change about the service a person told us, “Not being able to go out. I never go out further than the garden. Going out would be lovely.”

The home held celebratory events for people, including barbecues in the garden in the summer.After the inspection the provider told us they would review and reflect on the feedback, and improve the opportunities for people to be supported to access the garden, and leave the home on excursions when required.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider used an external company to check, monitor and assess the care at the service. The registered manager told us they reacted to feedback to improve the care. A staff member told us there had been people who had improved their mobility after the service had liaised with physiotherapists to create a care plan.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Staff understood the need to gain consent before giving care to people. We saw staff asking or explaining care to people. However, where risks were managed the registered manager had not always gained informed consent from people or had not recorded it. The registered manager told us consent for bed rails was always gained and that was recorded on the care plan. However, this was a check box only and there was no evidence people had given informed consent. One person told us they did not want bed rails on their bed. They said, “They keep the side up on the bed. I need assistance to get out of bed. I feel like an animal, trapped.”

Other people said they had no choice over when they were washed, one person told us “‘There’s a fixed time, Friday mornings. You can’t change that.” And another said, “They come and say, ‘You’re having your shower.’”

After the assessment one of the registered managers told us they had reviewed the way consent was asked for and recorded, and they had checked people consented to any restrictive practices in their care, signed documents were uploaded to the electronic care system as a record of this.