Aurem Care (The Red House)

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question outstanding. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

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.

The provider did not always ensure they and staff treated people in a dignified way.

During our visit we observed some outdated and undignified practices. Examples included staff asking people if they could place a ‘bib’ on them instead of referring to them as a napkin or clothing protector. We observed a member of staff call across the lounge where people were sat and asked another member of staff if they could support a person with a commode. Staff were, at times, standing whilst supporting people with a drink rather than sitting next to them. We observed a member of staff approach a person and kiss them on the head. Kissing is an intimate act that crosses the line from providing care to acting like a family member or friend. We also observed people had clips placed in their hair. A visitor told us, “The staff have started putting clips in people’s hair. I’m not sure why. They’re not children.”

However, people and relatives fed back about the caring nature of staff. Comments included, “They are excellent, some of the finest”, “Staff are excellent, the level of care they give”, “Staff are very nice, all of them, very kind”, “They not only manage the needs of their residents with care and respect, they engage with them, having jokes and stopping to have meaningful conversations where possible.”

An external professional told us, “The staff are attentive, caring, and treat residents with dignity and respect.”

We also observed some kind and attentive interactions between staff and people. When people were being hoisted, staff talked through each step of the process. Staff would compliment people on their appearance and there was an overall sense that positive relationships had formed between staff and people.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

We observed the majority of people were given 2 handed plastic mugs and it was not clear from the care plans that these were all required. This infantilises people, removing their autonomy, treating them as a group rather than individuals. We also noted that all people in larger wheelchairs were all taken to a separate dining room. This indicated people were moved there as this was convenient for staff rather than considering people’s autonomy, dignity, and inclusivity.

Staff were not always considering the needs of people living with dementia in relation to person-centred activities. We observed a puzzle being placed in front a person who was not taking any interest in this. Staff kept going over to the person to encourage them however it was clear this was not engaging for the person. Another person was given a crossword and again the person was not able to engage in this activity. One external professional fed back, “If I were to suggest any improvements, it would be to continue enhancing activity variety.”

However, there were people and relatives about the activities provided in the service. Comments included, “[Family member] loves the ball games and there is often live entertainment”, “The home produces a weekly list of afternoon activities, such as a visiting singer, a quiz, or a physiotherapy session”, “The care staff make sure they engage [family member] in appropriate activities, for instance massaging her hands with creams and organising for her to listen to her favourite music through headphones and she always enjoys the guest singers that regularly attend.” One person who was partially sighted was also supported to have audio books so they could listen to their favourite stories.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

We found instances where people were not always being supported with their independence. There was a blanket approach by staff who were offering to wipes people’s mouths rather than offering the wipe to the person for them to do it themselves. One person told us, “I do have choice but losing your independence, I get frustrated. I like to go to bed before supper, I only have a sandwich, but it doesn’t always happen.”

People’s choices around care were not always accommodated. Where people were asked if they preferred a male or female carer to assist with personal care, this was not always accommodated. According to their care plan, 1 person preferred to have a female carer however, their care notes reflected at times they were having male carers assisting them. Another person told us, “I wasn’t asked who I prefer [male or female]. Interestingly, I find the men much gentler than the women. The women do it quickly to get it done.”

People told us they were not always given the option to leave the service for activities. One told us, “The other home I was in the carers made suggestions like, would you like to go on a trip to Bird World, they don’t do that here…. My only exercise is walking a little bit. I’d like to go on trips. I go in the garden, but I have to be with someone”. Another person told us, “I’m limited with my mobility, so I come [to the lounge] for 3 or 4 hours and I find it dull. It will be good when it’s summer and we can get outside”. The registered manager told us that trips outside of the service only occurred in the Summer and that they could arrange for individual outings for people. However, there was a lack of evidence that this took place.

However, other people felt very supported with their independence and were able to make choices. Comments included, “I choose my own clothes, they are washed, put in the wardrobe and I help myself”, “I’m pretty able at the moment, I’m independent, too much I’m told sometimes. I make choices, I’m up early. A relative fed back, “The Chef, has always served excellent food and that even anyone who is visiting is welcome to join the meals with their loved ones.”

The provider did not always ensure that staff listened to and understood people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

We found where people were sitting in the main lounge watching television, the room was also being used frequently as a walkthrough by staff to get to the medicine’s rooms. Each time staff walked past people they were blocking view of the television.

During the inspection, we observed a person ask a member of staff if they could help them change their jumper as they had spilled tea on it. The member of staff alerted a senior member of staff who said they would ask a member of staff to support the person. A member of staff did come back with a clean jumper but then assisted the person to the dining table and told them they would help them with this later leaving them in their stained jumper.

We observed that 1 person’s room was just outside of the area where they told us staff would discuss the handover at the end of a shift. They told us, “The only problem I have is the noise, this room is very noisy, carers chatting, handover is extremely noisy”.

However, we also saw instances where staff did respond to people. This included 1 member of staff reminding people to be cautious when sipping their hot drinks. We did see staff speaking with people and ensuring people received the support they needed. In the afternoon a member of staff came through with a person who was upset. We heard the member of staff say, “Now don’t forget, I am your best friend. If you ever want to cry you come and see me. Don’t cry, you’ll spoil your makeup.” They sat comforting the person and bringing them tissues.

One relative fed back, “[Family member] very much enjoys the delicious, homemade meals, and lit up recently when [chef] produced a chocolate cake to celebrate her Birthday.”

The provider did not always promote the wellbeing of their staff.

We noted from rotas that staff were at times undertaking a night shift and then required to do 3-4 hours training during the day immediately following this. Expecting staff to attend training immediately after a night shift can impair learning and can negatively impact staff well-being.

We also noted from the minutes of a meeting that staff had raised concerns that, due to the length of time morning personal care can take, at times they missed their break. However, it was recorded that the member of senior staff responded, ‘If you miss your morning break it is up to yourselves to prioritise your time well, so you do not miss it. …If you miss your break that does not mean that you can take it later.” The was no action recorded from this concern and continued inability to take breaks can lead to emotional strain for staff.

However, staff did feedback that they felt very supported by the leadership team. Comments included, “I had worked in various care homes around the area, I like it here. [Registered manager] knows me well” and “I am okay and I am supported by the senior carers. They help.”