Aaron Court Care Home

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 the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant people were not treated with compassion and there were instances where people’s right to privacy, dignity and compassionate care was compromised.  We found the provider was in breach of the legal regulation in relation to dignity and respect. Confidential information was observed left out in a communal area, breaching people’s right to confidentiality. Mealtimes were observed to be task based with minimal interactions from staff. People’s needs were not always met in a timely way. People were not always given choices. Staff explained how they maintained people’s dignity, but this was not always people’s experience.

This service scored 35 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect. We observed individual moments of warmth and dignity-promoting practice, such as when a member of agency staff responded patiently to a person who had expressed worry about being a burden, and when another agency staff member offered respectful personal care. Some staff clearly knew people well and people felt comfortable chatting and laughing with them. Some staff demonstrated good understanding of dignity principles. For example, one member of staff said, "I talk to them like my parents with respect. I close the door and the curtain when I change them, so they don't feel uncomfortable.” Staff we spoke with often described promoting dignity through choice and explanation, for example, “I always explain before I do anything, such as what would you like to wear today?” and “Every person has their privacy looked after. I explain what I am going to do and understand how they are feeling and ask their permission. We need to be friendly.” However, we found staff were task focussed, carrying out daily routines without engaging in meaningful conversation with people, prioritising tasks over dignified interactions. One staff member commented, “Sometimes I don't feel we have given people the correct care we should have, as there is so little staff.” We observed people left without meaningful interaction, stimulation, or emotional support. Personal care was not always maintained, and several people appeared unkempt. We observed one person remained in soiled clothing after receiving personal care. Staff were often disengaged, failing to offer choices or provide support in a respectful manner. Relatives told us about their concerns about maintaining people’s personal hygiene. For example, one relative told us, "I find [Name] with dirty fingernails, unwashed hair, and clothing covered in stains.” Another relative said, “I found [Name] with dried mucus on their face.” We observed personal items broken and discarded under beds, and confidential documents left accessible in communal areas. This failure to ensure people experienced kind, considerate and respectful care was a breach of the legal regulation dignity and respect.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met their needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. While some staff demonstrated good person-centred care, others did not. Care plans contained an ‘About Me’ section, however, this information was often incomplete, which meant staff lacked important information about the person, their wishes and preferences. Some people’s bedrooms were not personalised with the things that were important to them. One person told us "It does not feel like my room. It's like staying in hospital. I miss my things.” Some people felt staff did not know them very well. Comments included, “The staff can be a bit iffy. They don't really know me.” On one occasion we found a person walking around the home who appeared confused and was visibly distressed. They told us, “I'm not sure where I am.” We asked agency staff members on duty if they could help the person, but none of the staff we asked knew the person. We observed the person had written their own name on a piece of paper they found and had tried to stick it to their bedroom door, so staff knew which bedroom was theirs. We found another person had a QR code on their bedroom door which referred to another person. Agency staff we spoke with told us they had not received an induction before being asked to support people. Some staff told us, the staff members who write people’s care plans do not know the people at all.

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. People were not routinely involved in decisions about their care. Some staff demonstrated good understanding of supporting independence and choice. One staff member explained they, “Ensure all the residents within the home have choice, choice of food, clothing, activities, or if they would like to do something." Another member staff told us, “I promote them to remain independent, even if that means doing an activity for much longer.” However, our observations did not confirm these principles were applied in practice. Personal preferences were frequently disregarded. We observed people were not offered a choice of their preferred snack during the morning time, despite there being 3 options available. At lunch time, people were given lemon juice to drink. Some people expressed they did not like lemon juice, however, a member of staff told them there was no other options. A relative told us, "[Name] is not supported to have choice and control over their day-to-day life.” Another relative said, “[Name] is essentially confined to a chair in their room with no meaningful interaction, stimulation, or activity." One person told us the registered manager had said to them they could not have a radio or clock in their own bedroom. The person’s relative told us they had asked the registered manager for these items; however, they had also been told by the registered manager this would not be possible.

The provider did not always listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. We observed two occasions when a person asked for support with their personal care but their requests for support were not acknowledged or responded to by staff, until we prompted them to do so. Some bedrooms were uncomfortably cold, and one person was wearing a coat in bed to stay warm. No action had been taken to ensure this person’s immediate needs were met. We observed people who needed support to eat, and drink were left unsupported. One person’s food had fallen onto the floor, and we observed them struggling to find their food. Despite this they received no help from staff and their empty plate was cleared away. Another person was trying to eat their soup in their room. However, it had been placed too far away for them to reach properly, and they were spilling it on the floor. We saw several people had a drink in their room, but the drink was placed out of their reach. We observed 2 people who showed clear signs of emotional distress, including tearfulness and told us they were feeling sad. At the time, all staff were observed to be task focussed, carrying out daily routines without engaging in meaningful conversation with people, indicating limited attention to emotional needs. We observed disrespectful and dismissive communication where staff were abrupt and gave commands such as 'You will need to wait,' or 'You need to sit down,' without understanding individual needs. One person directly told us, "I just want someone to talk to me."

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care. We found concerns about workforce wellbeing and enablement. Multiple staff reported feeling let down by management. One staff member said they felt they were, "Not liked [by management] due to speaking up.” Staff described a lack of developmental opportunities and low confidence in the competence of some colleagues. One member of staff told us, “For me personally, I have always found them [registered manager] approachable and fair.” However, most staff told us they felt unsupported and lacked meaningful engagement or guidance in their roles from the registered manager. One staff member said, “The manager doesn't encourage staff development” and another stated, “Some staff are not competent. I am expected to work out of my remit.” Staff supervision records were repetitive and generic. Staff reported variable supervision experiences ranging from ‘Twice in 6 months’ to ‘None at all’ to ‘1 [supervision in 12 months]’. When staff were asked if there was trust between staff and leaders, responses were predominantly negative. For example, “The manager wouldn't act on issues raised" and "No but I find this is more between care staff and nurses over management." Staffing levels appeared to contribute to wellbeing concerns, with one staff member saying, "We are short staffed. We need eyes in the back of our heads." One staff member reported, "Staff become upset when they are unable to provide high standards of care due to feeling overwhelmed with the workload and being understaffed or not having the resources required to provide high standards of care." Some staff reported recent improvements in management support. For example, one staff member said, "We weren't encouraged to speak up, but we are more so now due to a recent change in the management structure."