Aaron Court Care Home

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 the provider met people’s needs. At our last assessment we rated this key question as good. At this assessment the rating has changed to inadequate.  This meant services were not planned or delivered in a way that met people’s needs. We identified a breach of the legal regulation in relation to person-centred care. People’s care and support was not always in line with their choices and preferences. People and their relatives were not routinely included in the planning of their care. Care was task driven and we did not always see staff responding in a person-centred way. We observed staff missed opportunities to support people when they needed help. People and their relatives told us they did not always feel ableto raise concerns, and when they had they had not received a satisfactory response and sometimes received no response at all from the registered manager. Staff did not consistently recognise or respond to signs of distress or attempts at communication, which indicated a lack of meaningful engagement and respect for people’s' emotional and social needs. The processes in place did not ensure people had the best outcomes and were supported to lead healthier lives. We saw people’s care records contained contradictory information about their needs and risks which increased the risk of inappropriate care being provided.

This service scored 32 (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 make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Care was not consistently personalised or responsive to people’s individual needs. We identified care plans often lacked critical detail, such as accurate diagnoses, equipment use, and meaningful personal information. Care plans often contained outdated or inaccurate information. For example, one person’s care plan noted a significant health risk despite the concern no longer being current. We saw in another person’s care plan, there was incorrect documentation about pressure damage. Our observations revealed people’s preferences were frequently ignored when expressed. We observed numerous instances where choices about food and drink were disregarded despite clear expressions of preference. For example, cottage pie was served to people for their evening meal and one person stated they, "Did not like cottage pie.” Staff initially made no effort to offer the available sandwiches on view, doing so only after we intervened. One person’s care plan stated they preferred to have a bath to wash. However, a review of their personal care records showed they had received just one bath in the last month indicating preferences were documented but not acted upon. While some staff described their role in respectful, personalised terms, for example, “Providing care that is individual-based and has the best interests and wishes of the person at the forefront,” others were unable to articulate what person-centred care meant beyond referencing care plans. Staff described barriers to person-centred care, for example, one staff member told us, "There is definitely not enough time to talk and listen to people." Staff told us their concerns about care plan accuracy, for example, one staff member said, "They [care plans] are not accurate." One person told us, “They do try to get to know what I like, it’s just not always followed through.” Relatives told us they had to repeatedly highlight changes in needs before action was taken, with one stating, “They only listen when I push.” These failures demonstrated a breach of the legal regulation person-centred care.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Continuity of staffing was problematic, with relatives reporting, "Staffing levels a problem," “The whole floor is run on agency staff,” and "The turnover of staff is ridiculous, I don't know who anyone is.” Leaders acknowledged the high use of agency staff impacted care continuity. One member of staff told us, “At the beginning of every shift, we have handovers from the previous staff, and we have huddles with the nurse in charge before starting shift. When the nurse in charge gets back from the flash meeting if any other changes are needed to be implemented, we are told then.” However, 2 members of agency staff told us they were unfamiliar with peoples' personal histories and care plans and had not been introduced to the people they were supporting. Some staff members told us they did not have enough support from management to understand the needs of people living at Aaron Court. Another relative stated, “Care is not coordinated at all at Aaron Court.”

The provider did not always supply appropriate, accurate and up-to-date information. People did not always have information in different formats. Care plans and records were not captured in ways that met people’s requirements for meaningful communication and decision-making. Care plans detailed people’s individual communication needs, aids such as glasses or hearing aids, but lacked clarity on how staff should support people with these requirements.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result. The involvement of people and/or their family in making care decisions was inconsistent. Some people and families reported good involvement whilst others reported their involvement was limited and not encouraged by staff or the registered manager. The frequency of resident and relatives’ meetings was variable. A relative told us, "There was a family, friends and residents meeting in May 2024, but nothing since." Communication about care was frequently described by relatives as inadequate. Comments included, “Communication is poor. No one discusses anything with us" and "They do not tell us anything. There is a lack of communication between staff." When asked if the provider kept them informed about changes or incidents, relatives gave mixed responses. Comments included, “They do tell us if there is a problem," “The only time I’ve had calls is when ambulance have been called,” and “They haven't made any effort to keep me in the loop."

The provider did not make sure people could access the care, support and treatment they needed when they needed it. Due to inconsistencies in record keeping, incomplete records and lack of checks of care records by management we could not be assured systems were in place to address any barriers to accessing care which people may have faced. This included making timely referrals to other agencies or identifying changes in need. Access to activities appeared inequitable, with relatives reporting less able people had limited opportunities. We observed several people were alone in their rooms with no source of stimulation and no proactive effort by staff to provide interaction or comfort. We saw some people did not have access to a television, music, or activities. One relative said, "I don't feel the people who are less able are included or encouraged to go to participate. I have mentioned this to the manager a few times." One staff member told us, “A lot of residents are kept in bed due to lack of equipment and staff."

Staff and leaders did not listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this. Care experiences varied considerably. We found some people received better care than others. For example, while some people had regular personal care, others were found with unwashed hair, stained clothing, and visible dirt. One person was left waiting for their evening meal until other people had finished their meals, which meant they received a different experience at mealtimes to others. A member of staff told us this was because the person required a modified diet. People’s access to certain areas and facilities in the home was sometimes restricted. For example, a communal toilet was locked during all 4 of our site visits. We discussed this with the new interim home manager on the first occasion, and they told us this would be addressed so people could access this facility. We heard from one person and their relatives how the lack of access to this toilet caused them significant distress, embarrassment, and discomfort. Some staff we spoke with raised concerns about the lack of essential equipment in the home, especially for people living upstairs. One staff member told us they had reported an issue to the registered manager, “A hoist broke 7 weeks ago, yet we are still waiting for it to be fixed.” Another member of staff told us they had requested a shower chair for people to be able to have a shower. They stated, "We have not received one to date. Eight residents on a unit have not had a shower. They are always having a bed bath." One person had been forced to dry themselves after bathing with paper towels, as they had no access to a towel. Two people did not have appropriate access to a bin in their bedroom.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People and relatives were not always consulted with as part of end-of-life care planning. Advance care planning appeared limited, with people and relatives reporting restricted involvement in planning for the future. Comments included, "I have not been asked about anything else to do with [Name] apart from [Do not attempt resuscitation] DNAR" and "No, I have only been asked about DNAR." Another relative said, "No one discusses anything with us. Apart from funeral plans.” Some people had complex needs with progressive health conditions that meant their health was likely to decline. However, staff had little knowledge of what conditions people had to identify the signs of symptoms of health decline or assess whether the person was approaching the end of their life and in need of support. Care planning documentation failed to record assessment and planning to outline the associated needs, risks or required interventions. We could not be assured the provider explored people's wishes for the future.