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 inadequate. 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. The provider was in breach of legal regulation in relation to dignity and respect.

This service scored 45 (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. We saw bathroom doors left open during personal care and staff entering bedrooms without knocking. We observed one person was not properly covered during transfers, and clothing was not adjusted to maintain their modesty. We observed interactions that lacked sensitivity or explanation, where people were moved or had personal items adjusted without being told what was happening. Relatives and professionals told us people’s experience varied depending on staffing levels, staff skills and who was on duty. Some relatives raised concerns about personal hygiene and appearance, saying people were left unclean or unsupported for long periods. Comments included, “Kindness yes, compassion sometimes, dignity no,” and “[Name] looks like a tramp. Nails are always filthy and [Name] smells awful.” Some relatives described upsetting incidents, such as finding a person undressed in a shared area and seeing people shouting for help. Most staff understood how involving people in their care can improve dignity. Some relatives praised staff for being caring and patient. Professional partners told us they sometimes saw compassionate, respectful interactions. We observed staff giving calm explanations, offering comfort and showing patience, including one incident handled with clear kindness. One staff member told us the team was “highly compassionate” when supporting people and families at the end of life. Some people said they felt treated kindly and supported to maintain routines.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics. While there were examples of staff building personal relationships and treating people as individuals, poor record-keeping, communication gaps and inconsistent staff familiarity meant this was not reliable. We found repeated errors in people’s care records, including people being referred to by the wrong name or pronouns, incorrect health conditions being listed, and information copied from other people’s plans that did not apply. Some records included statements about risks or behaviours that were not relevant to the person. Staff could not always rely on care plans to guide them in providing care that reflected each person’s identity, history and preferences. Some people we spoke with said staff knew them. One person said, “I think so, they know me quite well.” Other people said this depended on who was on duty and whether staff were familiar with them. One person said, “There are lots of changes, and you don’t see the night staff once they put you to bed.” Another said, “I know some of them but not others.” Some relatives said people were sometimes treated in a task-focused or general way rather than as individuals. They raised concerns about personal preferences not being followed, such as being offered foods they did not like, clothing being mixed up between people, and personal belongings going missing. One relative described how an important personal event was not recognised because a message sent to the home “never got through.” Some relatives described staff knowing people well and engaging with their interests. They gave examples of staff reading with people, singing with them, or encouraging hobbies and social interaction.

The provider did not consistently promote people’s independence, choice and control over their care, treatment and wellbeing. People did not always experience care that maximised their independence or respected their everyday choices. This led to reduced autonomy in some aspects of daily life, such as where to sit, when to move, and how personal care was provided. There was at times a reliance on staff-led decisions rather than people’s own preferences. While some personal choices and independence were supported, systems did not reliably ensure people’s rights to independence and control were consistently upheld. We observed occasions where people’s movement or choices were limited in everyday situations, which reduced autonomy. We saw some staff and leaders repositioning people or adjusting clothing without first explaining what they were doing. Care records did not consistently show people’s preferences were clearly recorded or followed in practice. Some professional partners said they were unsure whether individual preferences were consistently reflected in day-to-day care. Some relatives said decisions were sometimes made for their loved one, particularly where the person had dementia or found communication difficult. One relative said their family member avoided speaking up because they did not want to “make a fuss.” However, some people told us they were supported to maintain personal routines and independence. One person said, “If I want a lie in, I can tell them.”

The provider did not consistently listen to or understand people’s needs, views and wishes. Staff did not always respond promptly to people’s needs or act to minimise discomfort, concern or distress. People did not always get help quickly when they were in pain, distressed or unwell. We found delays in how staff noticed problems and acted. For example, we observed a person who was crying, appeared unwell and required support, and another person who appeared sweaty with a swollen eye. In both cases, staff did not respond promptly at the time of observation. We heard a person calling out for help for 13 minutes without staff response. One professional partner reported hearing a person repeatedly calling for help and having to intervene before staff responded. Our observations identified inconsistencies in staff responses to people’s immediate needs, including uncertainty in how to assess and respond to changes in people’s condition. People were at times left in communal areas without staff nearby and without access to call bells. Staff did not intervene promptly when one person hit another, and we had to step in to ensure people’s safety. We observed a person who was at high risk of falls left sitting under a hair dryer without supervision. We observed people left alone in shared areas when they were upset, without timely reassurance or support.

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. Although some improvement was starting, systems were not strong or consistent enough to give staff the confidence, stability and professional support they needed to deliver safe, caring and person-centred care every day. Frequent changes in leadership, and limited staff supervision and support affected staff morale and confidence. Some staff told us they felt low, tired and uncertain because managers changed often and the direction of the provider was unclear. Comments included, “We are finding it ridiculous how quickly managers are coming and going. ”Several staff members said they had not had formal supervision for long periods. One member of staff told us, “They [supervisions] were not happening at all.” Others said there had been recent improvement, but this feedback was mixed. The lack of regular supervision and professional support reduced opportunities for staff to talk about their work, manage stress and develop their skills. Leaders told us they wanted to improve how staff were supported, including restarting supervision, being more visible and recognising staff efforts. One leader told us, “We want to ensure a safe space for staff.”