Aaron Grange Care Home

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 inspection we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (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 make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Assessments captured key information about mobility, nutrition, health conditions and risks, and there was some good detail in areas. Staff demonstrated they knew people well, and we saw appropriate use of tools such as those used for assessing malnutrition and pressure risks.

However, assessments were not always updated or aligned. We found a number of risk assessments and care plans needing review, which meant staff did not always have clear or current information to follow.

People told us staff understood their needs and supported them well, and staff provided examples of adapting care based on day-to-day changes. While the provider had started work to strengthen assessment quality, further improvement was required to ensure all assessments were consistently person centred, up to date, and comprehensive.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

While some plans contained detailed instructions, such as clear hoist and sling guidance for people with complex mobility needs, some others lacked the information needed for staff to consistently deliver safe and effective care.

Some monitoring records showed missed blood sugar monitoring, inconsistent completion of food and fluid charts, and unclear food fortification or dietary instructions. Some pressure care plans lacked required clinical direction, for example stating only “staff to manage” without clearly describing the required treatment for a pressure sore.

People were receiving good care based on our observations, and staff were knowledgeable, but the gaps and inconsistencies in documentation meant the provider could not evidence that care consistently followed best practice.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Recordings showed appropriate involvement of external professionals including the dietician, district nurses, GPs, community mental health teams and other multi-disciplinary teams. This was evident where behaviours were reviewed jointly by staff and other professionals or where people with complex needs had multi-disciplinary oversight.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider supported people to access healthcare, and referrals to GPs, district nurses and dieticians were evident. Staff understood the importance of nutrition and hydration, and people told us they were offered alternatives if they did not want the main meal. Observations showed positive mealtime interactions.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Tools such as those used to assess malnutrition or pressure risks were in place and usually up to date, but associated actions were not always completed or recorded. Several care records showed contradictions. For example, care plans stating weekly weights while records showed monthly weights, or diabetes plans lacking evidence of required monitoring.

Outcome related documentation such as food charts, repositioning charts, and blood sugar monitoring records were incomplete for some people. These gaps meant the provider could not be assured that planned interventions were being carried out or that people’s progress (or deterioration) was being recognised promptly. We fed this back and the provider has already begun to take action to address this and has since updated us with their progress.

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 sought consent from people in day-to-day interactions, and we observed staff asking before providing care or support. Staff were knowledgeable about capacity and consent, and the clinical lead demonstrated clear understanding of the Mental Capacity Act.

However, care plans did not consistently record how people consented, the communication methods they used, or which decisions they had capacity to make. For people who lacked capacity in certain areas but not others, we could not be assured decisions were always made in line with individual ability and best interest processes.

Where capacity assessments and consent information were present, they were not always complete or decision specific. The provider had identified this issue prior to inspection and had started updating plans.