Arncliffe Court 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 people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate.

The provider was in breach of legal regulation in relation to consent to care.

This service scored 38 (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.

For example, we identified ongoing inconsistencies in the quality and level of detail within people’s care records, as well as in how the provider involved relatives in contributing relevant information. This limited the extent to which care plans were consistently centred around individuals’ needs and preferences. Information was not always recorded from the person’s perspective or aligned with their wishes, meaning records did not reliably reflect their unique requirements.

Although assessments and care plans were completed and reviewed, the lack of meaningful person-centred involvement, alongside inconsistent record-keeping, reduced their overall effectiveness. In addition, some individuals reported they had not seen their care plan or been involved in the review processes. This restricted their ability to make informed decisions about their care and support. However, a relative told us they had been consulted in their loved one’s care plan and made some contributions towards how the care and support was provided.

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

There was a lack of sufficiently detailed and accurate information within care records to clearly reflect individuals’ care and treatment needs. For example, records showed that some nationally recognised assessment tools were used to evaluate people’s needs and risks, such as skin integrity and nutrition; however, these were not always followed in practice. We found that repositioning records were not consistently completed in line with recommendations, which increased the risk of pressure sores. In addition, checks were not routinely carried out to ensure staff were meeting people’s assessed needs and maintaining their skin integrity.

Although regular clinical meetings were held with the multidisciplinary team (MDT), records of identified issues and agreed actions were not consistently maintained. This limited the ability to effectively monitor performance or analyse trends and patterns over time. However, some healthcare professionals we spoke with told us staff know people well and can raise concerns when they feel there is a need to do so.

The provider did not always work well across teams and services to support people.

For example, information about people was not always effectively shared, and we identified ongoing examples where teams did not always work effectively with other healthcare professionals to meet people’s’ needs.

We received information from a relative about a person who had experienced a fall. Staff did not ensure appropriate and ongoing monitoring following the incident, and it was later identified nearly a month later the person had sustained a hip injury. This resulted in a delay in seeking medical attention from relevant healthcare professionals. We raised this with the provider who informed us they learnt from the lesson and implemented better systems to prevent this from happening again.

However, some healthcare professionals told us they worked well with the staff teams.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

For example, some people were not supported to maintain their health and wellbeing. We observed some people remained in their bedroom for the whole day with a lack of any meaningful engagement, to support their wellbeing. There was no evidence of this being people’s choice or of them being offered an alternative. People’s comments included, “Nothing much happens here. We just sit here and watch the TV. There’re other people I talk to here, but nothing happens.”

Support for people to maintain healthier lifestyles, particularly in relation to personal hygiene, was inconsistent. During our first day of our on-site visit, we observed some people’s toothbrushes appeared dry, crusted, or unused, with some items still appearing brand new. In addition, some people did not have access to basic toiletries within their bedrooms to support their personal care needs.

However, we evidenced other professionals were involved in people’s care, including GPs, speech and language therapists (SALTs), chiropodists, and mental health teams.

People told us they had enough to eat and drink and we observed some people being supported to choose their.

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

For example, care plans were not always up to date or sufficiently detailed to reflect people’s current needs, and they were not consistently followed by staff. Daily care records were frequently incomplete and were not effectively monitored by management to track progress or identify when changes were required.

People’s care and support were reviewed as part of the ‘resident of the day’ process; however, there was no evidence these reviews involved the person themselves or their representatives. In addition, many records contained inaccurate or inconsistent information, which undermined the reliability of care planning and oversight.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

For example, consent was not consistently documented within people’s care records in relation to their ongoing care and treatment. Records did not demonstrate people had agreed to the information recorded about their care or to the specific interventions provided.

Although we observed staff seeking verbal consent when delivering care and support, particularly in communal areas, the absence of formal, recorded consent meant there was limited assurance people’s rights, choices, and preferences were consistently respected and upheld.

In addition, some records indicated staff were signing documentation on behalf of individuals. This practice does not align with the provider’s policy or the requirements of the Mental Capacity Act (2005), which stipulates consent must be clearly recorded. Where individuals may lack capacity, providers were required to evidence appropriate involvement of others, such as family members or independent mental capacity advocates, in decision-making processes.

At our last assessment we found concerns with Deprivation of Liberty Safeguards (DoLS) not being submitted in a timely way. We found improvements were still required in this area.