Arncliffe 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 requires improvement. At this assessment the rating has changed to inadequate

This meant people’s needs were not met.

This service scored 36 (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 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.

For example, we found people’s care was not always planned or delivered in a way which met their individual needs and preferences. Some people relied on staff to help meet their needs, but they were not always supported to use communal areas or take part in social activities. This placed them at increased risk of social isolation.

A relative told us, “[Name] has dementia and if she eats in her room, she washes her dishes in the sink which is continually blocked as [Name] puts her food in it. We’ve asked she eats in the dining room, then they [Staff] know what [Name] has eaten. This has not happened.”

We found some people were not receiving care that reflected their personal wishes and goals. One person told us they would like more clothing, while another expressed a wish to visit a relative in another care home. These preferences had not been reflected in care plans or acted upon. needs. However, some people told us staff listen to their needs and provide the necessary support when needed.

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.

For example, we identified the need for improvement in the accuracy of care records and the effective sharing of information between staff to ensure care was consistently coordinated. In addition, stronger managerial oversight was required to ensure systems and processes were applied consistently and effectively across the service.

However, systems and processes were in place to support people in accessing healthcare professionals when required. Staff demonstrated an understanding of people’s diverse needs and made efforts to seek appropriate support from external healthcare services. For example, staff worked with district nurses to provide support with people’s clinical needs, such as wound care.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

For example, we found that staff did not always follow guidance to make information easy for people to understand, in line with the Accessible Information Standard. In some cases, staff had not adapted their communication approaches to meet the needs of people living with dementia. Menu choices were not available in an accessible format reducing people’s ability to choose meals independently.

Additionally, people did not always have access to information about their care and support. There was no evidence of people having access to their care plans or having been involved in formulating and reviewing them.

However, we observed examples where staff provided information and choices in ways which were adapted to people’s needs, demonstrating some awareness of the importance of communication. For example, staff uses simple language, gestures and objects of reference when communicating with people.

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 always involve people in decisions about their care or tell them what had changed as a result.

Complaints were not always managed effectively. For example, one person told us, “I really don’t like it when they come and check on me in the night. There’s a bar code on the wall and they have to put the light on to be able to scan it. It wakes me up. The others don’t like it either, I’m not happy about it and I’ve said but they haven’t done anything about it.”

There was limited evidence people, or their relatives had been involved in reviewing their care. Many people and relatives told us they had not seen their care plans, meaning they were not fully engaged in decisions about care and support.

We raised this with the management team who told us moving forward, they would take steps to address and improve these areas. such as recording people and their relatives views and involvement in care planning and reviews.

People and their relatives told us they could raise concerns. A relative told us, “When I raise concerns, they act on it and keep me updated. I have no problem raising any issue with staff as I know they will listen.”

The provider did not always make sure people could access the care, support and treatment they needed when they needed it.

For example, while care plans were reviewed. they were not consistently developed in partnership with people and their relatives and were not always being followed in practice by staff.

People provided mixed feedback regarding access to the garden areas and opportunities to leave the home with staff support for shopping or other activities. Some people indicated limitations were due to staff availability.

Not everyone had access to call bells where required, which limited their ability to request support and reduced their safety and independence.

However, people confirmed they had access to healthcare professionals, such as GPs and district nurses, and referrals were made when required to support their health needs.

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

For example, we could not be assured outcomes for people were being effectively monitored and met. This was because people had not been consistently involved in reviewing their care, and we found several examples where care plans contained contradictory information. Although some care records demonstrated consideration to people such as mobility needs or the impact mental health on communication, staff did not always follow this guidance in practice.

People were not consistently supported to access meaningful activities. Although activities were provided, they were not always tailored to people’s interests or preferences.

People shared mixed feedback about activities. Their comments included, “I like it here. We have a gab together me and these 2 ladies. They get us what we need and they’re not in our faces. We just need more going on” and “Since I came here which is ages now, I have asked for a newspaper like the Daily Mail. They said this would be arranged, but I am still waiting.”

Although activities were being facilitated within the service, these did not meet everyone’s needs. We raised this with the provider who confirmed additional activity coordinators would be employed for each unit to improve activity provision and engagement. We raised the specific concern regarding access to a daily newspaper, and the provider advised this would be arranged to meet the individual’s request.

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.

For example, although care plans included information relating to end-of-life care, such as the presence of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and the location of associated documentation, we found some plans lacked sufficient detail and clarity. Specifically, they did not consistently include comprehensive information about people’s wishes, preferences, or expectations for how they wished to be supported at the end of their lives. This lack of personalised detail limited staff’s ability to provide person-centred care and increased the risk people’s dignity, comfort, and cultural or spiritual needs may not be fully respected.

Furthermore, the absence of advance care planning and a lack of forward planning meant important decisions regarding treatment and support may not have been clearly understood or met. However, some people’s plans did identify their relatives as the people to consult at the end of life, and this was clearly recorded in their care plans.