Aran 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

Systems were in place to gather information regarding people’s health and care needs, but care plans and risk assessments did not consistently assess all known needs for people. Staff worked alongside a variety of healthcare professionals to ensure people had access to these services. However, some care records did not hold person-centred information regarding people’s particular healthcare needs which could prevent staff from supporting people safely and effectively. Actions were being taken to review the information held in people’s care records in order to address these concerns. Improvements had recently been made in the quality of food that was provided after people raised concerns. Concerns were raised regarding the information available to staff about people’s dietary needs and immediate actions were taken during the assessment to address these concerns. The provider did not have effective oversight of DoLS which had the potential for unnecessary restrictions being placed on people.

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.

One person reported they had a 'thorough' assessment prior to coming into the service and relatives spoken with confirmed this had been their experience of the assessment of their loved ones’ needs.

Staff told us they were provided with the information they needed when people were admitted to the service and that work was then done to build up a fuller picture of people’s needs. The manager showed us the tools in place used to assess people’s needs and the information received from third parties, such as health professionals, to support this process.

Assessments and care plans did not consistently assess all known needs for people. Information held in some people's records was inconsistent or incomplete and, in some cases, lacked person-centred detail. For example, in 1 person's file, there was no initial assessment and no personal history recorded. In another person’s file, we saw conflicting and incorrect information regarding the person’s oral health care needs.

Most people were happy with the care and support they received and the access they had to other healthcare services such as their GP and physiotherapy services. However, a number of people told us the quality of food had been poor following the departure of the chef and the sous chef earlier in the year. They told us after raising their concerns the food had much improved. One person told us, “I told them that the food is disgusting…. Whoever we have now has done good menus.” Another person said, “The food is excellent. It’s very carefully thought-out diet wise – they make sure you have a good diet.”

Staff in the kitchen, both permanent and agency, raised concerns during the assessment. These concerns related to lack of permanent staff, the need for better equipment, concerns regarding modified food and how this was prepared. Staff also raised concerns regarding notice boards that were introduced in the kitchen and there was some confusion regarding the information they held regarding people’s dietary needs. As the kitchen was supported predominately by agency chefs, the lack of clarity around some people’s nutritional needs was of concern as it placed some people at potential risk of harm.

Processes were in place designed to ensure information was gathered on people’s nutrition and hydration needs when they first came into the service and shared with kitchen staff. However, these were not effective. During the assessment a number of noticeboards were put in place in the kitchen, with the purpose of displaying and making available information regarding people’s specific dietary needs. However, they were not fully completed during the assessment and staff reported the information held on them was factually incorrect and potentially unsafe. This was raised during the assessment and it was noted another chef had been bought into the service to provide staff with additional skills and training. The immediate feedback provided during the onsite assessment was taken on board and assurances given that the lack of clarity around some people's nutritional needs would be immediately addressed.

People confirmed staff supported them to access to healthcare services to meet their needs. People told us they could see their GP if they were unwell and had no concerns regarding accessing healthcare services.

Staff reported positive working relationships within their own teams, across shifts and with other healthcare professionals. The deputy manager described how information was gathered across all floors in order to assess how many people needed to see the local GP during their weekly visit to the service. Staff and the GP all reported this system worked well and meant people were able to see their GP in the comfort of their own home quickly, if required.

A healthcare professional reported they had a good relationship with the service and told us, “They [care staff] are good with wound management, and good at identifying pressure wounds and putting equipment in place.” A weekly ward round was in place with the GP which was overseen by the deputy manager. The GP spoke positively about their interaction with all staff and confirmed the service worked well with them to bring any concerns regarding people’s well-being, to their attention. They told us, “Staff will contact us if people are poorly and are quite good at escalating concerns to the emergency services.”

We found evidence to demonstrate appropriate healthcare services were sourced to meet people's needs. This included referrals to the falls team. Staff shared information regarding people’s needs through handover and arrangements were in place for weekly GP ward rounds and visits from the local tissue viability service.

People told us they were supported to maintain and improve their health and to access healthcare services. A relative told us, “They are proactive in addressing what is wrong with [person].” One person described the improvements in their health following support from physiotherapy exercises.

Staff were aware of the needs of people they supported. Staff shared information at handover to ensure continuity of care. Staff knew when to escalate any concerns they had and to seek input from others to support people with their health needs.

Systems in place to monitor people’s care and treatment and their outcomes were not robust. Care records did not consistently detail person-centred information regarding people's healthcare needs and where accidents and incidents took place action was not taken in a timely manner to ensure lessons were learnt. We saw 1 person's care plan lacked person-centred information in respect of their Parkinson's diagnosis and another person's care plan and risk assessment held conflicting information regarding their falls risk.

People told us they were happy with the care they received and were supported by staff who knew them well. One person told us, “The staff are very friendly. You can have a laugh with them and they treat you right. I feel 100% safe. There always seem to be enough staff and there’s no waiting. That is something that I would notice because I’m unstable on my legs and someone is always there when I need them.”

Staff were aware of people's needs and how to support them accessing and attending medical appointments. Where people had been given physiotherapy exercises to follow, staff supported people to follow these instructions which provided people with the potential to improve their health and well-being.

Risks to people were now being monitored in order to provide the management team with an overview of people's current care needs. Where additional support was identified, it was sought. ‘Resident of the day’ reviews had also commenced with the intention of providing a complete, holistic review of each person. However, a number of areas identified during the assessment had not been highlighted in the management’s monthly governance meetings and further work was required to ensure processes were embedded and effective.

People told us staff obtained their consent prior to supporting them and we observed this. People told us they felt safe and there were no restrictions placed on them. We observed people walk freely throughout the unit without restriction.

Staff had a basic knowledge of consent to care and treatment but were unable to identify those people who had a DoLS authorisation in place. This had the potential for unnecessary restrictions being placed on people. We asked the manager how they could assure themselves that staff were sufficiently knowledgeable in this area and were provided with the necessary tools to understand what it meant for people. The manager told us staff had been given information cards on the subject and it could be covered in team meetings. We were not assured the provider had effective systems in place to ensure staff understood people’s rights under the MCA and DoLS.

Systems and processes in place had not enabled the manager to have effective oversight of DoLS, which had the potential for people to be unlawfully deprived of their liberty or subject to unnecessary restrictions . There was a lack of action and oversight to assess staff competencies, understanding and knowledge in this area. For example, we noted 1 person’s DoLS authorisation was about to expire and no evidence was available to demonstrate it had been reapplied for. For another person, where a best interest decision had been made for sensor and impact mats, there was no information available to demonstrate who had been involved in the assessment or how the person was given a voice.