Aran Court Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We found the provider had failed to operate effective governance systems to enable them to assess, monitor and improve the quality of care for service users. There was a lack of effective analysis of accidents and incidents and complaints, which would identify any potential trends and areas for action to ensure the safety of people living at the service. The provider’s policies and procedures were not being consistently followed when responding to complaints, accidents and incidents and DoLS which meant the provider did not have effective and robust oversight of the service. This was a breach of Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The arrival of a new management team at the service was positively welcomed by people, relatives and staff alike. However, it was of concern that 2 members of the management team left the service during the assessment process. We were advised actions were being taken to recruit into those positions as soon as possible. Staff reported morale had improved and they were being given the opportunity to raise any concerns they may have and have their voice heard. Staff continued to work well with other healthcare professionals in order to meet people’s healthcare needs. Both staff and people’s views of the service were being sought to obtain feedback on the service in order to drive improvement. The management team took on board the feedback provided during the assessment process and committed to putting actions in place to address the concerns raised.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff reported that following the departure of the last manager in December 2023, the service had suffered and they had to deal with a variety of managers, all of whom had different expectations. Staff reported since the arrival of the new management team, including the manager and deputy manager, things had improved at Aran Court and the service felt more stable. In light of this, it was disappointing to learn that 2 members of the management team have left the service during the assessment process. The majority of staff spoke positively about the changes and improvements in morale; however, not every member of staff had this experience. All staff did speak highly of their peers and colleagues and the supportive nature of the people they worked with. It was evident from our observations that staff worked well together, on each floor, and were supportive of each other.

Supervision processes were now in place and staff informed us they had recently had supervision meetings with the manager. We saw that staff meetings and surveys were also in place and had gathered some positive feedback from staff.

Staff spoke positively of the senior management team and their visible presence in the home following the departure of the former manager. They felt they could approach the regional manager and they would be listened to. The majority of staff felt they could also approach the manager for support and felt confident the changes being brought in by the new management team would have a positive effect on the service. Staff told us they were relieved things had settled down. The manager told us they felt fully supported by the senior management team and the organisation.

The manager conducted daily ‘walkarounds’ to engage with people and staff. A relatives meeting had been arranged to meet the new manager, but not all relatives were aware of this and others told us they had not been introduced to the new manager yet. Staff told us they could speak to the manager if they needed to raise a concern.

Staff told us they were confident that if they spoke up, they would be listened to, but were unable to provide any examples of when they had done this. Staff told us the manager had made themselves available at a set time on a weekly basis for them to discuss any concerns they may have. Staff confirmed they had been asked to speak up and raise any concerns or bring new ideas to management and, on the whole, felt listened to. A member of staff told us they had spoken to the regional manager regarding some personal issues and had found them to be supportive.

The provider had a whistleblowing and safeguarding policy in place and staff were aware of this. A system had been put in place to allow staff to feedback any concerns anonymously.

Staff told us they understood their roles and responsibilities and allocation systems in place worked well. The manager told us they were still in the process of learning the provider’s systems and processes. The provider had ensured additional management support was put in place to support the manager. Care staff knew people very well. The appointment of the clinical lead was seen as beneficial to the service, but it was disappointing the deputy manager had left after a very short period of time. The manager reported audits had identified poor recording on food charts and action had been taken through a group supervision to ensure staff recorded the necessary information to evidence people’s nutritional needs were being met.

Although the provider had policies and procedures in place, they were not always followed. This included adherence to the provider’s complaints process, accident and incident reporting and oversight of DoLS. The provider’s own audits had not identified areas for action found on assessment, resulting in concerns regarding poor governance and oversight of the service. This included the concerns we found regarding a lack of person-centred information in care plans, such as details of people’s preferences, individualised risk assessments and, in some cases, information about long term health conditions. There was also a lack of evidence to demonstrate people were involved in the assessment and review of their care. As a result, opportunities to respond to accidents and incidents and learn lessons in a timely manner were lost. It was encouraging to see home governance meetings were now taking place and evidence of some analysis of accidents and incidents. However, as effective monitoring and analysis of, and response to, accidents, incidents and complaints was not embedded, the provider could not be confident the quality of the information being discussed was providing them with a full picture of what was happening at the service.

People reported the service worked to access additional services to support their needs.

Staff reported positively on the relationship the service had with other professionals including the tissue viability nurse, Enhanced Assessment Bed co-ordinators and the local GP.

Professional partners were, on the whole, complimentary of the service and how the staff worked well with them and communicated well.

Processes were in place to ensure information was obtained regarding people’s needs prior to them being admitted to the service. However, some people’s care plans lacked information regarding their preferences and how to support them safely and effectively with particular health care needs.

The manager and senior management team reported regular home management meetings were now in place to provide oversight of the service. Analysis of falls had been conducted and any trends identified. However, as some accidents and incidents had not been investigated fully to identify any actions or lessons to be learnt, the provider could not be confident they were in receipt of all the relevant information to assist them in learning from these events and driving improvement across the service. Staff reported their views were now being considered and they were being asked for feedback and potential improvements.

There was no analysis of complaints received for any trends and no oversight of management of the response to complaints. The provider’s policy in relation to accidents and incidents had not been consistently followed. This meant the information being fed into clinical governance meetings was not robust as it did not provide the full picture of what was happening in the service and opportunities to focus on continuous improvement across the service were being lost. All these concerns were fed back to the provider during the assessment process. Assurances were given that actions would be taken to address these concerns and provide effective oversight of the service in order to improve service delivery. People and staff surveys were taking place to obtain feedback on recent changes that had taken place in the home. ‘Residents meetings’, led by the ‘Resident’s Ambassador’ took place on a quarterly basis, but more work was needed to obtain feedback from those people who did not attend these meetings. Systems were being put in place to give staff the opportunity to complete feedback anonymously at any time. The provider had an action plan in place that was being updated and reviewed in response to this assessment.