Aarons Specialist Unit

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

At our last assessment to the service in March 2023, conditions relating to Deprivation of Liberty Safeguard [DoLS] authorisations were not being met. The provider had not taken action to meet the required conditions of DoLS authorisations. This was a breach of Regulation 11 [Need for consent] of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. Although some improvements were still required, enough improvement had been made at this assessment and the provider no longer remained in breach of this regulation. People’s needs were assessed prior to their admission to the service. People supported to eat and drink enough. The service worked collaboratively across services to meet people’s needs. We found the service was not always working within the principles of the Mental Capacity Act 2005.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives we spoke to felt involved in the planning of their family member’s care and support needs and confirmed they had participated in this process. A relative told us, “The home visited X previous placement and I was involved and kept in the loop during the whole admission process. I felt I was able to ask any questions throughout.”

Staff were confident that people’s individual needs had been suitably assessed and recorded. A member of staff told us that senior staff wrote the care plans and completed any updates. They told us about the documentation, “I think they are quite good, but I am not sure how often they are updated.” The member of staff implied that not all people’s care plans were as up to date as they should be, particularly as people’s needs changed but suggested this did not impact on the delivery of care and support provided by staff.

People’s needs were assessed prior to their admission to the service. The assessment helped the management team assess and determine if the person's needs could be met and if the environment was suitable for them. Information gathered was used to inform the person’s care plan and associated risk assessments. People’s protected characteristics under the Equalities Act 2010, such as age, disability, religion, and ethnicity were identified as part of their need’s assessment. Staff knew about people’s individual characteristics.

People indicated to us both verbally and through non-verbal cues that they were happy with the care and support provided by staff, and that staff were responsive to their needs. People told us staff were kind and caring. People told us they had enough to eat and drink at the service. Relatives were mostly positive about the service. Comments included, “They [Aarons Specialist Unit] know X quite well. The majority of the time and on the whole, they know X needs” and, “This is where X needs to be, it is absolutely amazing. On day 1, I felt it was my second home. The staff show X so much kindness and care.” A relative told us they had found the dining experience for their family member was very positive.

Most staff were able to demonstrate a good understanding and knowledge of how people using the service should be supported. However, staff’s practice did not always evidence this. For example, a person’s care plan recorded specific information relating to how staff should support the person to maintain a safe environment. Staff did not routinely follow the person’s care plan.

People's care plans and risk assessments were personalised to the individual. Records demonstrated people’s needs were reviewed to ensure their support plans continued to reflect their needs.

Information demonstrated the service worked with others, for example, the Local Authority, healthcare professionals and services to support care provision.

Relatives confirmed staff were responsive to their family member’s healthcare needs. However, relative’s comments relating to being kept informed of their family member’s healthcare needs and the outcome of any healthcare appointments were variable. A relative told us, “Sometimes we are, and sometimes we are not” and stated that as a family, “We do all the chasing” relating to enquiring about GP appointments and outcomes. They further stated, “Communication could always be better.” Another relative told us that the management team and staff readily provided information to them, and they had no concerns about communication.

Staff told us people’s health and wellbeing needs were assessed and met and that people had access to a variety of healthcare professionals and services as needed.

The service worked effectively within and across different organisations to deliver effective care, support, and treatment. People were supported to access appropriate healthcare services and support as needed.

People indicated to us both verbally and through non-verbal cues that they experienced positive outcomes. A person when asked if they were happy living at Aarons Specialist Unit, told us, “Ooh yeah” and that staff were kind to them. Another person when asked the same question replied, “I am happy, and staff are nice.”

People's care was assessed using nationally recognised tools and staff used monitoring means to monitor people’s care and support throughout the day.

During the assessment we observed a person having their freedom to mobilise within the service restricted by staff who were providing 1 to 1 support. This action by staff significantly limited the person’s ability to have some control over their life and their independence. People were not routinely given a choice of drinks by staff during the day.

Not all staff had received training in the Mental Capacity Act 2005 [MCA] or were able to demonstrate a good understanding of the principles. Although staff were able to tell us about how they made sure people were involved in decisions about their care, this did not routinely happen in practice as detailed under ‘people’s experience’.

The Mental Capacity Act 2005 [MCA] provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards [DoLS]. We found the service was not always working within the principles of the MCA as staff were observed to place disproportionate restrictions on a person using the service when they mobilised. There was no MCA for a person who wore a handling belt when mobilising. This equipment was used to provide staff with a supportive means of getting close to the person and enabling safe assistance. Following our assessment the registered manager completed and forwarded a MCA form for the use of the handling belt. Appropriate legal authorisations were in place to deprive a person of their liberty. Conditions imposed relating to DoLS authorisations were being met. For example, those relating to a review of a person’s medicines and their 1 to 1 support to be conducted.