Aria Court

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We observed staff being respectful and treating people with kindness and dignity. Staff could give examples of how they support people to make choices. People we spoke to commented that staff are ‘lovely’ and ‘great’. However, we observed missed opportunities for staff to reassure and engage with people.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The majority of people and their relatives were happy that they were safe and staff were pleasant. One relative told us ‘we’re very happy with the care. The staff are lovely, (family member) might not remember their names but recognises their faces, this is their happy place now’. One person said that all the staff were good and that when agency staff were used they seemed to be the same ones so they did have some knowledge of them.

The new manager in place discussed the importance of being a presence in the home and getting to know people. Staff told us that when they support people with their personal care that they close the door and curtains, let the person know what they are going to be doing, ask for consent every step of the way, involve them and make sure the person can tell them what what they prefer and are at the centre of their care. Staff said that they know people well and respect their confidentiality. Staff commented though that they don't have enough time to spend with people. One staff member said that they can be stretched and it would 'be good to have more personal time.' Another said that when people become distressed they have no time to reassure them and talk to them.

We received no concerns from partners and a review of the home carried out by the Local Authority completed in February 2024 provided positive feedback stating that staff are attentive and engaging.

During the visit we observed staff interacting well with people and staff in the activities team were chatting to people, holding their hands, laughing, singing. We observed staff talking people through every step when supporting them with moving and positioning. However, there were times when staff could have interacted more with people. When a staff member identified someone needed repositioning they took away their food without explaining why. When a member of staff was supporting someone with eating they didn't interact with them and at times drinks were placed in front of people without any interaction. We also observed staff talking more with residents who were more engaging and one staff member appeared to be frustrated with someone who was upset. However they did approach a senior member of staff who was able to reassure the person in a warm and caring manner.

One relative told us that they were happy that staff know their family member well enough to be able to make meal choices on their behalf. However they said that 'they are not able to communicate but would benefit from being with others’.

The Manager told us that they have good relationships with community groups including the local church, dementia charities, the local nursery and local library. She talked about reminiscence sessions with people. The chef told us how they engage with people to ensure that they take into account people's wishes. They told us about a finger friendly menu for people living with dementia, alternative foods for different conditions including people with diabetes or who need gluten free meals. The chef ensured people who needed modified and fortified diets still had their favourite options. The activities team told us that the management put on big events to mark cultural celebrations which people really appreciate.

During the visit we observed staff engaging with people about their cultures including their music interests and family.

During the visit we observed the system used by staff to upload photos and write about what people are doing. This is accessed by family and friends who can respond and add their own updates. We observed pictures of people attending a church service and enjoying live entertainment. Some care plans we observed included lots of information about a person's background, family, life history, hobbies, likes, dislikes and preferences. However, others contained minimal information and unhelpful, impersonal statements like 'the resident requires staff to recognise his individual level of cognitive ability' and 'the resident would like to be involved in activities to help him maintain or improve his cognitive ability.' One care plan stated that the person 'might like to discuss his care needs but has communication problems, so his family is able to make decisions for him.' However, there is no evidence of how they have tried to involve the person and use different communication methods and the family did not have legal authorisation in place.

People and their relatives told us they had choices of activities and food. One relative told us that they felt that staff knew their family member well enough to make choices on their behalf when they were not able to communicate.

The activities team gave examples of sessions they provide including singing, garden games, animal visits, exercises and quizzes. The local nursery visits once a fortnight and people have been to the cinema, church events and they hold a dementia cafe. They told us In the evening they play dominoes. There is a member of staff that also does gardening with residents. Staff told us that there are not enough activities. They said that 'a lot of people with dementia do get left, I wish there was more for people in bigger wheelchairs to do, restricted to stay in the home and even if not verbal they can't participate, sometimes only 2 activities done a day and not enough'. They told us activities are 'sometimes really childish'. They said that for people who stay in their rooms sometimes activities staff will do reading. Staff said that it is the 'same residents going out which isn't fair, always same people that go'. They said that 'some people have bigger recliner chairs or wheelchairs so can't go out and some are so social.' Another member of staff told us that they didn't feel people or care staff were asked what activities they would like to do and didn't feel activities provided stimulation. Staff raised concerns that due to lack of staff they are unable to support people with a shower or bath at the time they would like it.

During the visit we saw a board in reception with the activity timetable which shows daily morning and afternoon activities. We observed an activity taking place on one of the units where music was being played and staff were singing and dancing with people. People were enjoying the activity and engaging well. There is an activities room and the garden is well utilised and people were enjoying being outside. There is evidence of games and books available and a snooker table on one unit. During the visit we saw friends and family visiting people during the day with no restrictions and enjoying the cafe area. Specialist and adaptive equipment was seen including bath lifts, profiling beds, recliner chairs.

There was a lack of evidence of personalised activities for those with dementia. There was also a lack of evidence of 1:1 activities for people who spend most of their time in their rooms. The activity timetable is not specific to each unit and the rotas show there are between 2 and 4 members of the activity team working daily. The home uses technology to help people communicate with their relatives including an app where they can send and receive pictures and comments. Care plans often contain generic statements relating to people maintaining their independence. Care plans include observations which often focus on what the person cannot do and not what they can. Care plans have statements relating to people being unable to make their own choices but no guidance as to how to involve them in decision making. There is a lack of information in care plans about the activities that the person would enjoy at the home. Care plans refer to family and friends throughout. Sexual needs are considered in care plans.

One relative told us that the home identified a potential risk for their family member immediately and made them aware. One person told us that they believed staff would call the right people if they had concerns. One relative told us that staff are 'responsive to illness' and gave an example of their family member having breathing problems and it being acted on quickly. Another person told us 'they are quick to pick up on chest infections and get the doctor in.' However, another relative told us 'depending on which nurse is on duty, dispensing of ad-hoc pain relief can be delayed by up to two hours.'

The activities team told us that if required they will answer a call bell. Staff told us 'most of the time call bells do get answered and with an emergency' but they said it 'might be a struggle to get there immediately.' Staff told us that if someone had a fall they would ring the emergency bell. The Manager said that she completes call bell monitoring.

During the visit we did not hear call bells ringing for long periods or consistently sounding. However, we did hear people calling out for support and not being responded to. We observed some staff not able to communicate with people effectively to comfort people.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.