Aquarius 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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

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.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Some people had risks and needs that had not been fully assessed. For example, one person had advanced dementia, and their care records stated they were at risk of absconding. There was no plan of action, assessment of risk or guidance for care staff to follow to minimise this risk. Although the person had not absconded, the care plan lacked information to mitigate this risk and ensure their safety.

Some people’s care records lacked relevant information to ensure people were safe from the risks posed by other people. People’s care plans and risk assessments contained no information about what actions had been taken following a particular incident.

People were unable to recall being involved in their assessment and care planning processes. One relative told us, “I don’t need to see the care plan; there is a file in her room that tells me what she’s had to eat and what they have helped her with. I am happy with that.” “Another relative told us, “I am heavily involved in his care, and I am invited to review their care plan whenever I feel it is needed. The staff know that I want and need to be involved on a regular basis.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People’s care plans and risk assessments had not been routinely updated to ensure the information remained effective in minimising people’s risks. For example, one person’s care record showed they had received staff intervention due to a choking incident. Staff had given appropriate support, however, the person’s associated risk assessment had not been updated to communicate to all staff to be aware of the incident and current risks.

We observed that people received food and hydration which met their assessed needs. Choices were available and people could have alternative options if they wished.

Kitchen staff, and those responsible for supporting people with their food, had a good understanding of people’s assessed needs in relation to type and texture of food.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People told us the service worked with GPs and other health professionals to meet their needs. One person told us, “Staff get me ready for my visit to the local dentist.” A relative confirmed they were kept informed about changed in their loved one’s needs. They told us, “I see what goes on, and because I know he gets the medical care needed, I rest, because he is safe and happy.”

Staff worked with health professionals such as podiatry and Speech and Language Therapy, to ensure people got the care and support they needed. The management told us, “We have very good liaison with the dementia crisis team, the falls clinic, the GP and the district nurses. We also link in with the palliative care service, the community mental health team and the tissue viability nurses as required. For example, the district nurses visit us twice a day for all insulin and wound care.”

Staff told us, “Opticians and podiatry visit us, and the district nurses come twice a day. We book transport and provide an escort for people to attend hospital appointments unless their family wants to take them.”

A health care professional told us, “Staff use external services appropriately. They are aware of the services available and when and who to contact.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People told us they were supported with their health care. One person told us, “I can see the nurse or the doctor whenever it’s required.”

Staff had a good understanding of meeting people’s changing needs. One staff member explained about a person’s diabetes, the support they offered to help them manage this health condition, and when they would escalate any concerns and who to. People living in the service had access to other health care professionals, such as GPs, dieticians and specialist nurses. Staff were confident working with other health care professionals.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The management team were not always able to evidence how they had monitored and improved outcomes for people. This was because not all interventions had been recorded, and information about people’s care needs was kept in several different places in the electronic record and in paper records, which staff took time to locate. People received support from staff when health clinicians assessed their health needs. “One health care professional told us, “Staff are involved in the care provided and follow our instructions.” Staff told us they had training and support to people’s care and health needs.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Although staff had completed Mental Capacity Act (MCA) training there was an inconsistent approach to assessing people’s mental capacity. Mental capacity assessments, where needed, were not present in all the care plans we viewed. For example, one person who required a lap belt did not have the lawful authorisation in place for this restriction. The management team had started to address this; however, it remained a shortfall at the time of the inspection visit.

We observed staff consulting people about their wishes and well-being. People told us they chose their outfits, what they wanted to eat and drink and what activities they wanted to do.

Staff told us, “If someone doesn’t want to eat when it’s mealtime, we take it away, offer something else, and offer alternatives later. We ask kitchen staff to prepare whatever the person wants, and this is documented onto the system. There are always a range of choices.”