Aarons Specialist Unit

On this page

• 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

At our last assessment to the service in March 2023, we found the provider’s quality assurance arrangements to be ineffective. This was a breach of regulation as the governance arrangements were not robust. 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. Although people told us the service was well managed and led, improvements were required to the service’s quality assurance arrangements as shortfalls identified at this assessment were not routinely identified by the service. Following our assessment the above had been included for action to the service’s Home Action Plan [HAP].

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were positive about the management team and the support they received. Staff were aware of the provider’s ‘core values’ and where this information was recorded.

The registered manager and management team ensured the provider’s shared vision and values was discussed and understood by staff. This was discussed routinely during staff meetings.

Staff told us they felt supported by the registered manager and senior management team. They told us the registered manager and senior management team were visible within the service. Staff told us they found all members of the management team approachable.

The registered manager knew the service well and had a good relationship with staff, people who used the service and their relatives. Relatives were complementary regarding the management of the service. A relative told us that since the appointment of the new registered manager they had seen improvements at the service. They told us, “It [Aaron Specialist Unit] is better than it was, it has improved since X took over, and that is because X has gone to the senior management team to get things sorted.” Another relative told us, “The management team are excellent.”

Staff told us they felt able and confident to raise issues or concerns with the registered manager and senior management team.

Effective arrangements were in place for gathering people’s, relative’s and staff’s views relating to the quality of the service provided and those relating to their employment and what it was like to work at Aaron Specialist Unit. Meetings for people using the service and those acting on their behalf were held at intermittent intervals to enable them to meet and keep in touch with what was happening at the service. Quarterly newsletters were also shared with people using the service and those acting on their behalf to keep them updated with what was happening within the service. Staff meetings were held to give the management team and staff the opportunity to express their views and opinions on the day-to-day running of the service. We reviewed meeting minutes and saw they contained a range of information about the service as well as reminders about ‘freedom to speak up’, medicines management, staff quizzes on work related topics, report writing and documentation, staff interactions and their level of engagement and lessons learned. Staff told us they had a ‘voice’ and felt enabled and able to discuss topics and raise issues of concern.

The registered manager had effective arrangements in place to engage with and involve staff. This referred to seeking staff’s views relating to their employment and staff attending regular meetings on the day-to-day running of the service. Employee of the month was in place to recognise and reward employees for their achievements and contributions to the organisation. Several members of staff had been appointed as a ‘champion’ to implement key strategies and advice and support to staff in key areas.

Staff were positive about working at Aarons Specialist Unit. A member of staff told us, “It’s a good place to work, the job is fulfilling, and the staff are friendly. Colleagues are friendly and moral is not too bad.” The registered manager confirmed that since commencing in post, their primary focus had been to change the culture of the service, particularly in relation to staffing. They told us that this was through conducting regular meetings with staff, ensuring staff at all levels received regular supervision and amending the service’s rostering for staff. The registered manager told us they received regular supervision and had received an appraisal of their overall performance and records viewed confirmed this. The registered manager told us they felt supported by the provider.

The provider’s quality assurance arrangements monitored the experience of people being supported through its internal auditing processes. This information was used to help the provider and management team drive improvement, including the monitoring of trends and lessons learned. Whilst the above was mostly effective, these arrangements had not identified shortfalls found during this assessment. Where people could be anxious and distressed the use of de-escalation techniques was often secondary to the use of restraint by staff. Staff failed to raise safeguarding concerns with the management team at the earliest opportunity. Safeguarding procedures were not always followed as we found the management team had failed to inform the Local Authority and Care Quality Commission of an allegation of harm and abuse. Records showed de-escalation techniques were not routinely used or considered prior to the use of restraint by staff. We found gaps in staffs’ training. Although staff had received regular formal supervision, where areas for improvement were recorded relating to a staff member’s performance, there was a lack of information detailing how corrective actions were to be monitored and actioned. The service had a Home Action Plan [HAP]. Following our assessment the registered manager sent us a revised HAP and this confirmed the above had been included for monitoring and action. Most statutory notifications were sent to the Care Quality Commission following a serious injury or where a safeguarding concern had been raised with the Local Authority. Providers must inform us of all incidents that affect the health, safety and welfare of people who use services.

A record of compliments was maintained to capture the service’s achievements, which included a compliment from a healthcare professional following a review of a person who used the service. The healthcare professional told us they were extremely pleased what they had seen at the service, stating staff were friendly, knowledgeable and professional.

Documentary evidence indicated the management team and staff worked in partnership with key organisations to support care provision, service development and joined-up care. The registered manager confirmed the service had a good working relationship with a range of professionals and services, for example, Local Authority, Speech and Language Team [SALT], local GP surgery, dietician, dentist and optician. The registered manager told us the GP surgery completed a weekly ‘ward round’ by either visiting the service or conducting a review via a telephone call.