Aarons Specialist Unit

Updated 15 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by an inspector, a nurse specialist and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Aarons Specialist Unit is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Aarons Specialist Unit is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We observed the care people received in communal areas of the home. We had telephone conversations with 11 relatives of people who used the service. We sought feedback via email from nursing and care staff. We also spoke with the registered manager, deputy manager, the compliance manager and the activities organiser. We reviewed a range of records. These included 5 people’s care records and multiple medication records. We looked at 1 staff file in relation to recruitment. We also reviewed a variety of records relating to the management of the service, including policies and procedures.

Following our initial review we found concerns relating to compliance with the Mental Capacity Act. We therefore returned for a second visit to collect further evidence to enable us report on the key question of effective.

Updated 15 June 2023

About the service

Aarons Specialist Unit is a residential care home providing personal and nursing care to up to 22 people living with dementia and other neurological conditions. At the time of our inspection there were 22 people using the service.

Aarons Specialist Unit accommodates people across 4 separate wings, each of which has separate purpose built facilities.

People’s experience of using this service and what we found

People were not always safe. This was because risks assessments were not always completed to manage known risks associated with people’s care and support. The protocols for managing medicines were not always in line with best practice. Lessons were not always learnt from incidents that occurred at the service to minimise the risk of reoccurrence.

The systems used by the provider for monitoring the quality of care and support people received, identified areas of improvement. However, there was no evidence of actions taken to make the required improvements. The provider did not take required actions to meet the conditions of people’s deprivation of liberty safeguards authorisations.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The environment did not always promote people's dignity, privacy and their individual needs.

People were supported to manage their health conditions. They had prompt access to health and care professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 09 April 2020).

Why we inspected

The inspection was prompted in part due to concerns we received concerns in relation to the management of medicines and management of people’s behaviour support needs. As a result, we undertook a focused inspection to review the key questions of safe, and well-led only. We returned for a second site visit to extend the inspection to include the key question effective as we found concerns related to this.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aarons Specialist Unit on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care, need for consent and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.