The inspection of Aden Lodge Care Home took place on 19 and 28 December 2016. We previously inspected the service on 23 November 2015 and at that time we found the registered provider was not meeting the regulations relating to person centred care, dignity and respect, consent, safe care and treatment, premises and equipment, good governance and staffing. We rated them as inadequate and placed the home in special measures. On this visit we checked to see if improvements had been made.Aden Lodge provides care and support for older people, some of whom are living with dementia. It is a purpose built home and provides single room accommodation with en-suite facilities. The home was divided into two units, one of which was an 11 bed unit, Ladybird Suite, for people living with dementia, and a 23 bed unit for people who were assessed as having residential care needs. At the time of inspection 33 people were living at Aden Lodge.
The home had a manager in post but they were not yet registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People told us they felt safe and each of the staff we spoke with understood the different types of abuse and their responsibility to report any concerns.
There were a number of risk assessments in each of the care records we looked at although they did not record an adequate level of detail to ensure people were protected from the risk of harm, particularly in regard to their safety when bathing or showering. Staff told us some people could not be bathed due to the risk of harm to the person but this was not clear from their individual records. When there was an accident or incident, staff recorded this but we found two examples where this information had not been passed on to the manager. A bathroom had exposed pipework which was a potential hazard to vulnerable people; we told the manager about this but when we checked on the second day of our inspection we found this was still a concern.
There were procedures in place to check potential staff were suitable to work with vulnerable people. People we spoke with did not raise any concerns regarding the staffing at the home but staff told us, and we saw; times when people on the Ladybird suite were unsupervised.
We found there were systems in place to ensure the management of people’s medicines were safe.
We saw evidence staff received an induction when they commenced employment along with training in a number of subjects. There was a programme of supervision but the manager acknowledged this was behind schedule.
Our discussions with the manager and staff showed they had a good understanding of the Mental Capacity Act and issues relating to consent. However where people lacked capacity to make complex decisions, mental capacity or best interests’ documentation was not always evident within their records.
People received a choice of meals and drinks. Catering staff were aware of people’s specific dietary needs including where people were at risk of weight loss and required the calorific content of their meals to be enhanced.
The layout and décor of the Ladybird suite was not dementia friendly. The lounges were not homely and the shape and size of the room meant chairs had to be arranged around the edge of the room. There was an absence of colour on the unit to assist people in differentiating between bedrooms and bathrooms.
People and their relatives told us staff were caring and kind. Staff spoke with people in a caring and inclusive manner, they respected people’s privacy and supported people in a way which maintained their dignity.
We received positive feedback from people regarding the activities at the home, which included gardening, baking, singing, memory word games, crafts and external entertainers.
The care records we looked at were person centred but they had not all been updated to reflect people’s current needs and they did not consistently provide an adequate level of information as to the support they needed. We found one person who had been at the home for approximately eight weeks did not have any care plans in place.
We saw evidence of two written complaints which had been logged, investigated and the complainant had received feedback regarding the issues they had raised.
We received positive feedback about improvements at the home. We saw evidence a number of audits. had been undertaken to assess and monitor the quality of the service provided to people, meetings had also been held with staff and relatives. During our inspection we found evidence of some improvement, however as evidenced within the main body of the report, there remain a number of areas where there is a need for further development to ensure the safety and well being of the people who live at Aden Lodge.
You can see what action we told the provider to take at the back of the full version of the report.