Aspen Court Nursing Home

Updated 11 November 2022

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 consisted of two inspectors, a nurse specialist professional advisor 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 service.

Service and service type

Aspen Court Nursing Home 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. Aspen Court Nursing Home 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 not a registered manager in post. The previous registered manager left in April 2022. The new manager had been in post since the start of June 2022 and was in the process of submitting their registered manager application.

Notice of inspection

This inspection was unannounced. The provider knew we would be returning on the second and third day of the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included any significant incidents that occurred at the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the previous inspection reports and actions plans submitted after the last comprehensive inspection. We contacted the local authority commissioning and safeguarding teams to support our planning. We used all of this information to plan our inspection.

During the inspection

We met and had introductions with people who used the service and spoke with 12 of them in more detail. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed the care and support provided to people across different parts of the day, including mealtimes. We also spoke with two relatives who were visiting during the inspection.

We spoke with 24 staff members. This included the manager, an area director, the deputy manager, the clinical lead, three nurses, five senior care assistants, eight care assistants, the chef, the maintenance person, a wellbeing and activities coordinator and the housekeeping supervisor.

We also asked the manager to share a questionnaire with the whole staff team to give them an opportunity to give us feedback about their experience of working in the home.

We reviewed a range of records. This included 28 people’s care and medicines records and 17 staff records in relation to recruitment, training and supervision. We also reviewed records related to the managemen

Updated 11 November 2022

About the service

Aspen Court Nursing Home is a residential care home providing nursing and personal care for up to 72 adults. At the time of the inspection 69 people were living at the service, including older people, people with physical health conditions and those living with dementia. The second floor can accommodate up to 26 people with nursing care needs.

Aspen Court Nursing Home accommodates people in one building across three floors, with each person having their own bedroom and en-suite bathroom. There were also communal living and dining rooms, a main kitchen, smaller kitchenettes on each floor and access to a secure garden.

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

Improvements were still needed with people's care plans and risk assessments as inconsistencies were seen across the records we reviewed. Records were not always clear about levels of risk or guidance for staff to follow to keep people safe.

People and their relatives were positive about the kind and caring attitudes of the staff team. One relative said, “The staff are very friendly and they show respect. [Family member] is very sociable and they have a good rapport, get on well together and have a good sense of humour together. They thrive on this.”

People were supported by staff who were dedicated in their role to ensure they received the care they needed. We observed a range of positive interactions between people and the staff team throughout the inspection. Staff responded appropriately, with patience, compassion and in a timely manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives told us they had been well supported throughout the COVID-19 pandemic and were updated if there had been any changes to government guidance or changes with visiting restrictions. One relative said, “They have been very good with this and ensured staff were wearing masks. They were providing tests and helping to keep us all safe.”

The manager had a visible presence and people and their relatives felt comfortable approaching them to discuss any issues or concerns. One relative said, “The new manager called me the other day to let me know her door is always open. I feel she has fallen into the job in a very caring way.”

People were supported to access healthcare services and had input from health and social care professionals if their needs changed. Health and social care professionals were positive with the improvements that were being made since the new manager had started.

Although feedback was positive about the changes that had been made by the new manager, not all staff felt supported or appreciated for their work. Some staff told us this impacted on the working environment.

Improvements had been made since the previous inspection and the provider’s monitoring processes had identified areas to be improved. The manager held daily meetings and carried out regular walkarounds to check on the care and support people received.

Incidents that occurred across the service were regularly notified to the CQC. However, safer recruitment practices were not always followed.

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

Rating at last inspection and update

The last rating for this service was inspected but not rated (published 21 July 2022). This is because it was a targeted inspection to look at a specific concern. We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

The last rating for a comprehensive inspection was requires improvement (published 21 April 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to follow up on the action we told the provider to take at the last comprehensive inspection.

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.

Enforcement

We have identified a continued breach in relation to safe care and treatment. We have identified a breach in relation to recruitment practices. 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.