Background to this inspection
Updated
12 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
The inspection was carried out by an inspector 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
Aarondale Care 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.
Aarondale Care Home is a care home without 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 carried out an inspection of the home to ensure it was safe and suitable to meet people's needs. We also observed the delivery of care and support at various times throughout the day, including the lunch time experience. We spoke with five people who lived at the home, one relative, the registered manager, a senior member of care staff and the chef.
We looked at records in relation to people who used the service including three care plans and systems for monitoring the safety and quality of the service provided.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at staff training and quality assurance records. We spoke with three members of care staff on the telephone. We also spoke with three relatives on the telephone to help us understand their experience of the care and support their loved one received.
Updated
12 November 2022
About the service
Aarondale Care Home is a care home providing personal care for up to 48 older people, including those living with dementia. The service is purpose built and accommodation is over three floors. At the time of the inspection there were 38 people living at the service.
People's experience of using this service and what we found
We found that people’s records did not always evidence their wishes and preferences for end of life care and support. We have made a recommendation about the recording of people’s end of life wishes.
At the last inspection we found the safety, effectiveness and oversight of the service was inadequate, and there were multiple breaches of regulations. Practices at the service placed people at risk of harm. Systems in place to monitor, assess and improve the safety and quality of the service being provided were not robust. People were not supported to have maximum choice and control of their lives and staff were not adequately trained or supported. There were failures in the provider's quality and assurance systems.
At this inspection we checked to see whether improvements had been made and found that they had.
People living at Aarondale Care Home benefited from a service that was committed to driving improvements in order to provide safe, high-quality care and support. The service had responded proactively to the findings at the last inspection and had worked hard to improve both the physical environment and the quality of care provided to people.
Regular health and safety checks were carried out to ensure the home was safe and suitable for people to live in. Risks to people were identified and managed and mitigated by staff to lessen the risk of harm to people.
People told us they enjoyed living at the home and appeared calm and at ease in their surroundings. Both people and their relatives were keen to tell us how well treated they were by staff who were respectful, kind and treated them with the utmost dignity.
Staff recruitment processes ensured staff were safe to work with people and staff received the necessary training and support to help deliver care to people which was tailored to their needs.
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.
A new registered manager had been reinstated since the last inspection and had overhauled governance processes and practices to help provide better oversight of the service, providing a more accurate picture of risks and areas for improvement.
Both the registered manager and the provider helped instil a positive culture which was committed to delivering high-quality care to people, and supported staff to ensure they understood, shared and practiced these values. The registered manager was not averse to challenge any shortfalls in practice that fell below these standards.
Since the last inspection, the management team had worked in collaboration and partnership with other relevant organisations to improve the service and help achieve better and more positive outcomes for people.
Although the service had made significant improvements and were no longer in breach of regulation, further time was required to evidence consistency and longevity of good practices.
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 inadequate (last report published 16 May 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
The service has been in Special Measures since 16 May 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 7 March 2022. Breaches of legal requirements were found in relation to safe care and treatment, need for consent, staff training, meeting nutritional and hydration needs and good governance. We also made recommendations in relation to reviewing people's care plans for care and support and staff developing more effective communication skills.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.
We also 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.
The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aarondale Care Home on our website at www.cqc.org.uk
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.