Aronel Cottage Care Home Limited

Updated 27 April 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 undertaken by two inspectors 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

Aronel Cottage 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. Aronel Cottage is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. 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 all this information to plan our inspection.

During the inspection

We spoke with eight people who used the service and six relatives about their experience of the care provided. We spoke to the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with seven members of staff including two registered nurses, two care staff, one ancillary staff and the chef.

We reviewed a range of records. This included fourteen people’s care records and medicine records. We looked at three staff files in relation to recruitment and induction. We reviewed accident, incident and falls records. A variety of records relating to the management of the service, policies and procedures were reviewed.

After the inspection

We continued to review information and sought clarification to validate evidence found. We looked at additional information requested including medicine records, assessments and information about people on modified diets. We sought feedback from health and social care professionals about the service.

Updated 27 April 2022

About the service

Aronel Cottage is a residential care home providing personal and nursing care to up to 38 people. The service provides support to people who have care and health needs including impaired mobility, frailty of age, diabetes and people living with Parkinson’s disease. At the time of our inspection there were 38 people using the service. Accommodation was in one adapted building over two floors which were accessed by a lift.

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

Aspects of leadership and governance of the service were not effective in identifying some service shortfalls. There was not an adequate process for assessing and monitoring the quality of the services provided and that records were accurate and complete.

People and their relatives told us current visiting arrangements were restrictive. We received feedback that the provider did not always follow government guidelines for visiting in care homes. We made a recommendation about visits to the care home and sign posted the provider to current government guidelines for visiting in care homes.

People were not always protected from avoidable harm because the provider did not have effective procedures in place to make sure people were safe. Incidents were not always responded to or reported to the appropriate authority. Action was not always taken to mitigate the risk of harm to people.

Processes were not in place to ensure support plans and risk assessments contain detailed and person-centred information to accurately reflect the needs of people. Risks to people's health and wellbeing were not consistently managed. We have made a recommendation about staff knowledge and understanding of dysphagia and modified diets.

Staffing levels were enough to meet people’s individual needs. Positive and caring relationships had been developed between staff and people. People were treated with kindness and compassion and staff were friendly and respectful. Feedback from people and their relatives told us they were happy with the service. Comments included ‘Nothing is too much trouble’ and ‘There appears to be enough staff, I don’t hear call bells constantly ringing and the staff seem to be calm and competent’

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.

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 good (Published 6 June 2018).

Why we inspected

We received concerns about the failure to notify CQC of incidents that affect the health, safety and welfare of people who use the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 Aronel Cottage on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to protecting people from abuse and harm, safe care and treatment and overall governance and management of the service, at this inspection.

We have made recommendations about visiting in care homes and improving staff skills in dysphagia.

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.