Background to this inspection
Updated
28 March 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
The inspection was carried out by 1 inspector, a specialist professional adviser 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
Aden Court 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. Aden Court 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, the local health and care partnership, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 spent time in communal areas observing the care and support provided by staff and visited people in their rooms. We spoke with 11 people who used the service, 3 relatives and 8 members of staff including representatives of the provider, registered manager, care staff and ancillary staff. We reviewed a range of records. This included 3 people's care records and multiple people's medicine records. We looked at 2 staff recruitment files and reviewed a variety of records relating to the management of the service.
Updated
28 March 2023
Aden Court Care Home is a nursing home providing personal and nursing care to older people. The service can accommodate up to a maximum of 40 people. At the time of our inspection there were 30 people using the service. The nursing home accommodates people in one adapted building with bedrooms on the ground and first floor. The main communal areas are on the ground floor.
People’s experience of using this service and what we found
People who were more able had a more positive experience than those who had higher dependency needs. People who relied mostly on staff to support them had inconsistencies in their care and support. Risks to individuals and within the service were known by staff, although systems and processes for managing and responding to risks needed to be improved.
Staffing levels were kept under review and a dependency tool was used to assess the numbers of staff needed. People, staff and relatives gave mixed feedback about whether there were enough staff available to meet people’s needs in a timely way. We made a recommendation the provider continues to keep people’s needs under review, along with the deployment of staff within the home, to ensure people’s needs are attended to in a timely way. Recruitment was ongoing to ensure staffing levels were adequate, although checks had not always robustly been completed before staff started working at the service.
Staff did not always follow correct procedures to control the spread of infection with regard to their own symptoms of illness. The home was visibly clean and mostly free from odours. Where more through cleaning was needed, this was identified by the management team and scheduled.
People were mostly 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 were supported to make decisions, although at times, some people felt they did not have a choice about whether they came out of their room if they relied on staff to help them.
Care and support not always planned in a way that met people's needs. Care plans were not always person-centred and did not always guide staff on people's current care needs. People’s preferences around end of life care were not recorded. Daily care records were not completed or sufficiently reviewed to show personal care was managed in line with people’s needs and wishes.
Systems to assess, monitor and improve the service were in place but not always effective. Quality checks and audits did not always identify actions or timescales, or result in sufficient improvements where actions were identified. There were systems in place to gather feedback about the service. There was evidence of the service working in partnership with health and social care professionals.
The provider was responsive to the inspection findings and sent information to show they were taking action to address the areas of risk identified at the inspection.
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 14 January 2019).
Why we inspected
The inspection was prompted in part due to concerns received about staffing levels, quality of care and management of the home. A decision was made for us to inspect and examine those risks.
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. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aden Court Care Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to risk management 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 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.