Aspen House Limited

Aspen House is a residential care home providing personal care to up to 22 people. The service provides support to older and younger adults who may also receive care with their mental health. At the time of our inspection there were 22 people using the service, 2 of whom had been temporarily admitted to hospital.

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

Safeguarding systems had not always been operated effectively and safeguarding referrals had not always been made when required. Medicines were not always managed safely. Risks were assessed however, not all risk assessments reflected people's current risks. The principles of the Mental Capacity Act (MCA) had not always been applied to people's care decisions. Managers and staff had been trained but had not always put this training into practice. The provider's governance systems to assess, monitor, improve and reduce risks in the service were not always effectively operated. Statutory notifications had not always been submitted and policies had not always been followed.

People were not supported to have maximum choice and control of their lives and did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

There were enough staff to meet people's needs in a timely manner. Recruitment processes were in place but some required checks had not always been completed. Measures were in place to help prevent and control risks from infection. People were supported to have enough food and drink and the provider worked well with other health and social care professionals involved in people's care. The premises had been adapted to meet people's needs. The service aimed to provide person-centred care to people.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Last rating and update

The last rating for this service was good (published 24 December 2018). At this inspection we found the provider was in breach of regulations in relation to the safe care of medicines, safeguarding systems, arrangements for assessing people’s capacity for their care decisions and the governance and oversight of the service.

Why we inspected

We carried out an unannounced focused inspection of this service on 14 November 2023.

This report only covers our findings in relation to the key questions safe, effective and well-led. 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. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aspen House Limited on our website at www.cqc.org.uk.

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.

The service was registered to provide support and accommodation for up to 22 people who may have a learning disability or mental health condition. There were 21 people living in the home at the time of our inspection.

The service had a registered manager. 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.

Aspen House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service remained safe. Risks were assessed and reviewed to keep people safe and protect them from avoidable harm. People were protected from unnecessary harm by staff who knew how to recognise signs of abuse and how to report concerns. Medicines were managed safely to ensure that people received their medicines as prescribed and to keep well. There were sufficient numbers of staff to meet peoples need. There were processes to minimise risks to people’s safety; these included procedures to manage identified risks with people’s care and for checking staff were suitable to work with people who used the service.

The service remained effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s consent was sought before care was delivered. Where people lacked capacity to make certain decisions; decisions were made in consultation with people who were important to them and made in their best interests. People maintain their preferred diet and were supported to plan, and prepare their meals they wanted to eat. Staff had the skills, knowledge and experience to work with people.

The service remained caring. People were treated with kindness and compassion by staff who knew them well. People were given time and explanations to help them make choices. People’s privacy and dignity was respected and they were confident that staff supported them in the way they wanted to be.

The service had improved and was responsive. People could participate in activities that interested them and be independent. Care records were personalised and contained relevant information for staff to help them provide the care people wanted. Information about making a complaint was available for people and they knew how to complain if they needed to. People knew how to make complaints and they felt that the staff and registered manager were approachable.

The service remained well led. Staff felt well supported by the registered manager and provider. Regular quality checks were completed and people could comment on the quality of service provision. Where necessary, improvements were made to the service.

Aspen House provides accommodation and personal care for up to 22 adults with mental health needs and is situated close to the centre of Derby. Aspen House also provides care and support to people in their own homes, There were 21 people living at the service and one person who was supported in their own home at the time of our inspection.

The service has a registered manager. 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 using the service told us they felt safe. Staff had a clear understanding of the types of abuse and how they could report suspected abuse. People had assessments which identified actions staff needed to take to protect people from risks associated with their specific condition, although some of these needed to be improved with additional information.

Where possible people were supported to manage their own medicines and encouraged to know what medicines they were taking and the reasons why, The arrangements for the storage, administration and recoding of medicines were good and this meant that people were protected from possible errors.

There were enough staff to provide safe and effective care for people. Staff had the skills and knowledge to ensure people were supported in line with their care needs and best practice. There were regular supervisions and observations of working practices which supported staff to meet people's needs effectively.

The registered manager and staff we spoke with were knowledgeable of and acted in line with the requirements of the Mental Capacity Act 2005. Staff sought consent from people before providing care.

People were supported to have their mental and physical healthcare needs met and encouraged to maintain a health lifestyle. Staff made appropriate use of a range of health professionals and followed their advice when provided.

People had positive relationships with the staff that supported them and spoke positively about their care and support. The provider sought out and respected people's views about the care they received. Staff actively promoted and uphold people's privacy and dignity.

Care plans and risk assessments contained relevant information for staff to help them meet people's needs. Although staff knew people well, further information in care plans about people's preferences and life history would further develop staff knowledge in providing personalised care. Care records were not always completed consistently to support staff to respond to changes in people's needs. People knew how to complain and information about making a complaint was available for people.

The registered provider operated an open and inclusive culture in the service, where the opinions of people who lived there, staff and visitors were valued and respected.

The registered manager assessed and monitored the quality of care and was committed to providing quality care for people. They used a range of methods to monitor the quality of care. The registered manager consulted with people using the service, professional visitors and relatives to find out their views on the care provided. People using the service felt they were listened to and found the registered manager to be approachable and responsive.

People living at Aspen House told us they were happy with the service they were receiving. Comments included, 'staff are respectful and listen to what I have to say'.

People supported in their own homes told us, that they liked the staff that supported them. One person told us, 'I get on with all of the staff that support me; they are respectful and make sure I can manage.'

People's support plans included information about their ability to make decisions regarding their life and their capacity to consent. People had signed their support plans to demonstrate their agreement with them.

People living at Aspen House told us they enjoyed the meals. One person said, 'meals are excellent and there is plenty of choice'. People supported in their own homes told us, that they were supported to do their weekly shopping and housework.

We looked at how medicines were managed for people living at Aspen House. Generally these were well managed; however on the day of our visit we identified one error, which was fed back to the registered manager. People supported in their own homes told us, that they were able to take their own medication but staff checked to make sure they had done this.

We saw that people had been involved in developing their support plans and reviewing their care and people that spoke to us confirmed this.

Comments included, 'this is the best place I've stayed at, I love it here.' And 'It's very nice here, the staff are friendly, I like it here.'

People told us they enjoyed the meals provided. One person said, 'the food is very good here.' Another person said, 'very good quality we have some lovely meals.'

People were encouraged to remain as independent as possible and to develop their skills. One person told us, 'I do my own laundry; staff are always around to support me if I need them.'

People that we spoke with confirmed that they felt safe and that staff supported them in a safe way. People told us that if they had any concerns they would talk to the manager.