Aspen Place

Updated 24 September 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 three 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

Aspen Place is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Aspen Place 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there were two registered managers in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 30 June 2022 and ended on 06 July 2022. We visited the service on 30 June 2022.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from Healthwatch, which 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 spoke with nine people who used the service and seven relatives about their experience of the care provided. 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 spoke with 11 members of staff including the provider, the registered managers, head of care, registered nurses, care workers, administrator, lifestyle manager and the catering manager. We spoke with five healthcare professionals who have regular contact with the service.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including quality assurance processes, training records, policies and procedures were reviewed

Updated 24 September 2022

About the service

Aspen Place is a residential care home providing personal and nursing care to up to 52 people. The service provides support to younger and older adults who live with physical disabilities and people living with dementia or learning disabilities. At the time of our inspection there were 50 people using the service.

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

People and relatives told us there was not always enough staff. One person told us, “They tell you to ring the bell. The wait times varies.” Relatives gave examples of their concerns about staff responses to call bells. Their comments included, “I did press the buzzer in an area out of the room and no one came for quite a while.” And “There are normally enough staff but at weekends it seems lower.” The provider was in the process of monitoring staffing levels to ensure people received timely support.

People’s care was not always person-centred. Some people had limited opportunities to take part in activities and were reliant on staff to facilitate this.

We have made a recommendation about expanding the adaptions within the environment to support people living with dementia.

People had their health care needs met. Some healthcare professionals spoke positively about how the staff had engaged with them but in some situations, visiting professionals spoke of potential delays in contacting community healthcare professionals.

Monitoring audits had not always identified concerns about person centred care or the feedback from some healthcare professionals.

People and their relatives told us they felt safe and were cared for by staff who knew them well. One relative told us, “I do know who to report to if we felt that my [loved one] was unsafe.”

People received their medicines as prescribed and medicines were managed safely. Accidents, incidents and safeguarding concerns were reported and investigated as required and actions taken to prevent reoccurrence. People were protected from the risk of abuse and staff were aware of their safeguarding duties and how to report concerns.

People were supported by staff who had completed training in line with people’s needs. Staff were recruited safely and received supervision where opportunities to develop and feedback about their practice were discussed. 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

The last rating for this service was good (published 09 May 2019)

Why we inspected

The inspection was prompted in part due to concerns received about the experiences of people living in the dementia unit and pressure area care. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. 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.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led section of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aspen Place 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 person centred care and 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 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