Background to this inspection
Updated
1 October 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
Two inspectors carried out this inspection.
Service and service type
Aspinden 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. Aspinden care home 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 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, such as notifications. These are events that happen in the service that the provider is required to tell us about. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with the registered manager, clinical lead nurse, acting deputy manager, five care staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We had a tour of the building and reviewed a range of records. This included four people's care documentation, two staff files and a sample of people's medication records. Following the inspection, we continued to seek clarification from the provider to validate evidence found. We also reviewed a range of records relating to the management of the service.
Updated
1 October 2022
About the service
Aspinden Care Home is a residential care home providing personal and nursing care to 26 people. At the time of our inspection there were 25 people living at the service. People had their own rooms with shared bathroom facilities. The home supported people who had a history of long-term homelessness and alcohol dependency.
People's experience of using this service and what we found
There continued to be improvements at the home but we identified that medicines were still not being managed safely. This meant people were at risk of not receiving their medicines as prescribed. Risk assessments were not robust and were not updated when people’s needs changed. This meant people were at risk of receiving unsafe care.
Accidents and incidents were analysed but actions were not always completed following incidents. We identified that there was at times poor record keeping of client information and it was stored in different formats, which meant it was hard to locate and there was a lack of guidance for staff.
The providers governance and auditing systems did not always identify issues with the quality of the service. This meant appropriate action had not been taken to ensure people received good quality care.
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.
The provider had effective processes in place for managing and preventing infection. The provider had systems in place to safeguard people from the risk of abuse.
Staff spoke positively about the improvements at the home, and they told us they felt supported by the registered manager.
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 service was inspected but not rated at the last inspection (published 11 January 2022). At our last inspection we found breaches of the regulations in relation to safe administration of medicines, person centred care and good governance. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve. At this inspection we did not look at key question relating to the breach of regulation 9 (person centred care). We will look at this when we next inspect.
Why we inspected
We received information of concern in relation to how the provider was assessing and managing risk. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. You can see what action we have asked the provider to take at the end 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 Aspinden Care Home 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 assessing risk, medicines and good governance.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.