• Care Home
  • Care home

Aspinden Care Home

Overall: Requires improvement read more about inspection ratings

1 Aspinden Road, London, SE16 2DR (020) 7231 4303

Provided and run by:
Equinox Care

Important: We are carrying out a review of quality at Aspinden Care Home. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

9 August 2022

During an inspection looking at part of the service

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.

21 October 2021

During an inspection looking at part of the service

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 21 people living at the service and one person was in hospital. People had their own rooms with shared bathroom facilities. The home supported people who had a history of homelessness and alcohol dependency.

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

Medicines were not always managed safely. Risk management plans were not always in place when a specific risk had been identified. Risk management plans provide staff with guidance as to how they could reduce possible risks. The provider did not always have effective processes in place for evidencing Covid 19 testing. We signposted the provider to national guidance. The provider did not have effective systems in place to record incidents and accidents and learning from these had not been embedded into the service. We made a recommendation to the provider regarding staffing levels at the home.

Some people did not have care plans which meant staff did not have important information to respond to people’s needs. The provider was not always ensuring information about people's care and support was available in suitable formats to meet their support needs.

After the last inspection, the provider completed an action plan providing a clear time frame on how they would address the breaches of regulations. Some areas had been addressed however we found ongoing actions still needed to be completed to ensure people received safe care and support. We also found some aspects of the provider’s quality assurance systems and structures were ineffective because areas identified for improvements in the action plan had not always been completed.

The home was welcoming, and we saw some nice caring interactions between people and staff. People’s nutritional needs were being met.

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 requires improvement (published 17 August 2021) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements but the provider was still in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we had about this service. This indicated a need to prioritise the service for an inspection to review the quality of care provided. We undertook this targeted inspection to check if the provider was still in breach of regulations. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

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.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified breaches in relation to safe care and treatment, person centre care and good governance. We made a recommendation to the provider regarding staffing levels. We served the provider with a regulation 17(3) letter which requires the provider to submit a detailed action plan telling us how they are going to make improvement to the care people receive.

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.

26 May 2021

During a routine inspection

About the service

Aspinden Care Home is a residential care home providing personal and nursing care to 26 younger and older people. At the time of our inspection there were 22 people living at the service and one person was in hospital. People have their own rooms, but they share bathroom facilities. The service was previously registered as accommodation for people who require treatment for substance misuse. The home supports people who have a history of alcohol dependency.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The home did not always have effective measures in place to ensure the environment people lived in was safe. The registered manager did not always appreciate the risks people faced and did not make sure the risks were appropriately mitigated. We observed the home was not very clean in places. Medicines were not always managed safely. The provider did not have safe procedures in place to prevent the spread of infection.

The provider was not recruiting staff safely. Staff training had not always been completed. The provider was not recording people’s fluid intake, and this placed people at risk. 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.

We observed some occasions when people were not cared for in a dignified way. People and their relatives told us staff were kind although our findings did not suggest a consistently caring service or a service that was always respectful of people’s choices. There was a lack of meaningful activities happening within the home.

People's end of life wishes were not always documented appropriately. This meant in event of a death, staff would not always be aware of people's preferences. The provider had effective processes in place to handle complaints. There was a lack of person-centred practices to ensure people's needs were met.

Staff told us they felt supported by the management team. The home did not always have effective quality assurance and governance systems in place.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This is the first inspection as the service was registered with another directorate and registered with adult social care on 02 September 2020.

Why we inspected

The inspection was prompted in part due to concerns received about a recent fire at the service. A decision was made for us to inspect and examine the risks. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so. We have identified breaches in relation to safe care and treatment, staffing, person centre care, dignity and respect, meeting people’s nutritional needs and good governance. We made a recommendation to the provider regarding training, staffing and providing activities. Please see the action we have told the provider to take at the end of this report.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

20 , 21 and 27 February 2018

During a routine inspection

We do not currently rate independent standalone substance misuse services.

This was an unannounced inspection to follow up on whether the provider had made the required improvements identified during our previous inspections, including the requirements set out in the warning notices served following our inspections in June and October 2017

Following our inspection in June 2017 the provider agreed voluntarily to suspend admission to new clients until improvements had been made.

The warning notice served following the October 2017 inspection required the provider to make improvements to the environment by 19 February 2018.

As the issues had previously been so wide ranging, at this inspection we looked at all our key questions; is the service safe, effective, caring, responsive and well-led.

At this inspection, we found that the provider had made a number of significant improvements and had addressed all the issues identified in the warning notices from the inspections in June and October 2017.

Whilst the provider was on a journey to improvement new systems and processes to ensure the safety and quality of services was not fully embedded and further work was required. In addition, we identified a new concern about the lack of robust pre-employment checks for new staff. We found the following areas that the provider needs to improve:

  • Governance systems were not fully embedded; as a result, the provider could not assure itself that it was delivering a good quality service. The provider was not following all of the new systems and processes it had developed.

  • The new model of service delivery was not yet fully embedded into day-to-day practice and the measurement of outcomes needed further work.

  • The provider did not have formal systems in place for staff, clients or carers to give feedback regarding the service.

  • Further work was needed to ensure that there was a positive culture of safeguarding within the staff team.

  • The provider was not following safe recruitment guidelines. It had not ensured that staff had given a full work history prior to starting employment or that there was a system in place to alert them when disclosure and barring checks were due for renewal. The service needed to ensure that all staff received regular supervision.

  • All but two bathrooms and toilets were still in need of urgent refurbishment. Further improvements were needed to ensure that cleaning records were routinely maintained and that communal toilets were regularly checked to ensure they were clean.

  • The provider did not provide information to all clients in an accessible format. Several clients had verbal or written communication needs that were not being met.

  • The provider had not ensured that discharge plans were in place for all clients who wanted to leave the service or who were not considered suitable to stay.

  • Not all incidents of verbal abuse towards staff were being reported.

However, we found the following improvements had been made since our last inspection in October 2017:

  • At our last inspection in October 2017, we found that the systems to ensure the cleanliness, hygiene and maintenance of client bedrooms and bathrooms were not effective. The bathrooms were in need of refurbishment. At this inspection, we found cleanliness had improved and two bathrooms had been refurbished.

  • New systems had been introduced to ensure the safety and well-being of clients and staff. Staff were monitoring the ‘wet room’, which was the communal living area where clients were able to smoke and drink. An interim measure was being put in place to ensure that the front door to the service could no longer be opened from the outside without staff being aware of who was entering the building.

  • Staff were able to tell us what action they would take if the fridge temperatures fell out of range.

  • Risk assessments were updated following changes in client presentation.

  • The physical healthcare of clients had improved. There was good communication with the GP and a new GP contract in place.

  • There were systems in place to ensure that learning from incidents was shared with staff.

  • The action plan for fire safety had been addressed.

  • At our last inspection in October 2017, we found same sex accommodation guidance was not followed; there was no same sex accommodation policy in place. At this inspection, we found a same sex accommodation policy had been developed and the service was considering how they could implement this.

  • The service model had improved, it was now clear that the focus of the service was on harm reduction and recovery.

  • The system for supporting clients with their finances had been improved. Staff only supported clients with their finances where there had been agreements put in place because clients lacked capacity.

  • The service had made many improvements to its safeguarding procedures,

  • Medicines management and administration had improved since our last inspection in October 2017. New staff were in the process of completing medication training and competency assessments.

Following the inspection, we agreed that the provider would assess and admit new clients to the service.

26, 27 October and 1 November 2017

During an inspection looking at part of the service

We do not currently rate independent standalone substance misuse services.

This was an unnounced, focused inspection, where we looked at whether the provider had made the required improvements that we said it must at our previous inspection in June 2017.

Following the June 2017 inspection the provider voluntarily agreed to stop new admissions. In addition, two warning notices were served relating to Regulations 12 safe care and treatment and 17 good governance.

At this inspection, October 2017, we found that some improvements had been made , but that further improvements were needed, including the embedding of new systems introduced since the last inspection.

We served a warning notice relating to Regulation 15 premises and told the provider if must ensure premises were clean and safe. In addition, we asked the provider to continue not to admit new patients until further improvements had been made. The provider agreed to do so until February 2018.

We found the following areas that require improvement;

  • Systems to ensure the cleanliness, hygiene and maintenance of client bedrooms and bathrooms were not effective. Some areas of the service smelt of urine and bathrooms were in need of refurbishment.

  • CCTV had been introduced in the entrance of the building.However, systems to monitor who entered and left the building were not robust and did not ensure the safety and well-being of clients and staff. In addition, staff could not see into the ‘wet room’, which was the communal living area where clients were able to smoke and drink.

  • Staff were not taking appropriate action when fridge temperatures fell out of range and the majority of staff had not had their competence to administer medicines assessed.

  • Further improvements were needed to ensure that risk assessments were updated following changes in client presentation, for example following a hospital admission.

  • Further improvement was needed in how client’s physical health care needs were managed.Communication with the visiting commuity nursing team needed improvements to ensure clients needs were met.

  • Systems to share learning from incidents with staff were not in place.

  • There were a number of fire safety actions that still needed to be addrerssed. Personal evacuation plans for clients with mobility issues did not meet their needs. A fire door within the premises had been locked, which meant that the safety of clients and staff had been compromised.

  • Improvements were needed to ensure that observation were carried out in the ‘wet room’ when they were due according to smoking risk assessments.

  • Whilst monitoring of mandatory training had improved, staff take up of the majority of mandatory training was below 75%. Not all staff received supervision regularly.

  • We found that there were no capacity assessments in place for clients where there were  areas of concern regarding capacity other than DoLs authorisations. Records showed that only half of the staff team had completed mental capacity training.

  • The provider had not implemented changes required to ensure it was delivering care in accordance with guidance on same sex accomadation although had considered how it might implement this.

  • Staff needed to ensure that all incidents were reported, including incidents of verbal abuse towards staff.

    However, we found the following improvements had been made since our last inspection in June 2017:

  • Medicines management and administration had improved, but the revised systems needed further embedding. The service now had risk assessments for client’s self- administering medication and were completing medication audits. The majority of staff had completed medicines training

  • Processes for identifying, assessing and managing risk had improved. All clients had a risk assessment in place, including moving and transferring.

  • There had been improvements in communication with community psychiatric nurses. A revised GP contract was about to be introduced, with the aim of improving physical health support to clients and improving communication with staff.

  • A fire safety assessment had been completed; regular fire alarm tests and evacuation drills were being carried out.

  • Observation of clients at risk had improved. The service had fitted CCTV into all communal areas. Clients were now regularly observed at a minimum of hourly.

  • New systems to identify who was supervising which staff had been introduced, along with a standardised supervision template.

  • A permanent manager had been appointed and arrangements were in place for them to receive a handover from the acting manager.

  • The service had developed a detailed referral form. They had introduced drug and alcohol stars. These were used to document discussions with clients regarding how they wanted to be supported with managing their alcohol intake. These were detailed and person centred. Staff had identified and managed clients nutritional and hydration needs.

  • Staff had completed safeguarding training, were able to tell us how to make a safeguarding referral and safeguarding information was clearly displayed for both clients and staff to see. All safeguarding concerns had been appropriately considered with alerts made to the necessary stakeholder organisations.

  • An audit programme had been introduced.

  • Staff were committed to the clients and to the service. Staff felt that managers were open and approachable. Staff were positive about the changes they had seen taking place since the last inspection.

8 & 9 June 2017

During an inspection looking at part of the service

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

  • The service did not have an effective model of care in place. The service stated that they were following a harm reduction model of care. However, there was no clear service model in place which included what the aims and objectives were of the service and how harm reduction was going to be achieved. There were no clear procedures in place which stated how the harm reduction approach would work in practice. Clients did not have contracts or agreements in place as to how to support them with harm minimisation.
  • A stable leadership team was not in place. The registered manager had been away from the service for nearly six months and whilst an acting manager was in place the long term plans were not clear. The provider had not ensured that the manager was appropriately supported to maintain the safety and quality of services.
  • The provider did not have established systems in place that provided assurance that the service was appropriately meeting the needs of the clients, following up concerns raised by other stakeholders and using audits to maintain standards within the service.
  • The service did not have clear criteria for admission. The service was not ensuring that comprehensive assessments were undertaken before admission. This meant that clients were at risk of receiving care that was not safe or appropriate and did not meet their needs.
  • There was not sufficient staff to ensure there was safe care and support for clients. We saw from client’s records that some clients required support from two staff for their personal care needs. Staff shifts were unfilled; there were some night shifts where there had only been one member of staff working. The service did not have a system in place to be able to measure staffing levels to ensure they were safe.
  • Robust safeguarding processes were not in place. The provider did not have records to show if staff had completed mandatory safeguarding training or not. The service did not have safeguarding information on display about how to make a safeguarding referral. Not all staff were able to tell us how to make a safeguarding referral. Safeguarding was not discussed as a regular agenda item at staff meetings or at the senior management incident sharing meeting. The incident form did not record if a safeguarding referral had been made.

  • Risk assessments were not updated following changes in clients’ needs and did not always contain all the relevant information regarding clients’ risks. The service had not raised serious incidents following safeguarding alerts being made by the local hospitals regarding the potential neglect of clients .The provider held a meeting to discuss incidents; however the actions from these meetings were unclear. There was not a process in place to discuss feedback from incidents with staff or clients. There was not a system in place to ensure that learning from incidents occurred.
  • There were significant fire safety concerns at the service. The service had not implemented an action plan put in place after the London Fire Brigade had been called to the service in March 2017. Significant areas for action to ensure fire safety remained outstanding, including the development of personal evacuation plans for clients with mobility issues or who may have been drinking. The service had not recorded that a fire drill had been carried out during the previous year. Fire alarm tests had not been carried out regularly during 2017
  • At the previous inspection in September 2016 we found that the service did not have appropriate systems in place to manage medicines. There was no controlled drug register, risk assessments for client’s self-administration or completed medication audits. At the current inspection we found that the service still did not have the appropriate systems to manage medicines. There was a controlled drug register in place. However, the service did not carry out risk assessments for clients self-administering medication or complete medication audits. The service did not have records of staff completing training in medicines management.
  • At the previous inspection in September 2016 the service manager was not clear on the training needs of the staff and the service did not have an efficient system in place to record mandatory training compliance rates or specialist training rates. At the current inspection we found that the service still did not have a system in place to record mandatory training compliance rates or specialist training rates. This included safeguarding and mental capacity act training.
  • At the previous inspection in September 2016 we found that staff did not always ensure clients had comprehensive care plans to address all identified needs. Clients with epilepsy did not have specific care plans or risk assessments in place for the safe management of their epilepsy. At the current inspection in June 2017 we found that staff did not always ensure that clients had comprehensive care plans to address all identified needs. Clients with epilepsy did not have specific care plans in place for the safe management of their epilepsy. Clients did not have care plans for their individual needs such as their personal care needs, moving and transferring needs or how to support them with ensuring their rooms were clean. Clients did not have a copy of their care plans which were in an accessible format.
  • At the previous inspection in September 2016 we found that the service did not document agreed decisions made with clients around restricting their alcohol and finances. At the current inspection in June 2017 we found that there had been no improvement and the service was still not implementing a robust process for supporting clients to manage their alcohol misuse and documenting agreed decisions with clients around restricting their alcohol.
  • The provider was not ensuring that that the physical health care needs of clients were met. The provider did not ensure that risk assessments and care plans were updated to include information regarding physical health care when client’s needs changed. The provider did not ensure that visits from health care professionals were clearly documented with the agreed actions and outcomes of these visits.

  • The service was not able to ensure the safety of the clients in the communal areas of the building. The service did not have appropriate security at the front entrance and it was not possible to accurately know who was entering or leaving the building. Staff could also not observe communal areas. Staff were not observing clients using the ‘wet room’, which was the communal living area where clients were able to drink and smoke. We observed clients who had been drinking heavily in this room. This meant clients were at risk of injury and abuse.

  • The service did not have a same sex accommodation policy in place and had not considered separation of bedroom and bathroom facilities according to gender.

  • The provider did not respond appropriately when clients’ needs changed and the service was no longer able to meet their needs.

  • The service was not using the Mental Capacity Act appropriately. Staff did not document when there were concerns regarding capacity, there were no capacity assessments in place. There were no records that staff had completed mental capacity training.

  • The service did not support staff by ensuring that they had regular supervision. The service did not supply staff with personal alarms so that they could call for support if needed.

  • The service did not support clients to clean their rooms on a regular basis.

Following the inspection a notice of proposal was served proposing that no more clients were admitted to the service until the issues of concern were addressed. This was voluntarily accepted by the provider who has stopped admissions. In addition two warning notices were served relating to regulations 12 safe care and treatment and 17 good governance.

12 & 13 September 2016

During a routine inspection

We do not currently rate independent standalone substance misuse services.

We found the following issues that the service provider needs to improve:

  • The service did not have appropriate systems in place to manage medicines. Staff did not use a controlled drug register, carry out risk assessments for self-administration or complete medication audits to check stock levels.

  • Staff had not completed comprehensive care plans to address clients’ identified needs. Clients with epilepsy did not have risk assessments or care plans for this specific need.

  • The service manager was not clear on mandatory training that staff were expected to complete. The service did not have an efficient system in place to record mandatory training compliance rates or specialist training rates.

  • The service manager was not aware of the duty of candour policy. However, staff showed an understanding of this principle and the need to act in an open and transparent way with clients in the event of an incident.

  • Clients with literacy and numeracy difficulties did not have care plans in an accessible format.

  • Staff did not follow best practice guidelines in recording agreed decisions made with clients around restricting their alcohol and finances.

  • Not all staff were aware of the role of the independent mental capacity advocate under the Mental Capacity Act (MCA) and knew how to support a client to access this.

However, we also found the following areas of good practice:

  • Staff knew how to report incidents and record them appropriately. The service had a good system to review and learn from incidents.

  • Clients who used the service had recovery plans. The serviced used the alcohol recovery star tool.

  • The communal environment was clean and staff followed infection control procedures. However, during out visit we noticed that some bedrooms had an unpleasant smell.

  • The service manager held team meetings once a month. Team meetings minutes demonstrated good discussion between the team on a variety of topics.

  • There was good management of physical healthcare. The service had good working relationships with the local GP who visited the service every Wednesday. The service manager described good links with local mental health teams and liaised with them if they suspected a client’s mental health was deteriorating.

  • There was a weekday and a weekend chef who prepared fresh food daily for clients. The chef adapted meals to suit dietary requirements.

  • The service was adapted for clients who used a wheelchair.

  • The staff said they worked well together as a team and there was a good team dynamic. Agency staff felt support and part of the team.

9 May 2013

During a routine inspection

People using the service told us they were happy with the care and support they received and staff asked for their permission in providing this. One person told us, "The staff are polite and nice and are available if I have any questions'. Another said, 'They are very effective in the support they give me.'

Care records were up to date and provided a comprehensive assessment of people's needs and appropriate care planning. People's physical, emotional and social needs were addressed and care plans were developed in discussion with people who use the service.

There were effective arrangements in place to safeguard people from abuse.

Effective, non-discriminatory recruitment and selection processes were in place, with appropriate pre-employment checks being carried out.

There was an effective system available for people to raise concerns or complaints. People we spoke with told us there had been no reason for them to raise a complaint

25 July 2012

During an inspection looking at part of the service

We carried out an inspection of Aspinden Wood Centre on 18 August 2011. During that inspection people we spoke with told us that they were happy with the care that they received and that the staff were kind and caring. Although these views were borne out by some of the care, treatment and support they received, we found concerns in the following areas of service provision: care and welfare; safeguarding; staffing; supporting staff; notifications; and records.

Following the inspection, the organisation provided us with an action plan to tell us what they were doing to make improvements. We visited on 25 July 2012 to see whether they had made these improvements.

At our recent inspection all of the people we spoke with told us that they were given a good standard of service and received the care and support they needed. One person told us that 'the staff are polite and helpful.' Another told us that the staff treated them well and they were happy at the centre.

Overall, we found that the concerns we identified previously had been addressed and the centre was now meeting the essential standards of quality and safety

18 August 2011

During a routine inspection

During our visit we spoke to some of the people who live at the home. They told us that they were happy with the care that they received. They said that the staff were kind and caring. One person told us, 'looking back over the years this is a good home'. Another person told us, 'staff go out of their way to be helpful and the manager's door is always open to us'.

The staff who we spoke to told us that they enjoyed their work. They said that they were well supported. They received the training they needed and felt confident in doing their jobs. One member of staff told us the work was challenging but rewarding, especially as their relationships with the people using the service developed and they were able to help them improve their lives.