Background to this inspection
Updated
22 April 2021
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 Care Act 2014.
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
This inspection was carried out by one inspector and one pharmacist specialist.
Service and service type
St Aiden’s Cottage is a 'care home.' People in care homes receive accommodation and nursing or personal care as a 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 did not have a manager registered with the Care Quality Commission, although the current manager had applied to become the registered manager. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
We visited the service on 1 March 2021. We requested information from the provider after our visit and received this between 10 March and 9 April 2021.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service. We sought feedback from relatives via email and received three responses.
We spoke with seven members of staff including the manager, the provider’s head of care outcomes, a nurse, a senior care assistant and three care assistants.
We reviewed a range of records. This included four people's care records and multiple medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at records relating to one person’s specific medical needs and quality assurance records relating to reviews of care plans and risk assessments.
Updated
22 April 2021
About the service
St Aiden’s Cottage provides personal and nursing care for up to 41 younger and older adults living with a range of conditions including mental health issues, dementia, learning disabilities and autism. At the time of inspection 31 people were using the service.
People’s experience of using this service and what we found
Medicines were managed safely and effectively. Risks were identified and managed appropriately. There were effective processes to ensure lessons were learnt. Improvements had been made to the premises which were clean and tidy. Recruitment procedures were robust. There were enough staff to meet people's needs and people were protected from the risk of abuse.
Staff were responsive to people's needs, but we did find one person’s specific needs were not always consistently met, possibly due to care records not always being accurate. People’s care plans and individual risk assessments reflected their current needs, but it was not always clear from electronic records whether these had all been reviewed regularly. The provider had identified these issues and was taking steps to address them.
Quality monitoring systems had improved. Staff said the management team had made improvements and things had improved significantly. The service did not have a manager registered with the Care Quality Commission (CQC) at the time of this inspection, although an application had been submitted.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, Right Care, Right Culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right Support, Right Care, Right Culture. Staff ensured they continually maximised people's choice, control and independence in a safe and inclusive environment, whilst also following national infection prevention and control (IPC) guidance. Each person had their own individual person-centred care plan and risk assessments which promoted their rights, privacy and dignity
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 and update
The last rating for this service was requires improvement (published 3 December 2019) and there were three breaches of regulation. The provider completed an action plan after the last comprehensive inspection to show what they would do and by when to improve person-centred care, safe care and treatment and good governance.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements regarding person-centred care, safe care and treatment and good governance. This report only covers our findings in relation to the key questions safe, responsive and well-led which contained those requirements. The inspection was also prompted in part due to concerns about the safe management of medicines at this service. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of the full report.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 St Aiden’s Cottage on our website at www.cqc.org.uk.
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 coronavirus and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.