Archived: Aaron Lodge Care Home

Updated 27 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 and 20 February 2017and was unannounced. The inspection team consisted of two adult social care inspectors.

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury of scolding. The information in relation to this incident is being reviewed by the Commission.

However, the information shared with CQC about the incident indicated potential concerns about the management of risk of scalding. This inspection examined those risks.

We reviewed the information we held about the service before the inspection including the Provider Information Return (PIR) which was received from the service on 11 December 2016. This document provides information about the service. The commissioners of the service were contacted prior to the inspection.

During the inspection we spoke with eight staff members including the acting manager, six relatives/visitors and one visiting nurse. We viewed six care plans and case tracked two people who lived there which meant we looked at a range of their care records.

In view of the people living at Aaron Lodge Care Home having communication and cognitive difficulties we used observation as our main method of assessment with people who lived there. We undertook two SOFI [Short Observational Framework for Inspection] assessments where we observed the interactions between staff and people who lived there. SOFI is a way of observing care to help us understand the experience of people who had difficulty conversing with us.

Updated 27 April 2017

This unannounced inspection of Aaron Lodge Care Home took place on 14 and 20 February 2017.

The home was last inspected in May 2016 and judged as 'inadequate' overall and placed into 'Special Measures.' We identified ten breaches of the regulations.

These were in relation to safe care and treatment [two breaches of this regulation], dignity and respect, staffing levels, staff training, consent, person centred care, governance, nutrition and hydration and safeguarding.

This unannounced inspection took place to check if the provider had made enough improvements to meet their legal requirements.

Aaron Lodge is a dementia care home registered to provide care for up to 48 people living with dementia across two floors. There was a passenger lift within the care home.

At the time of the inspection 21 people were living at the home and the care provider had announced closure of the care home. The Local Authority was working with the care provider to ensure all people living at Aaron Lodge Care Home were being transferred to another suitable care home. We undertook this unannounced inspection to check that the people who lived there were safe.

A manager was present at the time of inspection that was brought into the care home to manage the transition of care for people to another care home. There was no registered manager in post within the care home at the time of our inspection.

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 were not always being kept safe from harm and the provider remained in breach of the regulation related to safe care and treatment. Medicine records seen were not always accurate and there had been two incidents reported of the person being subjected to harm.

The care provider remained in breach of the regulation related to safe care and treatment.

Care plans we viewed had been updated with person centred information and some contained a photograph. The information within the care plans provided staff with enough information they needed to know to be able to care for the person however it was difficult to find information within them.

The provider was no longer in breach of regulation related to person centred care.

At the last inspection we raised concerns regarding the staffing levels in the home. The provider was in breach of regulations relating to this. We found there were not enough staff to provide the care people needed at the time they needed their care. We checked if there was enough staff to meet the needs of the people living at the care home on this inspection. The methods used were the SOFI [Short Observational Framework for Inspection] and other observations. We found there were enough staff to meet the needs of the people living in the care home at the time of this inspection. People were observed to be responded to by staff when they needed assistance and staff were observed engaging with people more frequently than on our last inspection. Staff were attempting to undertake activities with people but due to time constraints the care being delivered was mostly still task led.

The care provider was no longer in breach of the regulation related to staffing levels.

Previously we raised concerns about the service not always following the principles of the Mental Capacity Act (MCA) 2005. We found that consent was not being sought in line with the Mental Capacity Act 2005 and decisions were being made on behalf of people without following a best interest’s process. At this inspection we found the principles of the Mental Capacity Act 2005 had been adhered to. The care provider demonstrated they had followed the best interests’ process in line with the principles of the MCA 2005 legislation.

The provider was no longer in breach of this regulation related to Consent.

During our last inspection we raised concerns around people's dignity and safety. On this inspection we observed staff upheld people’s dignity at all times and were respectful of people’s wishes.

The provider was no longer in breach of the regulation related to dignity and respect.

At our last inspection we found that people were not always protected from abuse and the provider was in breach of regulations relating to this. We found that the procedure for reporting and acting on safeguarding's had improved since our last inspection in May 2016.

The provider was no longer in breach of this regulation related to safeguarding.

During our last inspection, we identified that not all staff had received up to date training as required by the provider. At this inspection we saw that staff had not received emergency first aid training and one staff member out of the four files we checked had not received up to date manual handling training. We were informed by the care provider the emergency first aid training had been placed on hold due to the announcement of the closure of the care home. The care provider also told us their in-house manual handling trainer’s training needed updating prior to them completing any additional training with staff.

The care provider remained in breach of the regulation related to staff training.

During our last inspection we identified that people were not receiving enough to eat and drink. We checked if improvements had been made on this inspection. We found that people were provided with jugs of liquids in their bedrooms and there were jugs of liquids in the lounges on both floors for people to have a drink if they wished. For people who were unable to monitor their own fluid intake staff were observed asking people during the day if they would like a drink. Fluid balance charts were no longer being completed retrospectively and the system of recording had also improved. People’s weights and food intake were being monitored in line with the recommendations being made by the medical staff and health care professionals.

The care provider was no longer in breach of the regulation related to nutrition and hydration.

During our last inspection we found systems were not robust such as the system for recording fluids/drinks, communication systems and systems of recording and reporting abuse. We checked these systems at this inspection and found the systems had improved. There was a new doctor’s visit sheet in care plans, a new more detailed handover sheet and a more robust recording and reporting of safeguarding concerns and incidents.

We no longer found the provider in breach of the regulation related to governance. However, further work was still required and we made a recommendation with regards to this as they did not always action concerns appropriately or pick up on some of the concerns we found.

You can see what action we told the provider to take at the back of this inspection report.