Background to this inspection
Updated
1 November 2019
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.
Inspection team
The inspection was carried out by an inspector, an assistant inspector and a specialist advisor with a background in governance.
Service and service type
Aston Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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 had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who lived in the service and three 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 the registered manager, nominated individual and a further three members of staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. Following our inspection, we received feedback from one professional who had involvement with the home.
We reviewed a range of records. This included two people’s care records in details and a further three care plans for specific information. We looked at four staff files in relation to recruitment and ongoing support as well as a variety of records relating to the management of the service. Policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and an environmental update. The registered manager also provided confirmation of action they said they would take during our inspection.
Updated
1 November 2019
About the service
Aston Manor is registered to provide nursing and residential care for up to 32 people, at the time of this inspection there were 26 people living at the home. The home provides accommodation across the ground and first floors in single en-suite bedrooms.
People’s experience of using this service and what we found
We identified gaps in staff refresher training in subjects including dementia awareness, safeguarding and the Mental Capacity Act (2005). Prior to our inspection, some training had been booked to address this.
On the day of our inspection, we witnessed an avoidable accident, although appropriate action was taken by staff in response. Risk assessments were sufficiently detailed. Staff were not aware of personal emergency evacuation plans, but were able to describe action they needed to take in the event of a fire.
Staff received regular supervision as well as meetings for them to raise issues and receive feedback.
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 administration of medicines was managed safely.
There were sufficient numbers of suitably deployed staff to meet people’s needs. The process followed for recruiting new staff was safe.
People felt safe and protected from harm living at this home. Staff knew how to identify abuse and told us they would report this.
People’s dietary needs were met. Mealtime audits had identified the need for staff to provide condiments. This was an issue found at our last inspection and remained a concern. Records showed people’s healthcare needs were met by a range of professionals.
Staff were caring in their interactions with people. Relatives confirmed this routinely happened. Staff respected people’s privacy and dignity as well as their equality, diversity and human rights.
Care plans contained enough information to guide staff. Relatives were involved in people’s care and told us staff knew their family members and their preferences well. One person’s end of life care needs were being well managed.
No complaints had been received at the time of our inspection. The registered manager told us activities were difficult to provide for the group of people they cared for. Some evidence of stimulation provided was evident.
A system of audit was taking place on a regular basis. The registered manager had actively looked to work in partnership with other services. Relatives and staff gave positive feedback about 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 last rating for this service was requires improvement (published 16 August 2018) and there were multiple breaches of regulation. The registered 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 improvements had been made and the provider was no longer in breach of regulations from the last inspection. However, a new breach of regulation 18 (Staffing) was found.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.