Archived: Aurora

We found the following examples of good practice.

• The service booked visits for families and friends and staggered the times of visits to reduce the risk of infection transmission between people. Visits took place in the garden. Visitors had their temperature taken before entering and provided their contact details for test and trace purposes. Visitors were given Personal Protective Equipment (PPE), including hand sanitiser and face masks, which they had to wear throughout their visit. The service had detailed pictorial guidance to people living there, staff and visitors on how to put on and take off PPE. The home used video calls to make sure people had regular contact with their families and friends and to provide people with activities.

• Staff were allocated to work in specific shifts, with specific colleagues to reduce the risk of spreading infection. The service had plans in place to ensure that, where people had to isolate zoning was able to be managed.

• The service had an infection prevention and control process in place. The provider was regularly testing people and staff for Covid-19, in accordance with government guidance.

• The provider supported people and staff to stay safe. Staff had been trained and were confident in the management and prevention of infection. Additional measures had been introduced to clean the service and make sure the risk to people and staff was reduced. Staff had individual Covid-19 risk assessments.

Examples included, staff in higher risk categories, including Black, Asian and Minority Ethnic staff. The provider's infection prevention and control policy and business contingency plan had been updated to include Covid-19.

Further information is in the detailed findings below.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good

People felt safe living at Aurora, with the staff, the support the staff gave them and with the environment. Staff were trained and competent to recognise and report any abuse or avoidable harm so that people were protected. Staff’s positive risk-taking approach meant that risks were minimised without limiting people’s freedom to take appropriate risks.

There was a sufficient number of staff with the right experience, skills and knowledge deployed to make sure that people were kept as safe as possible. There was an effective recruitment process in place to reduce the risk of unsuitable staff being employed. Staff were clear about their responsibility to report accidents, incidents and concerns and they followed the correct procedures to prevent the spread of infection. Medicines were managed safely.

Staff received induction, training and support to enable them to do their job well. Staff supported people to do their shopping, cook their meals and encouraged them to eat a balanced, nutritious diet. External healthcare professionals such as GPs, dentists and opticians worked with staff to help people maintain their health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People and their relatives liked the staff and described them as really kind, helpful and nice. Staff made people feel they mattered and knew each person, and the details about the support the person needed, very well. Relationships between people and staff were based on mutual trust and respect.

People were involved in planning their support and information about advocacy services was available if anyone wanted an independent person to assist them with their affairs. Staff respected people’s privacy and dignity and encouraged people to remain as independent as possible. People could have been supported to be more independent with preparing their own, healthy meals.

Each person’s support plan was fully personalised, agreed with the person and gave staff sufficient guidance to support the person in the way that would help them attain their goals. People planned their own activities and outings, with support from their keyworkers. The service had been responsive to people’s needs in a number of ways.

A complaints process was in place and people, their relatives and staff were confident that any issues would be addressed by the registered manager. End-of-life care had not been provided but would be discussed with the person, their relatives and external professionals if the need arose .

The registered manager provided good, pro-active leadership and ensured that staff were clear about their role to provide people with a high quality service, thus upholding the values of the service. Staff felt well supported, fully included and happy to be working at Aurora.

A quality assurance system was in place, including a number of ways in which people, their relatives, staff and other stakeholders were asked to give their views about the service and how it could be improved. Audits and monitoring checks on various aspects of the service were carried out.

The registered manager was aware of their responsibility to uphold legal requirements, including notifying the CQC of various matters. The service worked in partnership with other professionals to ensure that joined-up care was provided to people.

Further information is in the detailed findings below.

Is the service safe?

People told us they felt safe. They had been cared for in an environment that was safe, clean and hygienic. People's needs had been assessed, and risk assessments described how any identified risks to people were minimised. The service had sufficient staff who were knowledgeable about people's care and support needs.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. They were happy with the care that had been provided and their needs had been met. Staff had received training to support people with various care needs. Some of the people had complex needs that meant they were not able to understand their care plans, we saw that some of these had been written in a 'easy read' format to enable people to understand their planned care and support. The service provided people with adequate and nutritious food and drink that ensured they maintained good health.

Is the service caring?

People were supported by kind and attentive staff. It was clear from our observations and from speaking with the staff, that they had a good understanding of the needs of the people living in the home and that they knew them well. They were able to communicate effectively with people with limited verbal communication.

Is the service responsive to people's needs?

We observed that staff responded promptly to people's needs. We saw that care plans had been updated when people's needs had changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and people were supported to access a variety of activities of their choice.

Is the service well-led?

The service had a registered manager in post. We saw that the provider had effective systems to assess and monitor the quality of the service they provided. They regularly sought the views of people using the service and their representatives, and took account of these to improve the service.

We saw evidence that improvements had been made, including changes to the management within the home and recruitment of additional, permanent staff.

We observed a relaxed, friendly environment with staff engaging positively and respectfully with people who lived there. At the time of our visit, three people lived at Aurora, these being the same three people we had met with at our previous inspection. We were therefore able to directly see the improvements in the care provided and observed the three people all being more relaxed and engaged with staff and activities. Not everyone was able to tell us about their experiences due to their communication difficulties, although one person said they were 'happy.'

We found improvements in the care planning and risk assessments in place and saw these were now regularly reviewed and reflective of people's needs.

We looked at the processes in place for safeguarding vulnerable people, and also the management of medicines, and found these to be comprehensive and followed by staff.

Staff had received additional training since our last inspection and also now received regular supervision and support.

The provider had implemented systems for assessing and monitoring the quality of service and care provision, and we saw evidence of these during our visit.

At the time of our visit, three people lived at the home and were supported by staff on a one to one basis. People who lived at Aurora had varying communication abilities but were able to tell us they were happy living at the home.

During our first visit on 23 November 2012 we saw people were not always offered choices or involved in decisions regarding their care and support. We observed staff behaviour which was not always appropriate or adapted to meet people's individual needs; one example included the use of aprons at mealtimes whether people required them or not. There were three members of staff on duty, two of whom did not usually work in the home and were not familiar with peoples' needs.

We returned for a second visit on 26 November 2012 and found the atmosphere in the home was much improved. The staff on duty were permanent staff, familiar with peoples' needs, and were interacting and engaging with people in a positive, respectful way. Residents looked more relaxed and they were communicating more openly than during our first visit.