Archived: Aadams Residential Care Home Limited

Is the service safe? People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. The service was safe, clean and hygienic. The fabric of the building was in need of a total audit to determine which parts needed to be redecorated or replaced. The registered person had not taken appropriate steps to ensure people were protected against the risks associated with a lack of provision of appropriate window restrictors.

Is the service effective? People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing their care plans and they reflected their current needs.

Is the service caring? People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People at the home said that they felt their needs were very well met by the staff. We found that people's nutritional needs were met.

Is the service responsive? People completed limited activities in and outside the service. However, staff at the home believed this would improve with the employment of an activities co-ordinator. We noted that the microwave in the kitchen was not working. The catering staff explained that meals could be reheated in the oven; however, access to a microwave would ensure the reheating of food could be completed in a timely fashion, so as to meet the need of people living at the home. The service provider may like to consider the provision of a working microwave following discussion with the catering staff.

Is the service well-led? The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system; records showed that identified shortfalls were addressed promptly. Staff had a good understanding of the ethos of the home and wanted to ensure it was implemented.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People were comfortable and relaxed during our inspection. We observed care being provided in a safe and supportive manner. One person told us, 'I'm happy here. If I had to mark it out of 100 it would have to be in the 90's'.

Since our last inspection Aadams had made improvements in areas of non-compliance. New systems had been introduced to ensure people's monies held for safe-keeping by the service were secure. This meant the provider had arrangements in place to safeguard people against financial abuse.

We found furnishing, d'cor and carpets had been upgraded and maintenance was generally improved. Issues with infection control and general hygiene had been addressed by the manager. Although we noted that additional cleaning staff was required, the provider was in the process of recruiting extra staff.

Care planning was often limited and significantly inconsistent. Care files were poorly organised and held conflicting records. Reviews of care files, along with other documents such as personal details, were not signed and dated properly. This meant people were at risk of unsafe care because the provider had not ensured care records were clear.

Staff and people who lived at Aadams told us staffing levels were adequate for their needs. Rotas we checked confirmed this. This meant staffing levels adequately ensured safe support requirements for people living at the home. In order to maintain this, we noted that staffing levels would need to be enhanced if the service's occupancy increased.

Aadams was under a suspension of admissions at the time our inspection. This meant the local authority was preventing the home from admitting people until improvements had been made.

Is the service effective?

Aadams met people's nutritional needs in an effective manner. People and their representatives had been consulted about menus and meal options. Care records we reviewed held information about the regular monitoring and assessment of people's needs. This meant the provider had ensured people's nutritional requirements were properly managed.

We found inconsistencies throughout the files we reviewed. Records were not properly recorded and dated. There was limited or no recorded evidence of consent to care provision. This meant the provider was not effective in the appropriate management of people's records.

Is the service caring?

People were comfortable and relaxed during our inspection. Staff engaged with people in their care in a friendly, supportive and appropriate manner. People told us they were happy with the care provided. One person said, 'They look after me well and support me in a way I like to be supported. They're very respectful and maintain my dignity at all times'.

Most of the people we spoke with told us they were bored for much of the day. Care records were poorly organised and inconsistent. This meant people were at risk from inappropriate or unsafe care. The manager had not ensured records were signed and dated properly. The manager had not addressed our concerns found at the last inspection around the provision of social activities.

Is the service responsive?

People's needs were assessed before they accessed the service. This meant Aadams was able to confirm that they could meet the individual's support needs. People told us they were involved in their care planning. One person said 'I have seen and agreed my care plan. We are due to review this soon'. This meant people's needs were properly assessed because the manager was engaging people in this process.

Care records and reviews were not correctly signed and dated by staff and were inconsistent. Files were poorly organised and sometimes unclear. This meant people's changing needs might not be effectively monitored because the manager had not ensured records were properly managed.

We noted during our last inspection that the home did not provide activities to stimulate people on a daily basis. Most of the people we talked with during this inspection expressed feeling bored and unoccupied for much of the day. This meant the manager had not addressed our concerns and increased activities to engage people.

Is the service well-led?

Since our last inspection the provider had introduced new contracts that clearly outlined fees that were charged to people. These included terms and conditions of people's placements at the home. This meant the service was being transparent about what people were expected to pay.

Additionally, new systems and processes had been introduced to monitor the quality of service provision. This meant risks to people associated with care were being monitored.

Although people were relaxed and comfortable, care records were inconsistent. This meant people were at risk from unsafe care because the manager had not ensured care records were managed appropriately.

During our last inspection, we found that the manager was not registered with the Care Quality Commission. We found that although this was still the case, the manager was in the process of completing his application.

In relation to the management of the service, staff told us that they felt this had improved. One staff member said, 'Things are much better here now. I feel like we're managed better, but also able to get on with our jobs'.

People were cared for by staff who were seen to be very caring and friendly and had good knowledge of people's needs. People said, 'It's very good. There is a lot of common sense on how to treat people, they are all very good'. 'Everything is O.K. They are treating me well enough'. 'I do like living here. You get everything you need. They (staff) do their best and are good to me.' 'Everyone is very helpful'.

People who paid for their care did not have a contract that informed them of the terms and conditions of the service they paid for. Accounting systems were not sufficient to protect people from the risk of financial exploitation.

People had their medicines administered to them when they needed it by trained staff.

People told us they had all the comforts they needed but we found some places were not kept as clean as they should be. Some maintenance was required to bring the environment up to an acceptable standard.

People were not given good opportunities to give their views as to whether the service and accommodation provided met with their needs and expectations.

The manager employed had not applied for registration with the Care Quality Commission.

These included better pre assessment and discussion with people regarding their care and support needs. All areas of personal care need were identified and plans were organised and detailed enough to instruct staff on how best to meet individual needs in a dignified way. A one page profile was also used to support staff provide person centred care 'Helping you to help me' and 'My routine and what makes me happy'. One person told us 'I'm much happier now. I am able to get up and sit in my chair. If I need any help I only have to ring my bell and staff will come. No complaints'.

We found that risk management was being monitored adequately and procedures put in place to support staff manage risks effectively. This supported staff to provide care in a safe way.

Privacy locks had been fitted in the bathrooms and signage was used to alert people the bathroom was occupied.

People were supported by staff that were supervised and adequately trained.