Aronmore Residential Care Home

Updated 29 June 2022

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 Health and Social Care Act 2008.

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

The inspection was conducted by two inspectors and a nurse specialist advisor. An Expert by Experience supported the inspection by contacting the relatives of people who used the service after our visit. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Aronmore Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Aronmore is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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. At the time of our inspection there was a registered manager in post.

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 professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with two residents, the deputy manager and two care workers. The registered manager was on leave on the day of the inspection. 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 reviewed a range of records. This included ten people’s care records. We also reviewed multiple medicines records. We looked at six staff files in relation to recruitment and staff supervision and the training records for staff working at the home. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 29 June 2022

About the service

Aronmore Residential Care Home provides accommodation with personal care for older people, including those living with the experience of dementia and mental health needs. The service consists of a 27 bedded care home and four individual 'cottages' in the rear grounds of the main building. The service is registered for a maximum of 31 people and at the time of our inspection there were19 people living at the service, 17 in the main building and two in the cottages. Since the last inspection, the provider had not been taking new placements.

People’s experience of using this service and what we found

The provider did not always have effective systems in place to safeguard people from risk. Risks had not always been identified, assessed and recorded in care plans. Medicines were not always managed safely, and safe recruitment practices were not always followed to ensure only suitable staff were employed.

The provider had a process for recording incidents and accidents and lessons learned but these were not always recorded in the care plan so staff had relevant information to implement.

We observed staff were task focused and did not have time for much meaningful interaction with people. We made a recommendation for the provider to review how they deployed their staff to ensure the numbers of staff deployed were adequate to meet peoples’ needs and to ensure their safety.

There was also a lack of meaningful activities. We made a recommendation for the provider to consider recognised guidance for the provision of social and recreation activities for older people in care settings and provide meaningful activities for people living in the home.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. For example, the use of a senor mat without consent or a best interest decision for its use.

There had been some improvement in the environment and the provider had decorated some communal rooms and bedrooms but there were still areas such as bathrooms and toilets that required further maintenance. We made a recommendation for the provider to seek and implement national guidance in relation to providing a dementia friendly environment.

The provider had quality assurance systems in place, and we found there had been some improvements in how the home was managed but there remained identified shortfalls, such as risk assessments and the safe management of medicines, that the quality assurance systems had not picked up.

Although we identified a number of concerns during the inspection, relatives and staff were positive about the service and felt improvements had been made. Relatives said people were safe and well looked after by kind and caring staff and they would recommend the service to others.

People were supported to maintain healthy lives and access healthcare services appropriately. Care plans recorded people’s preferences, so staff knew their likes and dislikes.

Staff were supported to develop their skills and provide appropriate care through inductions, supervisions, appraisals, training and team meetings. Staff knew how to respond to possible safeguarding concerns.

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 inadequate (published December 2021) and there were breaches of regulation. The 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 the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care, staff recruitment, consent to care and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.