12 April 2023
During an inspection looking at part of the service
Aden House is a care home providing personal care for up to 60 people. At the time of our inspection there were 34 people living at the service. There are communal areas and accommodation on both the ground and first floor. The Butterfly unit on the ground floor supports people living with dementia.
People’s experience of using this service and what we found
There were not enough staff deployed at the service to meet or respond to people’s needs safely and effectively. The environment was unclean, in a state of disrepair and was not dementia friendly. Risks associated with infection prevention and control (IPC) were not effectively managed. Risks to people’s safety were not adequately assessed, monitored or managed. Medicines were not managed safely.
The service was working within the principles of the Mental Capacity Act (MCA) and appropriate legal authorisations were in place when needed, to deprive a person of their liberty. Policies in the service supported this and staff supported people in their best interests, in the least restrictive way possible. However, people were not supported to have maximum choice and control of their lives. People’s care was not delivered in line with their needs and preferences and their personal care needs were not always met. People’s privacy and dignity was not consistently maintained. Staff did not always speak to people in a way that was respectful. People did not always have fluids readily available to them.
Staff did not always complete relevant training to ensure they had the right skills and knowledge to support people safely. Appropriate support was not in place for staff. Care records did not contain an accurate overview of people's care and support needs. They were not person centred and were often incomplete. There was a lack of engagement and activities for people.
Shortfalls identified at the previous inspection had not been addressed. Systems and processes to monitor and improve the quality of the service were ineffective as they had not identified issues found at this inspection. Where issues had been identified, no action had been taken to improve the quality of the service. Incidents were not always reported appropriately. There was no oversight with regards to reporting, analysing and learning from incidents. Effective systems had not been established for gathering feedback from people and relatives. The provider did not always effectively work in partnership with other agencies as a means of improving the quality of the service.
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 01 July 2021) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection improvement had not been made and the provider remained in breach of regulations.
At our last comprehensive inspection (published 17 September 2019) we recommended the provider consider current guidance in meeting the requirements of the MCA. At this inspection we found the provider was now meeting the requirements of the MCA.
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.
During this inspection, we also checked whether the provider had followed their action plan to confirm whether they now met legal requirements.
The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.
Enforcement and Recommendations
We have identified breaches in relation to managing risks to people, infection prevention and control (IPC), medicines management, staff numbers, support and training, record keeping, person centred care, and oversight of the service.
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
The overall rating for this service is ‘Inadequate’ and the service is therefore 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 of their 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.