Archived: Aran Court Care Centre

Updated 10 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 14 and 24 November 2016.

The inspection was carried out by three inspectors and two experts by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our experts-by experience had experience of using this type of service.

Before our inspection we looked at the information we hold about the service including notifications and concerns we had received. Before this inspection we had received concerns about staffing levels, a high use of agency staff and some aspects of the care provided in the home. Notifications are incidents that occur in the home such as injuries or safeguarding concerns that the registered provider has a legal duty to tell us about.

We had asked the registered provider to complete and return the Provider Information Return (PIR) which we had received and used to inform our inspection. The PIR is a form that asked the provider to give some key information about the service, what the services does well and improvements they plan to make. We reviewed regular quality reports sent to us by the local authority that purchases care on behalf of people, to see what information they held about the service. These are reports that tell us if the local authority has concerns about the service they purchase services from on behalf of people. We also contacted the Clinical Commissioning Group that purchased services on behalf of people.

We observed how staff supported people throughout the inspection to help us understand their experience of living at the home. As part of our observations we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the needs of people who could not talk with us.

We spoke with 28 people that lived in the home, nine relatives, and 11 staff including those with responsibility for care, nursing and management of the home. We looked at seven people’s care records to check if they were receiving care as planned. We looked at records including staff training records, complaints records and records relating to the monitoring of the quality of the service. We looked at medicine management processes to determine if people received their medicines as prescribed.

Updated 10 January 2017

This inspection took place on 14 and 24 November 2016 and was unannounced.

We last carried out a full inspection of this service on 02 September 2015 when we identified that improvements were needed in two of the questions we ask; Is the service safe and Is the service well led. We carried out a focussed inspection on 09 March 2016 following a serious incident in the home to assure ourselves that people were safe and following that inspection we felt assured that people were safe. At this inspection we checked that the required improvements had been made and maintained. We saw that although some improvements had been there were issues that that meant that further improvements were needed to ensure that people received good quality care.

Aran Court Care Centre provides nursing and personal care to up to 86 people for reasons of frailty, physical disability, sensory impairment and mental health disorder.

The registered provider is required as part of their conditions of registration to have a registered manager in post. At the time of or inspection there was a registered manager in post but they had only been in post for a few weeks. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We saw that some improvements were needed to the management of medicines to ensure that people received their medicines as prescribed. We identified this as a breach of regulation.

During our inspection some people and their relatives and staff expressed their concerns regarding the staffing levels in the home and the high dependency on agency staff. People felt that on occasions there were insufficient staff available to meet people’s needs. The provider had assessed the number of staff needed to meet people’s needs but due to the dependency on agency staff to meet the required numbers because of a high turnover of staff people were unhappy with the number of different people in the home who did not know their needs. Some efforts were being made to meet the social needs of people but these were limited as there were no specific staff with responsibility for this area of need.

People’s needs were met but care provided to people was generally task orientated rather than person centred. For example, staff completed basic tasks for people such as assisting with personal care and ensured that they received pressure relieving equipment to prevent skin damage. However, staff did not always ensure that drinks and emergency buzzers were always accessible to people to ensure that their hydration levels were maintained and they were able to summon assistance if they needed it. Information received during and after our inspection showed that people’s continence needs were not always being adequately met.

People received food and drink that met their nutritional needs but mealtimes were not always a pleasant experience and well managed, particularly for people living with dementia.

Staff were supported to provide care to people through the provision of training, supervision and through meetings and handovers.

Systems were in place to listen to the views of people and take actions to address the issues raised through complaints, surveys and meetings. The quality of the service was monitored but the systems had not always identified areas for improvement and plans put in place to monitor and sustain improvements.

Systems were in place to ensure that people were given choices and consent obtained for the care and treatment they received.

You can see what action we told the provider to take at the back of the full version of the report