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Archived: Aran Court Care Centre Requires improvement

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Reports


Inspection carried out on 14 November 2016

During a routine inspection

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

Inspection carried out on 9 March 2016

During an inspection to make sure that the improvements required had been made

This focussed inspection was carried out on 9 March 2016 following information we had received that people were not always safe from harm. Aran Court Care Centre was last inspected on 2 and 4 September 2015. At that inspection we judged that although no breaches of regulations were identified improvements were needed in keeping people safe and the governance of the service. At this focussed inspection we looked at specific issues relating to the safety of people and to assess their safety at the time of this inspection. We have not reassessed the ratings.

Aran Court provides accommodation and nursing care for a maximum of 86 people

There was a registered manager in post at the time of our inspection. 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.

People were protected from the risks of harm because risks had been identified and management plans put in place.

People received support to eat when needed and food was prepared so that it was presented in a form that could be swallowed easily and safely.

Staff were aware of the actions to take in an emergency so that people received safe care. There was always at least one staff member on duty with the appropriate lifesaving skills to assist people in an emergency situation.

There were systems in place to ensure that information was passed on between staff and there was learning from accidents and incidents that occurred. There was monitoring of accidents and incidents to ensure that trends were identified and actions taken to prevent reoccurrence.

Inspection carried out on 2 and 4 September 2015

During a routine inspection

This inspection took place on 2 and 4 September 2015 and was unannounced. This was the first inspection since a change of provider took place at Aran Court in February 2015.

Aran Court provides accommodation and nursing care for a maximum of 86 people. At the time of our inspection 84 people were living at the home.

There was a registered manager at this home. 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 found people were not always fully protected against the risks identified as staff were not consistent in their response to our questions regarding the support people required. We found specialist lifting equipment had not received a service to ensure they were safe to use and it was unknown whether issues identified when the equipment was last services had been actioned.

Staff knew how to keep people safe from the risk of abuse and harm. They were aware of the action they would need to take if they were concerned about the treatment people received.

Staffing levels were sufficient to meet people’s needs and could be adjusted to reflect changes in needs. Agency care staff were not used to ensure consistency in care provision. Staff were kind and caring and we saw people’s privacy and dignity was maintained. People were supported to remain as independent as possible.

The registered manager had followed the principals of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards when assessing people’s ability to make specific decisions.

People were supported to have their medicines safely and routine healthcare needs were met by involving appropriate professionals.

People were supported by staff who were knowledgeable and received regular training. Staff were supported by the registered manager and nurses to provide them with information needed to provide care to people. People had access to food and drink they enjoyed. Meal times were relaxed and people received the support and guidance needed.

People who lived at the home as well as their relatives were aware of how to raise concerns or complaints and felt these would be listened to and action taken to improve the service provided. The registered manager encouraged relatives to be involved and share their comments about the service provided. Relatives were made welcome and could visit their family member at any time.

The registered manager had systems in place to monitor and improve the quality of the service provided. However, these were not always effective in identifying changes in people’s healthcare needs and in ensuring the environment and equipment were kept clean.