Archived: Aquarius Care Home

Updated 7 August 2021

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 Care Act 2014.

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 carried out by one inspector

Service and service type

Aquarius Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report.

We contacted health and social care professionals to obtain feedback about their experience of the service. These professionals included local authority commissioners and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they did not have any information about the service. We used all of this information to plan our inspection.

During the inspection

Some people were not able to verbally express their experiences of staying at the service. We observed staff interactions with people and observed care and support in communal areas. We spent time speaking with four people.

We spoke with six staff including; the administrator, care staff, senior care staff, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. This included speaking with staff in person on the day of the inspection and by telephone after the inspection.

We reviewed a range of records. This included three people's personal care records, care plans and people's medicines charts, risk assessments, staff rotas, staff schedules, two staff recruitment records, and meeting minutes. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found. We looked at training data and quality assurance records. We attempted to contact two relatives to gain their feedback, we left messages asking for feedback but did not receive any responses.

Updated 7 August 2021

About the service

Aquarius Care Home is a single storey residential care home providing personal and nursing care to 19 people aged 65 and over at the time of the inspection. The service can support up to 20 people. The service was not providing any nursing care when we inspected. This was being provided by community nurses for those that needed it.

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

People gave us positive feedback about the service and the staff. People told us, “The staff are easy going and polite, I don’t have favourites they are all very nice”; “I’m quite happy, they treat me well, good care, they are excellent people” and “I have lovely life. The staff are nice and they treat me well.”

Risks to people's safety had not always been identified. Risk assessments did not have all the information staff needed to keep people safe. People had not experienced harm as a result of this. Records of medicines that required special storage and recording did not always balance with the amount held in stock. Medicines were securely stored and kept at the correct temperature to ensure their efficiency. Staff had been suitably trained and had their competency checked to make sure they practiced safe medicines administration.

When people’s needs had changed their care plans had not always been updated and amended to detail their current assessed needs. Care plans and supporting documentation were not always individualised and person centred. Which meant that people may receive care and support which did not meet their needs.

The service was not always well led. The registered manager knew people well and people were comfortable communicating with them. The registered manager and provider had carried out the appropriate checks to ensure that the quality of the service was maintained. However, the audits and checks were not robust. They had not captured the issues we had identified relating to; risk management, staff recruitment practice and management of medicines requiring special storage. After the inspection the registered manager submitted an action plan detailing how they planned to meet these areas of action.

We were somewhat assured that the provider was using PPE effectively and safely. We signposted the provider to resources to develop their approach. Staff wore personal protective equipment (PPE) and followed guidance to make sure this was disposed of safely. Staff had access to PPE whenever they needed it. People had been isolated for the required amount of time on admission the service was clean, and all areas of the service were regularly cleaned.

Information in the service was available in a variety of formats to meet people’s communication needs. However, the menu board in the dining room was not in use to support people to know what was on offer and to remind people of the choices they had made. Clocks on display around the service which showed people what time, day and date it was were not working (or were showing different times and dates). This did not enable people to orientate themselves.

There were suitable numbers of staff on shift to meet people's needs. People’s call bells were answered quickly. Staff understood their responsibilities to protect people from abuse. People told us they felt safe.

People had been involved in planning and discussions about their wishes and preferences in relation to their end of life care. A range of activities were available for people who lived at the service and people were able to choose if they wished to join in with activities.

People told us they would complain to the staff or registered manager if they were unhappy about their care. The complaints policy was on display and gave people all the information they needed should they need to make a complaint.

People supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 6 March 2018).

Why we inspected

We received concerns in relation to infection control, management of pressure ulcers and staffing levels. As a result, we undertook a focused inspection to review the key questions of Safe, Responsive and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires improvement. This is based on the findings at this 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.

We have found evidence that the provider needs to make improvements. Please see the Safe, Responsive and Well-led key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aquarius Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.