25 September 2020
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 as part of our Thematic Review of infection control and prevention in care homes.
This inspection team consisted of two inspectors, a pharmacist specialist, a specialist advisor nurse 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. The Experts by Experience contacted people’s relatives by phone to request feedback.
Service and service type
Aarandale Manor 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 who was in the process of registering with the Care Quality Commission.
Notice of inspection
This inspection was announced. We gave a short period notice of the inspection as we were mindful of the impact and added pressures of Covid-19 pandemic on the service. This meant we took account of the exceptional circumstances and requirements arising as a result of the COVID-19 pandemic.
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. 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 used all of this information to plan our inspection.
During the inspection
We were only able to speak with one person who used the service as due to the current coronavirus pandemic, we were unable to speak with other people without compromising social distancing rules. We spoke with the nominated individual and two members of staff including the manager and the deputy manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included eight people's care records and 12 people's medication records. We looked at six staff files in relation to recruitment, supervision and appraisals. A variety of records relating to the management of the service, including quality assurance, training records and health and safety were also reviewed.
After the inspection
We spoke with 14 relatives of people living at the home. We also spoke with three nurses, two Care Home Assistant Practitioners, five care staff and two night care staff. We continued to seek clarification from the nominated individual and manager to validate evidence found.
25 September 2020
About the service
Aarandale Manor is a nursing home providing accommodation, nursing and personal care to 32 people at the time of the inspection. Some people were also living with dementia. The service can support up to 65 people. Aarandale Manor accommodates people in one adapted building over three floors.
People’s experience of using this service and what we found
Significant improvements had been made over the last year in the management of the home and the quality of care people received, despite management changes that had taken place.
Relatives commented that whilst management changes had taken place, the quality of care had not been affected and people were safe and received good care and support.
We observed people to be supported in a safe way, taking into consideration their needs, choices and wishes.
Risks identified with people’s health, medical and care needs had been assessed and documented with clear guidance on how to minimise the identified risk to keep people safe.
People received their medicines safely and as prescribed. Systems and processes in place supported this.
Recruitment policy and procedures supported the recruitment of staff who had been assessed as safe to work with vulnerable adults. We observed enough staff available to support people safely.
The home smelled fresh and was clean. There were increased infection control measures in response to the coronavirus outbreak. The provider reacted appropriately to keep people safe.
Staff received the required induction, training and support to carry out their role effectively. Care staff told us that they felt appropriately supported and that the management team were always available to provide direction and guidance.
The service supported people to eat and drink in ways which took into consideration their support needs, likes and dislikes.
People were 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.
Most relatives felt engaged with the service and confirmed that they received regular updates and feedback about their relative. However, some relatives did comment that communication between them and the home could be improved.
Management audits and checks enabled managers to oversee the quality of care delivery and make the required improvements where necessary. During the inspection, minor issues were identified with the recording of supervisions, appraisals, capacity assessments, best interest decisions and DoLS. However, following the inspection, these issues were addressed.
We have made a recommendation about the provider and management sustaining the improvements and embedding all learning and development going forward.
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 4 April 2019) and there were breaches of regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The regulation 17 breach was a continued breach from the previous inspection (published February 2018) and the second time that the service had been consecutively rated requires improvement.
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 improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced focused inspection of this service on the 3 and 4 September 2020 to check that the provider had followed their action plan, to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Aarandale Manor on our website at www.cqc.org.uk.
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.