• Care Home
  • Care home

Aster Care

Overall: Good read more about inspection ratings

26A Belle Vue Grove, Middlesbrough, Cleveland, TS4 2PX (01642) 852324

Provided and run by:
Atlas Care Homes Limited

Important: The provider of this service changed. See old profile

All Inspections

14 January 2022

During an inspection looking at part of the service

Aster Care is a care home for up to 102 young adults, older adults and adults living with a learning disability providing personal and nursing care in one purpose-built building. At the time of inspection 26 people were living at the service.

We found the following examples of good practice.

¿ We were assured the service had good infection prevention and control procedures in place as a designated setting.

¿ Effective screening procedures were in place for visitors.

¿ Staff wore personal protective equipment (PPE) correctly. The home had good stocks of PPE.

¿ All staff had received training and demonstrated good practices to maintain good infection and prevention control procedures.

¿ Good systems were in place to shield and isolate people in the event of an outbreak. Staff practised social distancing in the service.

¿ Clear procedures were in place to admit people safely into the service.

¿ People and staff participating in the Covid testing programme.

¿ People and staff were kept up to date with government guidance relating to testing and infection prevention and control guidance.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

24 November 2021

During an inspection looking at part of the service

About the service

Aster Care is a care home which provides nursing and residential care for up to 102 people. The service supports younger people, older people and people with a learning disability. 25 people were using the service when we inspected.

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

Medicines were managed safely but we have made a recommendation about record keeping associated with medicines management. People and relatives said people were safe at the service. Risks to people were assessed and action taken to prevent them. Staffing levels were monitored and staff were safely recruited. Effective infection prevention and control systems were in place.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of safe, effective and well-led the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The model of care and setting maximises people’s choice, control and independence

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human

rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

Quality assurance systems were used to monitor and improve the service. People, relatives and staff said their feedback was sought and acted on. Effective working relationships were in place with external professionals and community groups.

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 3 September 2021) and there were two breaches of regulation. 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 undertook this focused inspection to check whether the conditions we imposed on the provider’s registration in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met, and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led.

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.

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 Aster Care 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.

24 June 2021

During an inspection looking at part of the service

About the service

Aster Care is a care home which provides nursing and residential care for up to 102 people. The service supports younger people, older people and people assessed as requiring a period of recovery in its residential reablement unit. People are supported in three separate units, each of which has separate adapted facilities. At the time of this inspection 28 people were using the service.

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

Medicines were not always managed safely. Quality assurance processes were not always effectively monitoring or improving the service.

Risks to people were assessed and addressed, though further and sustained improvement was needed in some areas. Staffing levels were monitored and staff were safely recruited. People were safeguarded from abuse. Effective infection prevention and control systems were in place.

People were supported with eating and drinking, though further and sustained improvement was needed in recording this. Staff received regular training, supervision and appraisal. 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. The provider was refurbishing the premises and reviewing how it could be further adapted to meet people’s needs.

Staff spoke positively about the leadership of the manager. Feedback was regularly sought from people, relatives and staff. The manager and provider was working to strengthen links with external professionals and agencies.

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 inadequate (published 9 April 2021) and there were two breaches of regulation.

We imposed conditions on the provider's registration requiring action to be taken to improve the service. At this inspection enough improvement had not been made or sustained and the provider was still in breach of regulations.

Why we inspected

We undertook this focused inspection to check whether the conditions we imposed on the provider’s registration in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led.

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 remains inadequate. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Aster Care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to medicine records and quality assurance processes at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

17 February 2021

During an inspection looking at part of the service

About the service

Aster Care is a care home which provides nursing and residential care for up to 102 people. The service supports younger people, older people and people assessed as requiring a period of recovery in its residential reablement unit. People are supported in three separate units, each of which has separate adapted facilities. At the time of this inspection 54 people were using the service.

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

Risks to people were not always effectively assessed or monitored. Medicines were not always managed safely. Fire safety systems were not always effective. The provider’s recruitment processes were not always followed. Staff had not always received the training needed to support people effectively. Quality assurance processes were not effectively monitoring or improving the service.

Effective infection prevention and control systems were in place. People were safeguarded from abuse.

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. People were supported to access healthcare appointments.

Staff spoke positively about the leadership of the manager. People and relatives said they had good communication from staff at the service. The manager was working to develop and strengthen links with external professionals and agencies.

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 17 May 2019) and there were three breaches of regulation. The provider completed an action plan after that inspection to show what they would do and by when to improve. The service was inspected again in August 2020. The rating was not considered but two ongoing breaches of regulation were identified. A Warning Notice was issued following that inspection.

At this inspection enough improvement had not been made and the provider was still in breach of some regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to medicine management, risk management and training. 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

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.

Special measures

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 the 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.

26 August 2020

During an inspection looking at part of the service

About the service

Aster Care is a care home which provides nursing and residential care for up to 102 people. The service supports younger people, older people and people assessed as requiring a period of recovery in its residential reablement unit. People are supported in three separate units, each of which has separate adapted facilities. At the time of this inspection 55 people were using the service.

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

Medicines were not always managed safely. Risks to people were not always effectively assessed. Quality assurances processes had not identified or resolved the issues we found during our inspection. Effective infection prevention and control systems were in place.

Staff treated people with dignity and respect. People spoke positively about staff and the support they received. We received positive feedback on the management 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 17 May 2019) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of some regulations.

Why we inspected

We undertook this targeted inspection to check whether the breaches of regulation and other concerns identified at the last inspection had been addressed. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

As part of CQC’s response to the coronavirus pandemic we are also conducting a thematic review of infection control and prevention measures in care homes. The Safe domain also therefore contains information around assurances we gained from the registered manager regarding infection control and prevention.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified continuing breaches of regulation in relation to safe care and treatment and good governance. 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

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

2 April 2019

During a routine inspection

About the service: Aster Care is a care home which provides nursing and residential care for up to 102 people. The service supports younger people, older people and people assessed as requiring a period of recovery in its residential reablement unit. At the time of this inspection 57 people were using the service.

People’s experience of using this service: At the last inspection we found a breach of Health and Social Care Act 20018 (Regulated Activities) Regulations 2008 related to governance. We found a breach of the Care Quality Commission (Registration) Regulations 2009 as notifications had not always been made to the Care Quality Commission in a timely manner.

At this inspection the provider had made some positive changes. However, we identified three breaches of the Health and Social Care Act 20018 (Regulated Activities) Regulations 2008 related to dignity and respect, safe care and treatment and good governance.

We received mixed feedback from people about living at Aster Care. We observed that people were not always treated with dignity and respect. People's preferences were not always met because staff were often focussed on tasks. People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

Medicines were not always managed safely.

Staff knew how to safeguard people and report suspected abuse.

The registered manager and provider carried out checks and audits and sought feedback from people and their relatives. Quality assurance systems were not always robust. People’s confidential information was not always kept secure.

The management team worked with other agencies and professionals to best support people.

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

Rating at last inspection: At the last inspection the service was rated requires improvement (report published April 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up. We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will return to re-inspect this service within the published timeframe for services rated requires improvement.

8 November 2017

During a routine inspection

This unannounced inspection took place on 8, 13 and 22 November 2017. This meant the provider, registered manager, staff and people using the service did not know that we would be carrying out an inspection of the service.

The service was registered on 27 June 2017 and this was the first inspection of the service. This service had been rated 'Inadequate' under the previous provider and we needed to check that improvements had been made.

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

Aster care is purpose built and can provide nursing and personal care for up to 102 people across three separate units for people living with a dementia and people who have nursing needs. The service also provides support for working age adults who have a physical health condition, live with a mental health condition, learning disability or autism. At the time of inspection there were 39 people using the service who had nursing needs, were living with a dementia, had a physical disability or had a mental health condition.

The registered manager has been registered with the Care Quality Commission since 27 June 2017. 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.

The registered manager had not always informed CQC of significant events by submitting the required notifications. This meant we could not always check that appropriate action had been taken.

Quality assurance procedures had not identified that staff were not following the correct procedures for monitoring people at risk of dehydration and for turning percutaneous endoscopic gastrostomy (PEG) feeding tubes to stop them embedding into the wall of the skin.

Some aspect of medicines management needed to be improved. This included medicines audits and policies to make sure they were specific to the service.

The provider had not carried out quality assurance visits to monitor the service. The registered manager was carrying out some audits. Formal supervision sessions had not been carried out.

People's privacy and dignity was not always maintained. Doors were not always closed during personal care.

People and staff were aware of how to raise concerns about bullying, abuse and inappropriate behaviour. There was evidence that lessons had been learned, such as when safeguarding incidents had occurred, as measures were put in place to prevent repeat events.

Systems were in place to monitor the safety of the building. Staff participated in regular fire drills. Accidents and incidents had been reviewed and actions taken to review risks. Risk assessments were in place to keep people safe. They had been reviewed and were in-line with people’s needs.

Complete recruitment records were in place and also staff had Disclosure and Barring Service (DBS) checks in place. The DBS carry out criminal records checks and also ensure that people are not barred from working with vulnerable children and adults. This helps employers make safer recruitment decisions.

There were sufficient staff on duty, however break times were not managed well. The registered manager told us they would take immediate action to address this.

There was sufficient personal protective equipment available for staff. An infection prevention and control champion was identified within the service who provided staff with up to date information and training for all staff was on-going.

Staff were supported through an induction programme. Informal supervisions had taken place but not been recorded. Training was in place for staff.

People told us they enjoyed the food provided but wanted to be involved in menu planning. People were given choice and had been given enough to eat and drink.

Care records reflected recommendations and guidance made by health professionals to support people’s health and wellbeing. People were supported to access whatever healthcare services they needed to in order to remain healthy.

Mental Capacity Act assessments had been carried out when needed. The registered manager had followed the requirements of Deprivation of Liberty Safeguards (DoLS) and applications had been submitted when needed so that assessments could be made about whether people needed to be lawfully deprived of their liberty to maintain their safety. CQC had been informed when applications had been approved. Staff were complying with conditions applied to authorisations.

People were supported to make decisions about their own care; however this was not always reflected in people’s care records. This is because staff had not completed the records fully. The registered manager was aware that this was a training issue.

The service was clean and tidy and rooms were personalised. Some adaptations were in use at the service, such as handrails in communal areas and bathrooms. Further improvements were needed to create a dementia friendly environment.

A small number of assistive technologies were in place for people. These included wheelchairs, walking aids, mobile phones, Wi-Fi and a computer with voice recognition. Communication passports were not in place for people when they went into hospital. We have made a recommendation about this.

Staff provided safe care and support to people and knew people's needs well. Care plans were detailed and contained relevant information about people’s needs, wishes and preferences.

People told us staff were kind and respectful to them and staff encouraged them to remain independent. People spoke highly of staff. We saw people and staff laughing and joking during inspection. Staff responded quickly when people were anxious and upset. Staff supported people to maintain relationships with people important to them.

Staff took quick action when people became unwell and followed recommendations and guidance from health professionals.

People and staff gave mixed reviews about the quality of activities provided at the service. People had developed their own activities committee to improve the quality of activities for everyone.

People and staff spoke positively about the registered manager. Staff worked together as a team and they told us the morale within the team was good.

Meetings for staff and people using the service had taken place. Both parties had been kept up to date on the work being carried out by the provider and plans for the future. Feedback had been sought in both of these meetings. The registered manager told us that surveys were due to be carried out shortly.

The service worked in partnership with health and social care professionals involved in people’s care, with the clinical commissioning group, local authority contracts and commissioning and safeguarding teams.

People and relatives were aware of how to make a complaint, though none had done so. People told us they felt listened to when they had raised concerns.

The registered manager told us they provided end of life care to people when needed, however they were not providing this at the time of inspection.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Good governance. We also identified a further breach of the Care Quality Commission (Registration) Regulations 2009 by way of failure to make statutory notifications in relation to the abuse or allegation of abuse of people. You can see what action we told the provider to take at the back of the full version of the report.