Archived: Aisling Lodge

After the comprehensive inspection , the provider wrote and told us what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 31 August 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this breach. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 'Aisling Lodge’ on our website at

www.cqc.org.uk.

Aisling Lodge provides accommodation for up to 22 people who require support with their personal care. The service provides support for older people and people living with dementia. There were 18 people living at the service at the time of our inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 home is run.

At this focused inspection on 31 August 2017 we found that the provider had followed most of their plan, which they had told us would be fully completed by end of June 2017, and the legal requirement had been met.

We found that windows a number of windows had been replaced. Other windows frames and sills had been repaired and re-painted to make them safe. Work was still required to be undertaken to a door and a window. We were informed that this work was due to be carried out by 8 September 2017. On 12 September 2017 the registered manager informed us that this work had not yet been completed due to a delay with the contractor. The contractors have informed the registered manager that they will be undertaking the work by the end of the week.

Our last inspection took place on 14 January 2015 and as a result of our findings we asked the provider to make improvements to the cleanliness of the home and quality monitoring systems. We received an action plan detailing how and when the required improvements would be made by.

This unannounced inspection took place on 5 May 2016. There were 16 people receiving care at that time.

We found that sufficient improvements had been made to ensure people were cared for in an hygienic environment. We also found quality monitoring systems had improved. However, we found that not all areas of the building had been sufficiently maintained to provide a safe environment.

The service had a registered manager in place. 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.

Staff were only employed after the provider had carried out comprehensive and satisfactory pre-employment checks. Staff were trained, and supported, by the registered manager. There were sufficient staff to meet people’s assessed needs. Staff were aware of the procedures for reporting concerns and of how to protect people from harm.

People received their prescribed medicines appropriately and medicines were stored safely. People’s health, care and nutritional needs were effectively met. People were provided with a balanced diet and staff were aware of people’s dietary needs.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that there were formal systems in place to assess people’s capacity for decision making. The registered manager had prioritised the applications that needed to be made to the authorising agencies for people who needed these safeguards and had an action plan in place for achieving this. Staff respected people choices and decisions. Staff had received training in the MCA and DoLS, but this knowledge needed embedding.

People received care and support from staff who were kind, caring and respectful to the people they were caring for. People had opportunities to comment on the service provided and people were involved in every day decisions about their care.

Care records provided staff with sufficient guidance to provide consistent care to each person. Changes to people’s care was kept under review to ensure the change was effective. There was a programme of events for people to join in with. However, there were missed opportunities for engagement.

The registered manager was supported by a staff team that included a deputy manager, team leaders, care workers, and ancillary staff. The service was well run and the registered manager was approachable. People and relatives were encouraged to provide feedback on the service in various ways both formally and informally. People’s views were listened to and acted on. Concerns were investigated.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found.

Is the service safe?

People we spoke with said they felt safe at Aisling Lodge. Staff had undertaken training in protecting vulnerable adults from abuse and they demonstrated that they understood their responsibility to identify and report any concerns.

There were sufficient staff on duty to meet the needs of the people who lived at the home and additional staff were added to the rota to meet any specific needs, such as escorting people to hospital appointments. Risk assessments had been carried out to identify any potential health and safety risks to each person and actions put in place so that staff knew how to minimise the risks.

However, some areas of the home smelled unpleasant, which meant that the infection control system at the home was not robust enough to ensure that the home was kept clean.

Is the service effective?

People told us that they were happy at this home and that their needs were met by the staff. One person said, 'Coming here was the best thing that ever happened to me.' Relatives we spoke with were, overall, pleased with the service that was being provided to their family members.

Care plans gave staff clear guidance about the care that each person needed, and the way in which each person wanted their care to be delivered by the staff. Staff told us that the care plans were 'very useful.'

People's nutritional needs were assessed, recorded and monitored so that any specific requirements were met by the staff.

Is the service caring?

We spoke with a number of people who lived at Aisling Lodge and we observed how people related to the staff. We saw that people got on well with the staff who spoke to people in a caring and friendly way. People told us that staff treated them with kindness and respected their privacy and dignity. Staff also supported people to remain as independent as possible.

A relative told us, 'Everybody's been so kind to our [family member] and to everyone else. They're all really nice.'

Is the service responsive?

People's needs were assessed before they were admitted to the home and care plans were developed from the assessment. Care plans were reviewed and updated when people's needs changed so that staff would know how to meet each individual's changing care needs.

We saw that people's health needs were monitored, as staff ensured that people had access to other healthcare professionals such as their GP, dietician, optician and chiropodist.

Is the service well-led?

Prior to our inspection we had received a long list of concerns from a source that wanted to remain anonymous. We had asked the provider to investigate a number of the concerns, which they did and sent us their response. During the inspection we looked for evidence so that we could ascertain whether or not the concerns raised were genuine concerns. We found little evidence that supported the allegations made. Staff told us that the manager was 'very good, really OK' and that 'working here is really nice.'

However, the provider did not have a robust system in place to monitor the quality of the service being provided to people. We found that the provider had not carried out the actions they said they would, following a previous inspection when we assessed that their quality monitoring system was inadequate. The manager told us that a number of checks and audits were carried out, but agreed that there was no system to monitor whether any improvements were needed or carried out. This meant that the service was not as well led as it should have been.

We found that the provider was not compliant with some of the regulations in the areas we assessed. If you wish to see the evidence supporting our summary please read the full report.

We found that care records were current and reflected the needs of people who lived in the home. Staff demonstrated a good understanding and knowledge of the care and support people required.

Procedures were in place to ensure that people using the service received their medication appropriately and staff had undertaken training.

The premises were generally well maintained and records showed that appropriate safety checks had taken place on systems and equipment which meant it was safe for people to live in.

The provider had a recruitment procedure in place to ensure that only people suitable to work with vulnerable people were employed. Staff received a wide range of training to equip them for their role.

The provider had a system in place to check that people were satisfied with the service. However, they did not have an effective system in place to monitor and audit services provided to people who lived in the home.