Archived: Aquarius Residential Care Home

Updated 4 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 22 and 24 November 2016 and was unannounced.

The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using similar services or caring for older family members.

Before the inspection, we reviewed previous inspection reports, actions plans and notifications before the inspection. A notification is information about important events which the service is required to send us by law.

We spent time speaking with 11 people, one relative and one visiting health care professional. We observed staff interactions with people and observed care and support in communal areas. We spoke with eight staff including care staff, senior care staff, the cook, the registered manager and the provider. We also spoke with two further staff outside of the inspection visit.

We contacted health and social care professionals including the local authorities’ quality assurance team, people’s GP and care managers to obtain feedback about their experience of the service.

We looked at records held by the provider and care records held in the home. These included six people’s care records, medicines records, risk assessments, staff rotas, five staff recruitment records, meeting minutes, quality audits, policies and procedures.

We asked the registered manager to send additional information after the inspection visit, including training records. The information we requested was sent to us in a timely manner.

Updated 4 January 2017

The inspection was carried out on 22 and 24 November 2016. Our inspection was unannounced.

Aquarius Residential Care Home is a care home which provides accommodation with personal care for up to 20 older people. The home is a bungalow, which has been extended. It is located on the outskirts of Chatham. There were 20 people living at the home on the day of our inspection.

The home had a registered manager. 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 service is run.

At our previous inspection on 21 and 23 December 2015 we found breaches of Regulations 12, 15, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to meet the regulations.

The provider sent us an action plan on 29 April 2016, the action plan detailed that they had already met some regulations and aimed to be fully compliant by 15 May 2016.

At this inspection, people gave us positive feedback about the home and told us they received safe, effective, caring, responsive care.

Staff responsible for providing care had not all undertaken training to enable them to meet people’s needs. Eight out of 14 staff had not completed dementia training despite providing care and support for people who lived with dementia. No staff had undertaken epilepsy training despite caring for people who had a diagnosis of epilepsy. The training records also evidenced that no staff had undertaken catheter care training despite providing care for four people that had catheters in place to help them with their continence needs.

Records of staff supervisions showed that these meetings had taken place for new staff, however staff that had worked at the service for some time had not received a formal supervision since July 2015.

Risks to people had been identified and mitigated where possible. However, water temperatures in parts of the building were excessive which could cause injury to people. Action had not been taken quickly to resolve this over a four week period between October and November 2016. We made a recommendation about this.

Risks assessments relating to one person’s swallowing and choking had not been updated to reflect changes to their health. We made a recommendation about that.

Prescribed thickener which is used to thicken fluids to aid swallowing was left out and unattended. Prescribed thickeners should be kept locked away to prevent accidental ingestion of the powder. We made a recommendation about this.

Medicines had been generally well managed, stored securely and records showed that tablets had been administered as they had been prescribed. Medicines charts relating to creams and topical solutions showed inconsistent recording of application. We made a recommendation about this.

The registered manager demonstrated that they had a good understanding of their role and responsibilities in relation to notifying CQC about important events such as injuries, safeguarding concerns and deaths. The registered manager had not informed CQC about Deprivation of Liberty Safeguards (DoLS) authorisations that had been approved. We made a recommendation about this.

Staff had a good understanding of what their roles and responsibilities were in preventing abuse. The safeguarding policy gave staff all of the information they needed to report safeguarding concerns to external agencies.

The provider followed safe recruitment practice. Essential documentation was in place for all staff employed. Gaps in employment history had been explored to check staff suitability for their role. There were suitable numbers of staff deployed on shift to meet people’s assessed needs.

The premises were well maintained, clean and tidy. The home smelled fresh.

Meals and mealtimes promoted people’s wellbeing, meal times were relaxed and people were given choices.

Staff had a good understanding of the Mental Capacity Act and supported people to make choices. Deprivation of Liberty Safeguards (DoLS) applications had been made to the local authority by the registered manager, care plans did not show clearly that DoLS authorisations were in place. This was amended by the registered manager during the inspection.

People received medical assistance from healthcare professionals when they needed it. Staff knew people well and recognised when people were not acting in their usual manner.

People were supported to maintain their relationships with people who mattered to them. Relatives and visitors were welcomed at the service at any reasonable time and were complimentary about the care their family member’s received.

Staff were cheerful, kind and patient in their approach and had a good rapport with people. The atmosphere in the home was calm and relaxed. Staff treated people with dignity and respect.

People’s care was person centred. People were supported to maintain their independence. Care plans detailed people’s important information such as their life history and personal history.

People were encouraged to take part in activities that they enjoyed. People were supported to be as independent as possible.

People’s views and experiences were sought through surveys. People were listened to. People and their relatives knew how to raise concerns and complaints.

There were quality assurance systems in place. The registered manager and provider carried out regular checks on the home. Action plans were put in place and completed quickly. Staff told us they felt supported by the registered manager.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.