1 February 2024
During a routine inspection
Aden House is a care home providing personal care for up to 60 people. At the time of our inspection there were 29 people living at the service. There are communal areas and accommodation on both the ground and first floor. The Butterfly unit on the ground floor supports people living with dementia.
People’s experience of using this service and what we found
There had been insufficient improvement in management and oversight of the service since the previous inspection and we continued to identify repeated shortfalls that compromised the safety of people and the quality of care at the service.
Risks to people were again not safely assessed, monitored and mitigated. People continued to not always be protected from the risk of harm when they had been involved in incidents of a safeguarding nature. Accidents and incidents continued to not be appropriately addressed to ensure lessons learned were identified and the risk of harm reduced.
Concerns were again identified in relation to infection prevention and control (IPC) particularly regarding the management of a recent outbreak at the service. There were not enough staff to adequately respond to people’s needs, and medicines were not always managed safely.
Quality assurance systems were still not effectively implemented and consistently overseen by the manager. They were not always effective in identifying and monitoring shortfalls and driving improvement at the service. Whilst some improvements had been made to the environment, which appeared more homely, there were still significant shortfalls in other aspects of the service.
There was an activities staff member in place. However, the available activities were not always suited to the needs of people with dementia. People who were unable to participate in group activities received little to no activity.
The service was working within the principles of the Mental Capacity Act (MCA) and appropriate legal authorisations were in place when needed, to deprive a person of their liberty. Policies in the service supported this and staff supported people in their best interests, in the least restrictive way possible. However, people were not supported to have maximum choice and control of their lives and care was not delivered in line with their needs and preferences. Care records were not always complete and contained inaccurate and conflicting information. People’s care was not always collaboratively planned, or person centred. People’s varying communication needs were not always considered or met.
Staff were kind caring and respectful towards people. Systems were in place to support staff and they received appropriate training.
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 10 August 2023) and there were breaches of regulations. 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 the provider remained in breach of regulations.
At our last inspection we recommended the provider reviewed systems and processes for safe recruitment. We also recommend the provider sought advice and guidance from a reputable source to ensure people's privacy, dignity and independence was respected and promoted. At this inspection both recommendations had been actioned and resolved.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. During this inspection, we checked whether the provider had followed their action plan to confirm whether they now met legal requirements.
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 overall rating for the service remains inadequate based on the findings of this inspection.
Enforcement and Recommendations
We have identified breaches in relation to assessing and managing risks to people, IPC, medicines management, staff numbers, person centred care, record keeping and oversight of the service.
We have made recommendations in relation to joint care planning, people’s communication needs and obtaining feedback from people fully considering their equality characteristics.
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
The overall rating for this service is ‘Inadequate’ and the service remains 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 5 key questions it will no longer be in special measures.