CQC report explained · a nursing home
What the CQC found at Aden Court Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Risks linked to skin, nutrition, pressure care, infection and the environment were not always managed well. Inspectors also found gaps in topical medicine records and some missing controlled-drug signatures.
- Effective?
- Good
- This key question was not inspected during this visit, so no new rating was given in the report.
- Caring?
- Good
- This key question was not inspected during this visit, so no new rating was given in the report.
- Responsive?
- Requires improvement
- Care was not always person-centred or delivered in line with people's choices and needs. Records did not always show that personal care, food and drink, or repeated refusals had been followed up.
- Well-led?
- Requires improvement
- Management checks and audits did not always identify problems, set clear actions or achieve improvements. The home did work with other professionals and gathered feedback.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found risks in care, medicines and management systems, and the rating fell from Good.
This was an unannounced inspection on 26 January 2023. Inspectors observed care, visited rooms, spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
The home was not always safe or responsive. Records did not always show that people's food, fluids, personal care and other risks were being managed properly. Inspectors also found gaps in medicine records, delays in answering call bells and some incomplete recruitment checks.
The home was clean in most areas. People were supported with safeguarding, communication and activities, and the service worked with health and social care professionals. However, checks by managers did not consistently identify problems or lead to lasting improvements.
The overall rating is Requires Improvement. Safe, Responsive and Well-led were also rated Requires Improvement. Effective and Caring were not inspected in this visit, so the report does not give new ratings for those areas.
Safeguarding awareness
People and relatives said they felt safe. Staff understood safeguarding procedures and said they could report concerns.
“Staff understood safeguarding procedures and had received safeguarding training.” from the report
Clean environment
The home was visibly clean and mostly free from smells. Relatives also said they found it clean when visiting.
“The home was visibly clean and mostly free from odours, although we noticed one area had a lingering odour.” from the report
Activities
People could join group activities and receive one-to-one support. People told inspectors they enjoyed the activities.
“A [member of staff] has started here, doing an entertainment programme. Gives us something to do, an interest, yesterday arts and crafts and ended up playing dominoes and bingo.” from the report
Working with professionals
Inspectors found clear evidence that the home worked with the local authority, other professionals and relatives to support people's care.
“There was clear evidence of the service working closely with others and there was regular engagement with the local authority, other professionals and relatives in support of people's care.” from the report
Care risks were not reliably managed
seriousDaily records did not consistently show that people received safe support. Food and drink monitoring was ineffective for at least one person, and risks linked to skin and pressure care were not robustly monitored.
“Systems were not sufficiently robust to assess, monitor and mitigate risks to the health, safety and welfare of people using the service” from the report
Medicine records were incomplete
seriousThere were significant gaps in records for creams, and two controlled-drug records lacked staff signatures. Inspectors also saw a medicine trolley left unlocked and unattended for several minutes.
“The proper and safe management of medicines was not consistently demonstrated. This placed people at risk of harm.” from the report
Staff availability and personal care
needs fixingPeople who relied on staff sometimes waited a long time for help, including continence care. Inspectors recommended that staffing needs and how staff were deployed should continue to be reviewed.
“People who remained in bed raised concerns about the time they had to wait for staff to attend to them, such as for continence care.” from the report
Management checks did not drive improvement
seriousAudits and daily checks were inconsistent. They did not always set clear actions, timescales or responsibilities, so known problems were not always fixed.
“Checks sometimes lacked rigour and did not always identify actions, or result in improvements where actions were identified.” from the report
- 01How do you now check that people receive their prescribed creams and that the records are complete?
- 02How quickly are call bells answered, especially for people who need help with continence care or transfers?
- 03How do you record and act on repeated refusals of food, drinks or personal care?
- 04What has changed to make care plans more person-centred and to record people's end of life wishes?
- 05What actions, timescales and named responsibilities are now used when audits find problems?
This was an unannounced inspection prompted by concerns about staffing, care quality and management, and it inspected Safe, Responsive and Well-led; ratings for other key questions were carried over from the previous inspection. This explanation was written from the published report of 28 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2019
Aden Court Care Home was rated Good overall, but inspectors found that safety still needed improvement, including delays in personal care.
Inspectors visited without notice on 5 December 2018. They spoke with people living at the home, relatives, staff and health professionals. They also looked at care records, staff files, medicines, the building and management records.
The home was rated Good overall. Effective, caring, responsive and well-led were all rated Good. Safe was rated Requires Improvement because one person's exercise plan from a health professional had not been followed, and people reported lengthy waits for help to use the toilet.
Inspectors found improvements since the previous inspection in effective and well-led care. However, the safe rating had not improved. Some staff training was also out of date, although the provider had plans for this to be completed by the end of January 2019.
Kind and respectful staff
Inspectors saw staff supporting people with compassion and involving them in everyday choices. People and relatives also spoke positively about the staff.
“People responded well to staff and there was an atmosphere of friendly affection.” from the report
Safe medicines arrangements
Medicines were stored, administered and checked through established processes. Staff sought consent and respected people's choices if they refused medicines.
“People received their medicines safely and these were administered by staff who were kind and respectful.” from the report
Good activities and personalisation
Activities included outings, group sessions and individual sensory activities. Inspectors found that activities were linked to people's interests and wishes.
“People had regular access to a range of group and individual activities which supported their individual needs.” from the report
Good healthcare links
The home worked with several health professionals and records showed people were referred for support when needed.
“People were supported to access the healthcare they needed at the right time.” from the report
Health advice was not followed
seriousOne person had not been given exercises recommended by a health professional after a fall. The home took action during and after the inspection, but its existing process had not identified the error.
“One person had not received the care advised by a health professional and procedures had not identified this.” from the report
Waiting for toilet support
needs fixingPeople and relatives reported lengthy waits for help to use the toilet. Inspectors also saw someone wait about 10 minutes after using the call bell before receiving assistance.
“All of the people and relatives we spoke with told us there were enough staff however they all spoke about a lengthy wait for people to be supported to the toilet.” from the report
Some training was out of date
needs fixingNot all staff had completed training required under the provider's own policies. The provider said this would be completed by the end of January 2019.
“Just under a third of staff had not received up-to-date training about MCA and DoLS and only a third of staff had received in-date health and safety training.” from the report
Care planning involvement varied
minorSome people and relatives did not understand how care was planned or reviewed. The manager described plans to improve involvement and recording.
“Most of the people and relatives we spoke with were unaware or unclear about how their care was planned or reviewed.” from the report
- 01How do you now make sure advice from visiting health professionals is recorded, passed to staff and followed?
- 02What has changed to reduce waits for toilet support and responses after people use their call bells?
- 03Have all staff completed the Mental Capacity Act, deprivation of liberty safeguards and health and safety training that was out of date?
- 04How will my relative and our family be involved in creating and reviewing the care plan?
- 05How will you make sure activities and end of life support continue to reflect my relative's wishes?
This was an unannounced inspection covering the overall service and all five key questions, with checks on care, staffing, records, medicines, premises and management. This explanation was written from the published report of 12 January 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Aden Court Care Home
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2019Goodup from Requires improvementSafe: Requires improvementResponsive: GoodWell-led: Good
- December 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £980 to £1,260 a week. 86 can care for a couple. 11 years' experience on average.
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