CQC report explained · a nursing home
What the CQC found at Aston Manor EMI Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2019
Aston Manor was rated Requires Improvement; inspectors found kind, responsive care but gaps in staff training and some safety and management shortfalls.
This was an unannounced inspection on 15 August 2019. Inspectors spoke with a resident, relatives, staff and a health professional. They observed care and checked care plans, staff files, medicines records, training information and management records.
The home was rated Good for caring and responsive care. Staff were kind, respected people's dignity and knew residents' needs and preferences. Care plans gave staff enough guidance, relatives were involved, and people received support from health professionals.
The home was rated Requires Improvement for safe, effective and well-led care. Inspectors found staff refresher training was not up to date, a person had an avoidable accident during wheelchair support, and staff did not know some emergency evacuation information. Food texture records did not match a speech and language assessment, and condiments were still not routinely provided.
The overall rating remained Requires Improvement, although improvements meant the home was no longer in breach of regulations found at the previous inspection. A new breach of Regulation 18 was identified because staff training was not kept up to date.
Kind and respectful care
Inspectors saw positive interactions. Staff offered choices, protected people's dignity and supported independence.
“Staff were caring and kind.” from the report
Personalised support
Care plans gave staff useful information about people's needs, preferences and communication. Relatives were involved in care planning.
“People received person-centred care. Staff knew people well and understood how to provide care to meet people’s individual needs.” from the report
Medicines managed safely
Staff administering medicines had competency checks and training. Medicines were stored correctly and audits were carried out.
“The medication administration process we observed was very caring and respectful.” from the report
Good partnership working
Staff worked with a range of health professionals, including wheelchair services, dieticians and speech and language therapists.
“Staff worked well with different health professionals and services to meet their needs.” from the report
Staff training was not up to date
seriousSeveral staff had missed refresher training in key areas, including dementia awareness, safeguarding, the Mental Capacity Act, health and safety and infection control. This was the report's only new regulatory breach.
“The provider had failed to ensure staff training was kept up to date” from the report
An avoidable wheelchair accident
seriousA person's care plan did not explain how they should be moved in their wheelchair. They slipped out of the wheelchair and went to hospital, although they were later found to be uninjured.
“The person slipped out of their wheelchair in the lounge as they were not wearing a lap belt.” from the report
Emergency plans were not well understood
needs fixingTwo staff members had limited knowledge of people's personal emergency evacuation plans. The manager said staff would be reminded.
“We found two members of staff had limited knowledge of people's personal emergency evacuation plans.” from the report
Mealtime details needed correcting
needs fixingCondiments were still not routinely put out, despite this being identified at the previous inspection. One kitchen record also did not match the food texture recommended by a speech and language assessment.
“At this inspection, we saw this continued as a concern on both floors of the home.” from the report
CCTV consent was not formalised
needs fixingCCTV was being used for enhanced observation, but people or their representatives had not formally consented. The manager said this would be addressed.
“People or their representatives had not formally consented to this.” from the report
- 01Have all staff now completed the refresher training identified in the report, including dementia awareness, safeguarding, the Mental Capacity Act and health and safety?
- 02How do you now make sure staff follow the updated guidance for moving people who need wheelchair support?
- 03How are personal emergency evacuation plans explained to staff, and how do you check that staff understand them?
- 04How do you check that food texture records match speech and language therapy advice, and that requested condiments are available at every meal?
- 05Has formal consent now been obtained for the CCTV system, or has its use changed?
This was an unannounced inspection covering all five CQC questions, carried out because of the previous Requires Improvement rating. This explanation was written from the published report of 1 November 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.
What inspectors found, August 2018
Rated Requires Improvement; the home had improved since being Inadequate and leaving Special Measures, but inspectors found five continuing breaches.
This was an unannounced inspection on 21 and 25 June 2018. Inspectors spoke with people, relatives, staff and health professionals. They observed care and mealtimes, and checked care plans, medicines, staff files and management records.
The home was clean, medicines were managed safely and staff recruitment was safe. Relatives said people were safe, and inspectors saw some kind and discreet support. However, staffing did not always meet people's needs promptly at mealtimes.
Inspectors found missing care plans, risk assessments and capacity assessments for some new residents. Fire safety checks and staff fire drills needed improvement. People did not always receive dignified, person-centred care, meaningful activities or suitable communication support.
All five areas were rated Requires Improvement. The home had improved enough to leave Special Measures after the March 2018 inspection, but this was the second Requires Improvement rating and five regulations were still breached.
Safe medicines
Inspectors found medicines were stored securely and managed safely. Records checked matched the medicines given.
“Medicines were stored safely and securely and the management of people's medicines was safe.” from the report
Clean environment
The home was clean and tidy, and a previous unpleasant smell had been addressed.
“The home was clean and tidy. There was no malodour in an area of the home which had been malodourous at the last inspection.” from the report
Kind support
Inspectors saw examples of staff supporting people discreetly and respectfully, including during meals and personal care.
“We observed discreet and caring interactions between a member of staff and the person they were supporting to eat.” from the report
Safer moving and handling
Records for three people who used a hoist contained consistent detail, and staff were seen using the hoist safely.
“During the inspection we observed staff supporting people to mobilise and transfer using the hoist in a safe way.” from the report
Some management improvements
The manager had improved oversight of weights and accident patterns. Some audits also recorded actions to address problems.
“This demonstrated the registered manager had acted to improve an area of identified weakness.” from the report
Fire safety gaps
seriousOnly 17 of 32 staff had attended a fire drill, and none of the six staff listed for night duties had done one. Two people also lacked personal emergency evacuation plans when inspectors checked.
“Of the six-staff listed on the duty rota as working night duties, none had completed a fire drill.” from the report
Mental capacity procedures
seriousCapacity assessments and best-interest decisions were missing for some new residents. The home also delayed making a deprivation of liberty application until a person had been there for seven days.
“This evidenced a failure to understand the guidance regarding depriving people of their liberty and meant there was a risk people were being illegally deprived of their liberty.” from the report
Dignity and communication
seriousSome staff did not consistently engage respectfully with people who had limited verbal communication. The home did not use available picture cards or other accessible communication methods during the inspection.
“Where people had limited verbal communication, staff's tactics in engaging with them were limited and not always effective.” from the report
Limited activities
seriousPeople did not have consistent access to meaningful activities. Activity records were sometimes inaccurate and did not show that activities reflected individual interests.
“People's engagement in activity was infrequent and there was little to suggest the activity reflected their individual tastes or preferences.” from the report
- 01How do you now make sure every new resident has complete care plans, risk assessments and capacity assessments promptly after admission?
- 02What changes have been made to fire safety, including fire drills for night staff and personal emergency evacuation plans?
- 03How do you support people with limited speech to make choices and communicate their needs?
- 04What meaningful activities are available for my relative, and how are their personal interests recorded and used?
- 05How do you check that your action plan has fixed the problems found in this report?
This was an unannounced inspection of the overall service covering all five key questions, including care, premises, staffing, records and management systems. This explanation was written from the published report of 16 August 2018 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Aston Manor EMI Residential Home
7 rated inspections over 4 years: the service has improved, from Inadequate to Requires improvement.
- November 2019Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Aston Manor EMI Residential Home →
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Aston Manor EMI Residential Home →
- May 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2017Inadequatestayed InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- July 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2016InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- December 2014Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedCaring: Inspected but not ratedResponsive: Inspected but not ratedWell-led: Inspected but not rated
- October 2014
Registered with the Care Quality Commission on 10 October 2014.
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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