Aquarius Care Home

Updated 14 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Aquarius Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Aquarius Care Home is a care home with nursing care; however, the service was not providing nursing care, this was being provided by community nurses. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We gained feedback from the local authorities and other professionals who work with the service. We also sought feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they had not visited the service or received any comments or concerns since the last inspection.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service, 2 relatives and a person’s friend. We observed staff interactions with people and their care and support in communal areas. We spoke with 8 members of staff including the registered manager, deputy manager, head of care senior care workers, care workers, housekeeping and catering staff.

We reviewed a range of records. This included 8 people's care records and multiple medication records. We looked at 3 files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 March 2023

About the service

Aquarius Care Home is a residential care home providing accommodation for persons who require nursing or personal care to up to 20 people. The service was not providing nursing care, people’s nursing needs were met by community nurses. The service provides support to older people, some of who lived with dementia. At the time of our inspection there were 19 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

Staff did not provide effective support to identify people's aspirations and goals and assist people to plan how these would be met. There was not a consistent approach to supporting people to learn new skills or maintain their skills for as long as possible, where this was appropriate. Staff focused on people's strengths and promoted what they could do. People’s communication needs were not always met, easy read signage providing information and reminders was not always available.

The service provided people with care and support in a clean and well-equipped environment. The service was undergoing a programme of redecoration and repair. However, some safety aspects had not been identified and mitigated prior to the inspection. The risk to people from access to hot water and hot pipes and risks arising from people's diagnosed health needs had not been addressed.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. This is an area for improvement.

The service had systems and processes in place to safely administer and record medicines use. Medicines were administered in line with the prescription.

Right Care

People's care was not always person centred and did not always meet their assessed needs, they had not had baths or showers as often as they would like. However, people told us they were treated with dignity and respect and their privacy was respected.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough staff to meet people's needs and keep them safe. However, staff had not always had the necessary training to meet people's assessed needs. Training to work with people with learning disabilities had been provided to 8 out of 13 staff.

Right Culture

The provider's quality monitoring processes had not always identified concerns and improvements in the service. People, their relatives and staff had been encouraged and supported to provide feedback about the service. People and their relatives felt listened to.

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 provider registered with CQC under a new legal entity, 7 October 2021. The service continued to run with the same nominated individual and directors, management team and staff team under the new legal entity. The last rating for the service under the previous legal entity was requires improvement, published on 7 August 2021.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

This is the first inspection under the provider’s new legal entity.

You can read the report from our last comprehensive inspection under the providers previous legal entity, by selecting the ‘all reports’ link for Aquarius Care Home on our website at www.cqc.org.uk and choosing ‘old profile’.

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.

Enforcement and Recommendations

We have identified breaches in relation to risk management, mental capacity assessments, training, person-centred care, accessible communication and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.