The inspection was carried out on 9 October 2017 and was unannounced. The service was last inspected on 5 and 6 September 2016 and at that inspection we found improvements were needed in medicines management and the involvement of people with their care records to gain their input.

Aronmore Residential Care Home provides accommodation with personal care for older people including those with dementia care needs. The service consists of a 27 bedded care home and there are four individual ‘cottages’ in the rear grounds of the service. The service is registered for a maximum of 31 people and at the time of our inspection there were 28 people living at the service, 24 in the main building and four in the cottages.

The service is required to have 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. The registered manager had been registered with CQC since 3 August 2016. They are an experienced manager who had previously managed two other services owned by the provider.

At the September 2016 inspection we identified some shortfalls with medicines management, which the registered manager took action to address. At this inspection we found medicines management was good and processes for monitoring the medicines were in place and being followed. At the September 2016 inspection there was limited evidence of people’s input with their care records and people did not know about their care records. At this inspection action had been taken and this had been addressed.

Procedures were in place to safeguard people from the risk of abuse and staff knew the action to take if they had any concerns. Staff recruitment procedures were followed to ensure only suitable staff were employed at the service. There were enough staff available to meet people’s needs and the registered manager kept staffing under review so changes in people’s needs could be met.

Risks to individuals were assessed and plans put in place to minimise identified risks. Infection control procedures were being followed and he service was clean and fresh throughout. Systems and equipment were serviced at the required intervals and were maintained to keep them in good working order.

Staff training needs were identified and staff undertook recognised qualifications in health and social care. Staff received training in a variety of topics to provide them with the skills and knowledge to care for people effectively.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). People’s mental capacity had been assessed. For some people DoLS authorisations were in place to ensure that their freedom was not unduly restricted. Staff understood people’s needs and the importance of obtaining consent from people and of respecting peoples’ right to make choices for themselves.

People’s dietary needs and preferences were identified and met and there was a good range of meals available, including those to meet people’s religious and cultural needs. People’s nutritional needs and status were assessed and monitored. People’s healthcare needs were identified and monitored and they received input from healthcare professionals.

People and professionals were happy with the care and support being provided to people using the service. People, and where appropriate, their relatives, had been consulted about care needs and the care plans had been drawn up with their input. Care records were comprehensive and person centred and were reviewed regularly with input from people to keep the information up to date.

People were offered choices and staff treated them with dignity and respect. Staff had a good knowledge of people’

The inspection was carried out on 5 and 6 September 2016. This was a comprehensive inspection that was brought forward due to concerns raised around people’s safety and shortfalls identified by the local authority. The service was last inspected on 18 and 20 May 2016 and was compliant in all domains.

Aronmore Residential Care Home provides accommodation with personal care for up to a maximum of 31 people. The service consists of a 27 bedded care home and there are four individual ‘cottages’ in the rear grounds of the service. At the time of our inspection there were 29 people living at the service, one of whom was in hospital.

The service is required to have 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. The registered manager had been registered with CQC since 3 August 2016 and had recently taken over managing the service full time. They are an experienced manager who had previously managed two other services owned by the provider.

We found some shortfalls with medicine stock balances and recording so medicines were not always being safely managed. The registered manager addressed the finding at the time of inspection and said she would increase medicines monitoring so issues were promptly identified and dealt with.

There was limited evidence of people’s input with their care records and people did not know about their care records. The registered manager was aware and said this would be addressed.

People and relatives expressed their satisfaction with the care and support being provided.

Systems were in place to safeguard people from the risk of abuse and staff understood the action to take if they suspected abuse.

Risk assessments were in place for identified areas of risk to minimise them. Systems and equipment were serviced and maintained to maintain their safety.

Staff recruitment procedures were in place and being followed. There were enough staff on duty to meet people’s needs and recruitment was ongoing.

Staff received training to provide them with the skills and knowledge to care for people effectively.

We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS were in place to ensure that people’s freedom was not unduly restricted. Staff acted in people’s best interests to ensure their freedom was not unduly restricted.

People’s nutritional needs were assessed and monitored. People’s dietary needs and preferences were being identified and met.

People’s healthcare needs were identified and they were referred to the GP, community nurse and other healthcare professionals when required.

Staff understood the individual care and support people needed and provided this in a gentle and caring manner.

Staff respected people’s choices and treated people in a respectful and dignified way.

Care records were personalised and up to date and changes in people’s condition had been identified and included in the care plans.

People and relatives were confident to raise any complaints and systems were in place and being followed to record and investigate these.

The registered manager had recently taken over managing the service and demonstrated the knowledge and skills to do so effectively. The registered manager was approachable and listened to people and staff, taking action to address any issues promptly and to promote good practices.

Systems were in place to monitor the quality of the service and the registered manager was expanding these to ensure all aspects of the service were monitored. Work in this area was ongoing, with environmental improvements being planned for the service.

We were unable to speak with most of the people using the service as they had complex needs and were unable to share their experiences with us. Therefore we used a variety of methods to understand people’s experiences such as looking at care records, observation and speaking with staff and relatives.

We spoke with two members of staff, two relatives and four people who were using the service during the inspection. People’s needs were assessed and care plans developed to inform staff about how to meet them. People were able to access appropriate healthcare and identified risks were assessed to ensure staff took action to minimise these and keep people safe.

We saw positive interactions between staff and the people using the service and people told us they were happy with the care staff provided. One person said, “they look after us very well” and a relative we spoke with said, “they (staff) are excellent.”

People’s dietary needs were met and we observed staff assisting people in a sensitive manner, explaining what was being served and engaging people in conversation while they ate.

The premises were well maintained and health and safety checks were taking place to ensure the environment was safe for staff and the people using the service.

There were enough staff on duty to meet people’s needs and staffing levels were adjusted where required.

People were aware of the complaints procedure for the home and felt able to raise any concerns.

We carried out this inspection to check whether the provider was meeting regulation 21 of The Health and Social Care Act 2008 (Regulated Activities) 2010. On 13 November 2012 we carried out an inspection and found there were recruitment procedures in place to obtain the information required, however these were not always being followed and so the information was not always available to evidence that people were cared for, or supported by, persons of good character who are suitably qualified, skilled and experienced for the work to be performed.

During this inspection we found that the provider had made improvements and was now meeting the relevant regulation.

People were involved in making decisions about their care and were able to make choices for themselves and these choices were respected. Staff treated people with respect and listened to what they had to say. Staff were provided with information about people so they could provide care to meet their needs. People confirmed they were happy with the care they received and one person described the staff as “most helpful”.

Medicines were administered by staff with the training and knowledge to do so safely and people confirmed they received their medicines when they were due.

People said there was always someone to talk to if they were worried about anything. Staff understood safeguarding and whistle blowing procedures and were clear to report any concerns. Staff recruitment procedures were in place but were not always being followed, which could place people at risk.

Systems for monitoring and quality assurance were in place and were being followed. Surveys had been carried out in April 2012 and the responses were positive. Comments included “Thank you for your care and kindness……Aronmore is a friendly and homely place and we speak very highly of it” and “many thanks for your continuing good work”.

We spoke with four people using the service and four staff.

The inspection was carried out on 18 and 20 May 2015 and the first day was unannounced. The last inspection took place on 10 August 2013 and the provider was compliant with the regulations we checked.

Aronmore Residential Care Home is a service which provides accommodation for up to 31 older people who have a range of needs, including dementia. At the time of inspection there were 26 people using the service.

The service is required to have a registered manager in post, and there is a registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission 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.

People were happy with the service and we received positive feedback from people, relatives and visiting healthcare professionals, who felt the service was well run and people’s changing needs were being identified and met.

Staff recruitment procedures were in place and were being followed to ensure suitable staff were being employed at the service.

Staff had received training and demonstrated an understanding of people’s individual choices and needs and how to meet them. Staff supported people in a gentle manner, respecting their privacy and dignity.

Staff understood safeguarding and whistleblowing procedures and were clear about the process to follow to report concerns. Complaints procedures were in place and people and relatives said they would feel able to raise any issues so they could be addressed.

Medicines were being well managed at the service and people were receiving their medicines as prescribed.

We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS are in place to ensure that people’s freedom is not unduly restricted.

Care records reflected people’s needs and interests and were kept up to date. Communication between the registered manager and staff was effective and staff understood people’s changing care and support needs.

Systems were in place for monitoring the service and these were effective so action could be taken promptly to address any issues identified.