This inspection took place on 23 August 2018 and was unannounced, which meant the home did not know we were visiting. This was a comprehensive inspection. At the last inspection on 5 and 6 June 2017 the home was rated Requires Improvement and we found care and treatment were not always provided with the consent of the relevant person and staff did not always act in accordance with the requirements of the Mental Capacity Act 2005.

Aden View is registered to provide accommodation and personal care for up to 46 people. There were 43 people living at the home on the day of our inspection. Aden View Care Home is a purpose-built building offering accommodation over two floors accessed by a passenger lift. All bedrooms have ensuite facilities. One floor is designated for people living with dementia. There are three communal lounges, dining rooms and bathrooms. Outside there is an easily accessible garden.

Aden View Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home had a registered manager who was available throughout our inspection. 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.

The registered provider’s monthly quality reports showed effective oversight of the premises. The registered manager had systems to monitor quality throughout the home however this was not always achieved. Accidents and incidents were monitored. Fire safety and building maintenance were well managed.

Some feedback had been sought to engage people, relatives and staff in the running of the service. Information from this was used to develop the service.

People and their relatives told us they felt safe living at Aden View Care Home. Staff confirmed they had received safeguarding training and were able to describe how to identify and report any suspected abuse or incidents.

Standardised risk assessments were used in care plans so risks to people’s health and safety could be effectively tracked and monitored.

People’s dependency was monitored regularly however staffing levels did not always support people’s needs. Recruitment processes ensured staff were employed who were suitable to work in a care home setting however induction records were not in evidence.

Medicines were administered safely and with due consideration to national guidance.

Staff were appropriately trained and knowledgeable about infection control procedures.

The registered manager had systems in place for monitoring accidents and incidents and ensuring learning from these was implemented and understood through regular staff meetings and supervisions.

Care plans contained some information about people’s history, their preferences in relation to physical needs and some information about their social and leisure activities. Some consideration had been given to people’s consent and their capacity to do so for a range of care and support needs. The registered provider was operating within the principles of the Mental Capacity Act 2005 and applications to lawfully deprive people of their liberty (DoLS) had been appropriately submitted to the local authority.

Training completion levels were generally good. The number of staff trained on fire safety was low. Staff supervisions were planned and taking place regularly. Communication between the registered provider, the registered manager and staff was good.

People were provided with a choice of food and drinks and some snacks were available at certain times during the day. People were not always supported to access this.

People were supported to r

The inspection of Aden View took place 5 and 6 June 2017. The location had been previously inspected during January 2016 and we found a breach of regulation at that time, relating to good governance. The service was found to require improvement. We received an action plan from the registered provider to show how they would address the breach. During this inspection, we checked to see whether improvements had been made. We found the areas identified in the action plan had been addressed and improvements were evident. However, we identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to consent.

Aden View Care Home is registered to provide personal care and accommodation for up to 46 older people. The accommodation is provided over two floors, the first floor being accessed by a passenger lift. All bedrooms have en-suite facilities. There are a number of communal areas and dining rooms. There is a unit called Primrose for people living with dementia and other cognitive impairment. At the time of the inspection there were 43 people living at the home.

There was a registered manager in post and this person had been registered with the Care Quality Commission since March 2016. 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 told us they felt safe living at Aden View. The registered manager and staff were aware of relevant procedures to help keep people safe and staff could describe signs that may indicate someone was at risk of abuse or harm. Staff had received safeguarding training.

Staff were recruited safely and there were sufficient numbers of staff deployed to meet people’s needs. Staff told us they felt supported and we saw evidence staff had received appropriate induction, training and ongoing support.

Risks to people had been assessed and measures put into place to reduce risk. The building was well maintained and regular safety checks took place.

Medicines were managed, stored and administered safely and appropriately, by staff who had been trained to do so.

People were supported to have choice and control of their lives and we observed staff supported people in the least restrictive way possible; however, the principles of the Mental Capacity Act 2005 were not always followed.

We observed staff to be kind and supportive and people told us staff were caring. We observed people’s privacy and dignity was respected. There was a pleasant, relaxed atmosphere in the home.

Care records were person centred and reviewed regularly. A ‘resident of the day’ system helped to ensure people were regularly involved in reviewing their care and support at Aden View. People told us they could make their own choices in relation to their daily lives. Appropriate information was shared between staff to enable continuity of care.

Staff told us they felt supported by the registered manager and people and their relatives spoke positively about the registered manager. Meetings such as staff meetings and residents’ and relatives’ meetings were held regularly. The compliance review undertaken by the registered provider’s internal team highlighted the need to improve Mental Capacity Act 2005 associated work. The registered provider had developed an action plan to address this work, which was ongoing at the time of the inspection.

You can see what action we told the provider to take at the back of the full version of the report.

The inspection took place on 1 and 9 February 2016. The first day of inspection was unannounced and the second day was an announced inspection.

The service was last inspected 7 May 2013 and was compliant in the areas we inspected.

Aden View Care Home is registered to provide personal care and accommodation for up to 46 older people. The accommodation is on two floors, the first floor being accessed by a passenger lift. All bedrooms have en suite facilities. There are a number of communal areas and dining rooms. At the time of the inspection there were 38 people using the service. There was a unit called Primrose for people living with dementia and other memory problems.

The registered manager had applied to be de-registered as a manger in January 2016 and the current manager was in the process of applying for their registration. 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 who used the service felt safe living there and felt staff had the skills and knowledge to carry out their role. Staff we spoke with had a good understanding of their role in relation to ensuring people were kept safe from harm. Risk assessments centred on the needs of the individual and were reviewed monthly.

Training for staff was up to date and they had a good understating of their role in relation to the Mental Capacity Act 2008 (MCA)and Deprivation of Liberty Safeguards (DoLS). The manager was aware of their role in protecting people’s human rights and had made appropriate applications for a DoLS.

There was a choice of activities, both shared and individual available for people to take part in. Activities were organised by the activity coordinator.

Care records were person centred and focussed on the needs of the individual, however these were not always written by the staff who had provided people with their support.

People were offered a variety of food and drinks through the day but at lunchtime we observed there was not enough staff to support people eat their meal.

We observed interaction between staff and people who used the service was respectful and people felt the staff were very caring in their attitude toward them.

The manager had an auditing system in place. However, this had not been effective in identifying issues and concerns with the way information was recorded in people’s daily records, on the medicine administration records and on accident forms.

The manager was passionate about their role. Staff and people who used the service spoke highly of the manager.

We found one breach of the Health and Social Care Act 2008 (regulated activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

We decided to visit the home between 6pm and 11pm to gain a wider view of the service provided. This was part of an out of normal hour’s pilot project being undertaken in the North East region.

At the time of our visit there were 39 people living at the home; 20 people living on the ground floor of the building and 19 people living on the first floor.

Because some of the people living in the home had dementia, not everyone was able to tell us their views on how they were cared for. However, we observed people looked well cared for and were seen to have good relationships with the staff.

People also told us they were happy living at the home and they were well looked after.

Staff told us that although they were busy, there was sufficient staff on duty to meet people’s needs. We observed the staff offered support to people in a sensitive and unhurried manner.

People told us the staff were kind and they were well looked after. People told us they were able to choose how they spent their day and enjoyed the company of other people living at the home.

People told us they were offered a choice of food at meal times and the food was generally nice. One person told us sometimes their food went cold, as they did not eat as quickly as everyone else. Two people told us they could choose where to eat and sometimes they chose to have their meals in their room.

People told us the home was usually clean and had no unpleasant odours.

People told us there was always enough staff about when they needed them.

People told us they had not had to complain but they knew who they would speak with if they were not happy.

People told us that the care they receive was agreed prior to admission and that the staff were sensitive to their needs and knew the care that they needed.

People that we spoke with told us that they felt safe in the home and they knew who to speak to if they had any concerns. They also said they would have confidence that any issues would be properly dealt with.

A visiting relative said that they had no concerns and if they had they would speak with the manager or her deputy.

People told us that they thought the home was comfortable. One person said that they enjoyed been able to go outside into the garden, and another person said that they enjoyed the company of others in the home.

A relative commented that the home is usually fresh and clean however, on occasions there has been an unpleasant odour which the staff took steps to addressed.

People said that staff listened to what they said and were always about when needed.

Comments from relatives about the service their relatives received include:

“Thank you everyone for caring and looking after my mum during her stay.”

“Thank you all for the kindness and care that you gave … and thank you for the staff attending the funeral.”