Archived: Arden Grange Nursing & Residential Care Home

Updated 1 July 2021

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 Care Act 2014.

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 two inspectors.

Service and service type

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

The service had a manager who was in the process of registering with the Care Quality Commission. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with six people who used the service about their experience of the care provided. We spoke with seven members of staff including the manager, deputy manager, operations director, registered nurses, nurse assistants and care workers. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

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

Updated 1 July 2021

About the service

Arden Grange Nursing & Residential Care Home is a residential care home that was providing personal and nursing care to 34 people at the time of the inspection. The service can support up to 45 older people across three units. All accommodation is at ground floor level.

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

People received their medicines when they needed them. We have recommended the provider replaces the thermometer in the medicine fridge with a type which measures minimum and maximum temperatures. A record of accidents and incidents were maintained however there were no systems to monitor any trends. People felt safe and staff had been trained to recognise and report any concerns. People were supported by adequate numbers of staff who were safe to work with them. People were protected from the risks associated with the control and spread of infection.

The provider’s systems were not always effective in ensuring people received adequate food and drink. People did not always receive a consistent approach to maintain their skin integrity. People were supported by a staff team who were trained and competent in their role. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were able to personalise their bedrooms. People saw healthcare professionals when they needed. Before moving to the home people were assessed to ensure their needs and preferences could be met.

The provider’s systems to monitor and improve the quality of the service people received were not always effective in identifying shortfalls. People’s views were valued and responded to. The service worked in partnership with other professionals to ensure people received a service which met their needs and preferences. People were cared for by a staff team who were well supported in their role.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (report published December 2020).

Why we inspected

We received concerns in relation to staffing levels, people’s nursing care needs, diet and hydration, infection prevention and control, and the general management of the home. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 coronavirus and other infection outbreaks effectively.

The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.

We have identified a breach in relation to meeting nutritional and hydration needs. We have recommended the provider replaces the thermometer in the medicine fridge with a type which measures the current and minimum and maximum temperatures. Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arden Grange Nursing & Residential Care Home on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.