Archived: Arden Manor Care Home

Arden Manor Care Home is a care home providing personal care to 11 people at the time of the inspection. The home is registered for up to 23 people. Some of the people were living with dementia. People have access to their own bedroom along with communal spaces including lounges and gardens.

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

Risks to people were not managed in a safe way. After incidents occurred action was not always taken to mitigate the risk of further occurrence. Staff did not always have the information to keep people safe and this placed people at risk of harm and an inconsistent approach. People were not always protected from abuse as incidents were not always documented to ensure appropriate action was taken.

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 did not support this practice.

Infection control procedures had improved however there were still areas that required action. There were still some areas within the home that were in need of repair. Medicines management required improving as people did not always receive their ‘as required’ medicines as prescribed and protocols for covert medicines were out of date.

Staff received training however we were not assured the competency processes in place were effective to ensure staff had the skills and knowledge to support people in a safe way. People’s independency and dignity was not always promoted.

The systems and audits in place were not robust or effective in identifying areas of improvements. There was no evidence lessons were being learnt when things went wrong. Feedback had started to be obtained from people and their relatives however no action had been taken when areas of improvement had been suggested.

There were enough suitably recruited staff to offer support to people. People enjoyed the food available and were offered a choice. They also had the opportunity to spend time with their families and participate in activities they enjoyed. There were plans in place for people ‘s end of life care.

Peoples needs were assessed and reviewed and they were happy with the care they received. Health professionals’ advice was sought when needed and this advice was followed within the home. There was a complaints procedure in place. We were notified by the provider of events that occurred within the home.

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 last rating for this service was inadequate and there were breaches of regulations. We issued 2 warning notices following our last inspection. (Published 9 March 2023) The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The overall rating for the service has remained inadequate based on the findings of this inspection. 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 Manor Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to how people are safeguarded, the care and support they received in relation to risk management, capacity and consent and the systems in place to ensure the home is effectively governed.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations.

Arden Manor Care Home is a care home providing personal care to 21 people at the time of the inspection. The home is registered for up to 23 people. Some of the people were living with dementia. People have access to their own bedroom along with communal spaces including lounges and gardens.

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

People did not always receive safe care, as risks to people’s safety were not always assessed and care plans were not always in place or followed. There was no evidence lessons were learnt when things went wrong. Infection control procedures were not always followed to ensure the spread of infection was reduced, some of the environment and equipment was unclean and in need of repair. There were safeguarding procedures in place however these were not always followed to ensure people were protected from potential harm.

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

Staff did not always have the correct training, skills or their competency checked to ensure they supported people in a safe way. There were not enough staff to support people. Medicines were not always stored safely or administered by competent staff. Some people did not receive their medicines when needed.

The systems in place were not effective in identifying areas of improvement and audits completed were not identifying areas of improvement.

There was a choice of foods which people enjoyed. People received as required medicines when needed.

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 last rating for this service was good (Published 22 March 2022)

Why we inspected

We received concerns in relation to safety and leadership. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to Inadequate based on the findings of this inspection.

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 Manor Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to regulation 11 capacity and consent, regulation 12, Safe care and treatment, regulation 13, safeguarding service users from abuse and improper treatment, regulation 18 staffing and the skills of staff and regulation 17, Good governance.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements. If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service.

This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Arden Manor Care Home is a care home providing support with personal care to 20 people at the time of the inspection, some of whom were living with dementia. Accommodation is provided in one adapted building and the home can accommodate up to 23 people.

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

Effective infection control systems were in place and these were understood and followed by staff. The home was clean and fresh and there was regular wiping down of touch points and equipment. Visiting arrangements followed current government guidance. However, we found some areas of the home were in need of repair and items of furniture needed replacing. These were in the process of being addressed by the registered manager.

The provider's procedures for the recruitment of staff protected the people who lived at the home. People told us they felt safe living at the home and with the staff who supported them. There were sufficient staff to meet people’s needs. Staff knew how to recognise and report any signs of abuse. People received their medicines when they needed them from staff who were trained and competent to carry out the task.

There were effective systems to monitor and improve the quality of the service provided. The views of people who used the service and staff were valued and responded to. The registered manager worked in partnership with others to ensure a positive outcome for the people who lived at the home.

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 good. (Report published 23 February 2019).

Why we inspected

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. This included checking the provider was meeting COVID-19 vaccination requirements.

We received concerns in relation to management oversight, care planning and staff training and support. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

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

Follow up

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

This was the first inspection of Arden Manor since it was registered with the Care Quality Commission in February 2017.

Arden Manor 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.

Arden Manor accommodates a maximum of 23 older people, including people who live with dementia or a dementia related condition, in one adapted building. At the time of inspection 23 people were using the service.

A registered manager was in post. 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 said they felt safe and they could speak to staff as they were approachable. People and staff told us there were enough staff on duty to provide safe care to people. Staff knew about safeguarding procedures. Staff were subject to robust recruitment checks. Arrangements for managing people’s medicines were safe.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Activities and entertainment were available to keep people engaged and stimulated.

People were involved in decisions about their care. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Records reflected the care provided by staff. Care was provided with kindness and patience. Communication was effective to ensure people, staff and relatives were kept up-to-date about any changes in people's care and support needs and the running of the service.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received a varied and balanced diet to meet their nutritional needs.

A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to.

People had the opportunity to give their views about the service. There was regular consultation with people and family members and their views were used to improve the service. The provider undertook a range of audits to check on the quality of care provided.