Archived: Arboretum Nursing Home

Updated 21 February 2020

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.

Inspection team

The inspection was carried out by one inspector, a specialist professional advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Arboretum Nursing 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 registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before 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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and nine relatives about their experience of the care provided. We spoke with 11 members of staff including the registered manager, nursing staff, care workers and the chef. We spoke with four health professionals. 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 six people’s care records and multiple medication records. We looked at five staff 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found, including information about the provider’s training programme.

Updated 21 February 2020

About the service

Arboretum Nursing Home is a residential care home providing personal and nursing care to 46 people aged 65 and over at the time of the inspection. The service can support up to 54 people.

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

The provider’s audits in place to monitor the quality of the service were not effective and had not identified the areas of improvement needed which we found during our inspection and as detailed in the report.

The provider had failed to ensure people had personal emergency evacuation plans in place. Medicines were administered safely however there were no protocols in place to guide staff for medicines administered as and when required. Staff could explain the actions they would take to keep people safe from harm. The provider had a recruitment process to ensure they employed suitable staff to support people safely. Staff followed infection control guidance and had access to personal protective equipment.

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. The service was not working within the guidelines of the Mental Capacity Act.

People were supported to eat a healthy diet and staff knew people’s specific dietary requirements. The service worked closely with health professionals to ensure people received the support they needed.

People were supported by kind and caring staff who knew them well. People were treated with dignity and respect and people’s religious and cultural beliefs were respected.

People's support needs were assessed regularly and planned to ensure they received the support they needed. The provider had a complaints process which people were aware of to share any concerns.

Rating at last inspection

The last rating for this service was requires improvement (published 07 March 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to regulation 11 (need for consent) and regulation 17 (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 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.