Archived: Arthur's Court

Updated 18 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6 January 2017 and was unannounced. The inspection team consisted of an inspector and two specialist advisors who were registered nurses and had an in-depth knowledge in care of older people.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the home. This included previous inspection reports and notifications sent to us. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing any potential areas of concern.

We met and observed the majority of the people who lived at the service and received feedback from eleven people who were able to tell us about their experiences. We also spoke with four visitors to ask their views about the service.

We spoke to 14 staff, including the registered manager, deputy manager, senior care workers, and care workers, the cook, housekeeping staff, a maintenance person and the administrator.

We reviewed information about people’s care and how the service was managed. These included six people’s care records and everyone’s medicine records, along with other records relating to the management of the service. These included staff training, support and employment records, external agency audits, quality assurance audits and minutes of residents and team meetings. We also contacted health and social care professionals and commissioners of the service for their views. We received a response from four health and social care professionals.

Updated 18 February 2017

This unannounced inspection took place on 6 January 2017. Arthur’s Court is registered to provide accommodation with nursing care for up to 40 older people. There were 30 people using the service on the day of our inspection.

We last inspected the service in July 2013 and the service was meeting the regulations of the Health and Social Care Act (2008) we inspected.

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.

There were adequate staffing levels to meet people’s needs. There had been staff shortages during 2016 and the service had needed to use agency staff to cover gaps. At the time of the inspection the service had almost a complete full team of staff and were not so reliant on agency staff. People felt there were adequate numbers of staff on duty and that staff responded to bells promptly.

People were supported by staff who had the required recruitment checks in place. Staff received an induction and were knowledgeable about the signs of abuse and how to report concerns. Staff had received training and developed skills and knowledge to meet people’s needs. Staff relationships with people were caring and supportive. They delivered care that was kind and compassionate.

Measures to manage risk were as least restrictive as possible to protect people’s freedom. Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed. Topical cream charts to guide staff were not always clear. However following the inspection we received assurances from the registered manager that improvements had been made.

Care plans were personalised and recognised people’s health, social and psychological needs. We raised concerns with the registered manager that care plans did not always cover all aspects of people’s needs. Following the inspection the registered manager and deputy manager reviewed everyone’s care file. They put in place care plans where needed to ensure all people’s health needs were covered.

People’s views and suggestions were taken into account to improve the service. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.

Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, mental capacity assessments had been completed. However it was not always clear how best interest decisions had been made in line with the MCA. People’s families had been asked to consent but it was not always clear how this decision had been made.

People were supported to eat and drink enough and maintain a balanced diet. People were positive about the food at the service.

The provider had a range of quality monitoring systems in place which were used to continually review and improve the service. Where there were concerns or complaints, these were investigated and action taken. The premises and equipment were managed to keep people safe.