Archived: Arden House Residential Home

Arden House Residential Home is a care home providing accommodation and personal care to 13 people aged 65 and over at the time of the inspection. The service can support up to 14 people.

The service is within one adapted building with accommodation and communal facilities over two floors. There is a stair lift to the first floor.

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

The registered manager provided leadership and oversight within the service. Some audits and records required updates, but the registered manager was confident that these would be completed within the next four weeks. We have made a recommendation in the report about this.

People felt safe and well looked after. All areas were clean, tidy and there was sufficient cleaning taking place to keep people safe from the risk of infection. Relatives said they were confident that staff provided good care in a safe way.

Care plans and risk assessments were in place for people's support needs. People and their families confirmed that they were able to contribute their views on care and support.

Systems were in place for the assessment, monitoring and mitigation of risk towards people who used the service. The registered manager analysed falls and incidents to ensure learning from events was undertaken. This meant risks to people's health and safety were reduced.

Communication within the service was good. Relatives were kept informed of their family member’s health and welfare throughout the last nine months when they were unable to visit the service due to the pandemic.

People received their medicines on time and when they needed them. They had access to professional health care workers when needed, which helped to maintain their wellbeing.

Staff were patient, kind and respectful towards people. Care was person-centred and staff had time to chat with people during the day.

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.

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

Rating at last inspection

The last rating for this service was good (published 2 November 2018).

Why we inspected

The inspection was prompted in part due to concerns received about infection control and people’s capacity to make their own choices and decisions. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe 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.

We found no evidence during this inspection that people were at risk of harm from these concerns. 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 House Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Arden House Residential Home is located in Pickering. The home accommodates up to 14 older people in one adapted building. They do not provide nursing care.

Inspection site visits took place on 4 and 9 October 2018. At the time of this inspection, the service was providing support to 13 people.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Systems and processes were in place to keep people safe and risks associated with the person’s care needs had been assessed. There were sufficient staff to meet people’s needs and staff recruitment processes and procedures were robust and followed.

Medicines had been stored and managed safely to ensure people received their medicines as prescribed. Staff followed good infection control practices and the service was extremely clean and tidy throughout.

Staff received appropriate induction, supervision and training to provide safe and effective care. The registered manager worked in partnership with healthcare professionals and other organisations to meet people’s needs. People were provided with a healthy balanced diet and meals of their choice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; policies and procedures in the service supported this practice. Consent to care and support was clearly recorded and people told us they were actively involved in the care planning process.

Care plans contained person-centred information which focused on individuals and their specific care and support needs. Regular reviews had taken place to ensure this information was accurate and up to date.

We observed kind and caring interactions between people and staff. It was clear positive relationships had been developed and staff were extremely familiar with people’s likes, dislikes and preferences. People and relatives spoke positively about the staff team, their approach and respect for people’s privacy and dignity.

People and relatives spoke positively of the management team. There was clear guidance in place in relation to the reporting and handling of complaints. The registered manager requested regular feedback from people, relatives and staff to enable them to continuously improve the service. Quality assurance systems in place were effective.

Further information is in the detailed findings below.

The service is located in the market town of Pickering, close to shops, pubs, the post office, doctor's surgery, dentist and other amenities. The service has accessible grounds to the front and rear.

This inspection took place on 04 March 2016 and was unannounced. The service was last inspected August 2014 and was found to be compliant with the regulations inspected at that time.

At the time of the inspection 12 people were living at the service.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were cared for by staff who had a good understanding of how to keep people safe, and how to report any abuse they may witness or become aware of. Staff had received training in this area and this had been regularly updated. Staff, who had been recruited safely, were provided in enough numbers to meet people’s needs. People lived in a well maintained, clean environment. Staff handled people’s medicines safely and had received training in this area.

People who used the service were provided with a well-balanced wholesome diet which was of their choosing. Catering staff consulted with people about their likes and dislikes and provided the food people enjoyed. People were cared for by staff who had received training in how to meet their needs. Staff training was updated as required, and staff received support to gain further qualifications and experience. People were supported to lead a healthy lifestyle; this included eating a healthy diet and attending appointments with their GP and other health care professionals. Staff were trained in, and understood the principles of, the Mental Capacity Act (MCA) and understood when and how these principles applied.

People were cared for by staff who were kind and caring and understood their needs. Staff had good relationships with the people who used the service and there were lots of conversations and laughter. People had been involved with the formulation of their care plans and these had been updated and reviewed on a regular basis. Staff respected people’s rights to privacy and dignity.

Staff had access to information which described the people who used the service, their likes and dislikes and their preferences for the way they would like the staff to support them with their care. People had access to a range of varied activities both inside and outside of the service. Visitors were welcomed and encouraged. The registered provider had a complaints procedure which anyone could access if they had any concerns about the service provided. This was displayed around the service and provided to people in their welcome packs. Complaints were investigated and resolved to the complainant’s satisfaction whenever possible. Complainants were signposted to other agencies if they were not happy with the way the investigation had been carried out.

People who used the service were consulted about the running of the service and their views were taken seriously. Staff also had the opportunity to have an input into how the service was run. The registered manager had systems in place to ensure people lived in a safe, effective, caring, responsive and well-led service.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with five people using the service, three relatives, and the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were in place to make sure that the manager and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve.

Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk. The home was clean and fresh and the manager told us about the systems that were in place to manage the risk of infection.

Is the service effective?

The home had systems in place to ensure people's wishes were respected. People told us that the staff were very kind, and responded quickly to meet their needs. One person we spoke with told us that they liked to stay in their room, only coming down to communal areas for meals. They told us staff respected their wishes.

Is the service caring?

The manager had ensured that staff had a good understanding of people's needs. The home had developed an ethos of respect and valuing the views of people who used the service.

Is the service responsive?

We saw that care plans were reviewed regularly and any changes were made to ensure people's needs were met. One person we spoke with told us that staff had acted very quickly to seek medical advice. This had given the person confidence that their health needs would be met.

Is the service well-led?

The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

People we spoke with had confidence in the manager and said they would not hesitate in talking to her if they had any concerns.

We looked at three care files and found that care was planned and delivered in line with each persons care plan. Staff knew people who used the service well and we observed them chatting to each other in a friendly and accepting way.One person told us:"It is lovely here, the staff are marvellous, the way they look after me".

People who used the service received appropriate support from other professionals if they needed to.

We looked at how the service managed nutrition and found that people who used the service were provided with a choice of nutritious food and drink.

We looked at staffing levels as part of our visit and we found there were sufficient numbers of suitably qualified, skilled and experienced staff.

There was a high standard of cleanliness at this service and the premises were well maintained with relevant safety checks completed. The premises were warm, well lit and well ventilated.

We found that improvements were needed to the quality assurance system to ensure people's health, safety and care was monitored effectively and that appropriate action could be taken where necessary to make changes in the service.

We saw that people were encouraged to make day to day decisions for themselves. There was no evidence that any best interest meetings had taken place for people who lacked the capacity to make their own decisions. There was no evidence that staff had completed any training in the Mental Capacity Act 2005 (MCA). Staff spoken with were unsure as to what the MCA meant to them in their role. People's individual lifestyles were promoted.

We saw that medication was handled in a safe and appropriate way and it was stored securely.

We saw that staff were recruited only when they had provided a full employment history, two references and a criminal records bureau check. Staff files seen confirmed this.

People who lived at the home told us that staff did their best to help them solve any concerns or complaints. Several people told us, 'I have never had any complaints but I could speak to any of the staff if I had'.