Arden Grange Nursing & Residential Care Home

Updated 5 July 2023

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 Health and Social Care Act 2008.

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 3 inspectors.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

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 Healthwatch, the local authority and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 2 people who used the service and 5 relatives. We also received feedback via our website. We spoke with 12 members of staff which included the registered manager, housekeeper, care and nursing staff, the operations manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We looked at 6 care plans and medication administration records. We looked at 3 staff recruitment files and records relating to the health and safety and the management of the home.

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.

Updated 5 July 2023

About the service

Arden Grange Nursing and Residential Care Home provides nursing and personal care for up to 45 people including people with dementia. At the time of the inspection there were 23 people using the service.

The home is an adapted building with all care provided on the ground floor. People have access to lounges, dining areas and outdoor spaces. Bathrooms and toilets are situated near to all communal areas.

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

Improvement had been made to the environmental risks we identified at our last inspection, but some areas still required some on-going work. People’s medicines were not always safely managed.

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.

People were supported to eat and drink but records did not always confirm how much people should be drinking to keep them well. People’s care plans had been reviewed and updated since our last inspection. More work was needed to ensure these records always reflected people’s preferences and wishes, including their communication needs.

Although the provider had improved their quality monitoring and oversight since our last inspection, further improvement was needed to ensure shortfalls in the service were identified.

Staff understood how to protect people from harm and followed safe hygiene practices to prevent and control infection. People were supported by enough staff who had been safely recruited. The provider had systems in place to make sure lessons could be learnt from accidents, incidents and when things went wrong.

People’s needs were assessed and they had care plans in place. Staff had received the training they needed to meet people’s needs. People’s routine health needs were met, and referrals were made when people needed other health care support or staff were worried about a person’s health.

People were supported by kind and caring staff. Staff had developed good relationships with people and their relatives, and they were treated with dignity and respect.

People and relatives felt confident to raise concerns if they needed to.

Staff and the registered manager understood their roles and responsibilities; they felt supported by management and involved in the development of the service. People and relatives praised the service and felt staff and managers were supportive.

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 (published 28 December 2022). The provider had breaches in relation to people's safety, consent to care and treatment, dignity and

respect, person centred care and governance of the service.

At this inspection we found the provider had made improvements and was no longer in breach of the regulations for dignity and respect and person-centred care but remained in breach of the other regulations.

This service has been in Special Measures since 28 December 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 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 COVID-19 and other infection outbreaks effectively.

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.

Enforcement

We have identified continued breaches in relation to the management of people’s medicine, consent and the governance of the service.

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