14 August 2023
During an inspection looking at part of the service
Arbory Residential Home is a care home providing accommodation and personal care to up to a maximum of 60 people. The home does not provide nursing care. At the time of our inspection there were 39 people using the service, most of whom were living with dementia.
The accommodation at Arbory Residential Home is arranged over 2 buildings. The Lodge has accommodation over 2 floors and is an older building that has been repurposed into a care home. The Court is a newer, purpose built building where the accommodation is arranged over 3 floors. There are communal lounges, dining areas and a garden area.
People’s experience of using this service and what we found
We continued to find concerns about how some risks were assessed, monitored, and mitigated. There were still insufficient numbers of staff deployed to meet people’s needs at all times. Staff understood how to protect people from avoidable harm or abuse. Some reviews and investigations into incidents could have been more thorough to help ensure every opportunity for learning was taken.
Legal frameworks regarding consent, were still not being implemented fully. The premises and equipment within it were still not well maintained. Staff did not consistently receive an induction or probationary reviews. Work was underway to embed a more comprehensive programme of supervision. Whilst the provider offered staff a range of training which most staff were up to date with, a number of staff told us they would value more face to face training. Some care plans lacked completeness or contained conflicting information whilst others were more reflective of people’s needs. Improvements were needed to develop better partnership working with healthcare professionals to meet people’s healthcare needs.
We have made a recommendation that staff inductions, and the supervision program are developed in line with best practice guidance.
People were not consistently receiving person centred support and did not have access to meaningful activities on a regular basis. Governance systems were in place, and there was evidence local leaders were working hard to deliver improvements, however, many of the required improvements had been hindered by continued shortfalls in staff across all departments. Improvements to the environment were underway, but more needed to be done to deliver these within a suitable time scale to ensure people’s care and support was provided in a safe, clean, and well maintained environment.
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 requires improvement (published 8 February 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
The inspection was prompted in part due to concerns received about the quality and safety of people’s care, the cleanliness of the home and staffing levels. A decision was made for us to inspect and examine those risks. As a result, we undertook this 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.
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.
The overall rating for the service remains requires improvement.
We have found evidence the provider needs to make improvements. Please see the safe, effective, and well led key question sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arbory Residential Home on our website at www.cqc.org.uk.
Enforcement and recommendations
We have identified continuing breaches in relation to the suitability of the premises, consent, safe care, and treatment, staffing and governance. We identified 1 new breach in relation to person centred care.
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.