• Care Home
  • Care home

Archived: Arthur's Court

Overall: Good read more about inspection ratings

27 Highfield Road, Street, Somerset, BA16 0JJ (01458) 442319

Provided and run by:
Sanctuary Care (UK) Limited

Important: The provider of this service changed. See new profile

All Inspections

6 January 2017

During a routine inspection

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.

4 July 2013

During a routine inspection

People told us they were always treated with respect. One person said "you cannot fault the staff they are all very good". People were given the opportunity to discuss their care needs and how needs were to be met. We observed staff treating people with respect and supporting people in a caring and sensitive way.

Care plans were comprehensive identifying the health and social care needs of people. People told us the care they received was responsive and flexible. One person told us "I get the care when I need it". There were arrangements so that people had access to specialists and other health professionals.

There were good arrangements for the management and administration of medicines. Staff had the necessary information about medicines people received so their health needs were protected.

There were robust arrangements for the recruitment and selection of staff. Staff received the necessary training so they could undertake their roles and responsibilities in a professional manner.

There were good arrangements for monitoring and auditing the quality of the service. People had an opportunity to comment on the service they received. However this could be improved by the use of questionnaires asking for people's views and any suggestions for improvements.

31 October 2012

During a routine inspection

During our visit we spoke with six people who used the service and four people who had relatives who used the service. People told us they could chose how to spend their day. We saw there was information for people in the reception area of the home and we observed that people had a weekly timetable of activities in their rooms.

One visitor said they had always been welcomed in the home and staff members were always polite and caring. They told us the 'the staff are fantastic with the residents'.

People we spoke with told us that they were happy at Arthur's Court. One person told us, they had lived in the home for quite a while and were comfortable with the way the home was run.

One person commented on the staff in the home, 'the staff are all very good, you can trust them'.

Staff we spoke with had a very clear understanding of the care needs of people who lived in the home. We saw actions that promoted the dignity of people using the service were included in the person centred plans.

People spoken with told us they felt happy and safe at Arthur's Court.

Staff spoken with said that they were aware of the home's policies on recognising and reporting abuse and would not hesitate to report any concerns to the manager or duty nurse.

Regular audits of the premises, care practices and documentation were carried out to maintain the health safety and wellbeing of people at the home.

The manager in post at the service is not yet registered with the Commission.

During a check to make sure that the improvements required had been made

We identified concerns with the home in September 2011. In November 2011 we carried out an inspection and found that improvements had been made.

We received reports from the regional manager that gave us information about how the home has been maintaining their improvements. We received information about the training staff had undergone.

We visited the home on 14 February 2012 and confirmed that improvements had been maintained.

At the time of the inspection the service was being managed by European Care's peripatetic manager. A permanent manager has been appointed.

During the February 2012 inspection people at the home who were able to express an opinion said that they were satisfied with the care that they received at Arthur's Court. Not everyone was able to tell us about their care. We saw that these people were resting comfortably and looked peaceful and clean. Records indicated that they were regularly assisted to change their position and received assistance with food and fluids.

People were positive about the staff that looked after them. People told us that they were kind and knew them well.

14 March 2012

During an inspection looking at part of the service

We identified concerns with the home in September 2011. We carried out an inspection in November 2011 to check on improvements. We found that improvements had been made.

We have received reports from the regional manager that gave us information about how the home has been maintaining their improvements. We have received information about the training staff have undergone.

We visited the home on 14 February 2011 to confirm that improvements had been maintained. The home has operated a voluntary ban on admissions since September 2011. There were 13 people in the home including one person who had been admitted on 11 February 2011.

At the time of this visit the service was being managed by European Care's peripatetic manager. A permanent manager had been appointed and was expected to take full time responsibility at the beginning of March 2011.

During this inspection people at the home who were able to express an opinion said that they were satisfied with the care that they received at Arthur's Court. Not everyone was able to tell us about their care. We saw that these people were resting comfortably and looked peaceful and clean. Records indicated that they were regularly assisted to change their position and received assistance with food and fluids.

People were positive about the staff that looked after them. People told us that they were kind and knew them well.

9 November 2011

During an inspection looking at part of the service

At the last inspection on 20 and 27 September 2011 we had major concerns about four of the essentiall standards of quality and safety in Arthur's Court.

We were concerned that people were not receiving appropriate and safe treatment because their care needs were not assessed. The treatment they received was not planned or fully implemented.

People did not have accurate records containing comprehensive and appropriate information to enable staff to deliver the care required.

People were being cared for by staff who did not always have the necessary training and support.

The monitoring of the service provided in the home was not based on peoples' experiences and views. When concerns about the service were identified action to address them was not taken in a timely manner. This had placed people at risk of potential harm.

We took enforcement action against the provider about these issues and gave the home a short period of time to improve.

This inspection took place over two days and checked that improvements had been made in the timespan that we had specified.

We saw that the treatment people were receiving was based on their assessed needs. Improvements had been made to the planning and recording of their care. One person told us that their pain 'was not so bad' following more regular analgesia. Staff told us in detail how a person's health had improved. They were able to tell us all about the care the person received.

People living in the home and their relatives had been encouraged to give their opinions on the care they had received. At the last inspection people had been at risk because the arrangements for protecting them in the event of fire in the home were inadequate. The risks had been identified but no action had not been taken. At this inspection appropriate action had been taken to reduce the risk of harm to people.

27 September 2011

During an inspection looking at part of the service

Some people were unable to tell us about the care they received in the home due to the frailty of their physical condition or because they had a dementia. We saw that people were either in bed or had been moved to a chair in the lounge during the day. We saw that overall people appeared clean, well presented and were resting comfortably.

We spoke to most of the people who lived in the home permanently and were able to express an opinion. One person said "I am quite happy. Staff are alright. They get me washed, dressed and shaved. They bring me a cup of tea. They are pretty good. I don't seem to wait a long time.' Another person told us 'I can't grumble. I am stuck in bed. I tell the nurses what I want and they do try to help.'

One person had not been assessed by the home before they arrived and staff told us that they knew nothing about the person's needs or the care that they required although they thought they 'had dementia.'

On both visits to the home we spoke with someone who told us that they often had pain and we saw that they did not receive analgesic gel as often as it had been prescribed for them.

People told us that the food was good and that they were able to make choices. 'there are plenty of drinks and snacks and the food is nicely presented.' A person staying at the home for a short time said 'There is almost too much food. It is very good.'

People told us that they felt the staff were 'overworked'. One person told us they can only do so much. It takes a while to answer the bells.'Another person told us 'There are not enough carers'not enough to help you. They are just so busy.'

Most people spoke positively about the care that care staff provided. One person said 'Staff are alright. I can't grumble, they are very good. Every morning they get me washed dressed and shaved. If I want anything they are pretty good.' Other people said that staff were polite and helpful. Some people had a different experience. We heard that 'Some staff are alright. Others are not.'

There is no system either formal or informal that brings the provider's regional management or home manager into contact with people who live in the home. People told us that they did not know who the manager was.

14 December 2010 and 10 January 2011

During a routine inspection

People who spoke to us said that staff were kind to them and they felt well cared for. They said that if they were worried there was always someone to speak to.

People who could talk to us said that the food was good and there was plenty of it. People had some concerns about how they spent their day. We heard that it could be boring and sometimes lonely.

Sometimes people's particular preferences were not remembered.