Archived: The Arches

We found that the audits undertaken by the home had not identified errors with the administration and recording of controlled drugs for one person, and that the records of administration for another person did not correspond with the amount of medication held. This left people at risk of not receiving their prescribed medication. We held a management review meeting following the inspection to discuss the continued non-compliance. We made the decision to allow the home a further month using the new medication system before we returned to carry out another inspection.

Prior to the inspection we had received information stating that the home had insufficient numbers of staff to meet the needs of the people who lived at the home. During this inspection we checked staffing levels and found that staff were expected to work excessive hours to ensure that shifts could be covered. In addition to this, there were currently insufficient numbers of staff who had completed medication training to ensure that there was someone on each shift who could safely carry out this task.

We checked medication records, storage arrangements and staff training information to assist us in making a judgement about compliance. We also spoke with the manager and care staff.

We spoke with one person who lived at the home, two members of staff and the registered person as part of this inspection.

We found that care planning had improved and that documentation had been reviewed. Monitoring forms had been completed consistently to ensure that people's care records were up to date. A person who lived at the home told us that staff were attentive and their individual needs were met.

All staff had commenced training on safeguarding adult's from abuse to supplement the training they had completed at the time of their induction. Staff were able to describe different types of abuse and what they would do if they witnessed any poor practice. All staff had completed induction training when they were new in post.

Although no new staff had been recruited, the registered persons were in the process of recruiting a new manager and we were able to see that appropriate recruitment practices were being followed.

Quality assurance systems including audits and satisfaction surveys had been used to monitor the service provided . The registered person had taken steps to ensure day to day management of the home had improved.

We found that people who lived at the home had their needs for personal care met, but that there was little opportunity for meaningful activity. Care planning documentation had not been kept up to date and this could have resulted in people not having their current care needs met.

Staff were uncertain about the action they needed to take if they observed poor practice or incidents of abuse that had occurred between people who lived at the home.

Medication policies and procedures at the home were being adhered to, recording was accurate and medication was stored safely.

Recruitment practices at the home remained unsafe and staff training had been reactive rather than planned. There was a lack of evidence that staff had completed training, including safeguarding adults from abuse, dementia awareness and medication administration.

New staff had been recruited and the high turnover noted at the previous inspection had settled down. Staff were no longer working excessive hours.

The quality and safety of the service provided were not being monitored. Quality audits were not being completed. The registered person had not demonstrated that they were operating the service in a safe way that promoted good practice from staff.

We found that some staff had appropriate safety checks in place prior to them starting work at the home. However, some staff did not have these checks in place. This meant that people who lived at the home could have been supported by people who were not considered suitable to work with vulnerable people and this placed them at risk of harm.

Although new staff 'shadowed' experienced care workers and had 'orientation' into their new role, there was no evidence of induction training.

We found that there were sufficient numbers of care staff on duty. However, there was a high turnover of staff and this provided a lack of consistency for the people who lived at the home. In addition to this, some staff worked excessive hours and there was a possibility that they were too tired to carry out their duties effectively. Again, this placed people who lived at the home at risk of harm. Staff told us that they worked extra hours voluntarily and that pressure was not put on them to work additional hours.

We are now satisfied that the gas systems and the electrical installations at the home are safe and that people who live and work at the home have been protected from the risk of harm.