Archived: Arncliffe Court Care Home

The service is situated in Halewood, Merseyside. The property is a large purpose built residence that has five separate units for people with varying needs. Arncliffe Court is on a residential housing estate close to all local amenities and has good public transport links. There are local shops nearby and a main shopping area can be reached by bus or car.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission 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.

A comprehensive inspection took place in January 2015 which resulted in an overall rating of good for the service.

In March 2016 we received concerns in relation to the service people received at Speke House, one area of the service. These concerns included people’s care planning, the foods available to people and the length of time people waited for attention. We undertook a focused inspection to look into the concerns raised and to find out people’s opinions and experiences of the service. This report only covers our findings in relation to the concerns raised. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arncliffe Court on our website at www.cqc.org.uk.

During this inspection we found that improvements were needed to enhance people’s dining experience. We found that the dining room was noisy and that food was not always served at an appropriate temperature.

People had access to health care professionals when needed. Records demonstrated that people had received visits as required from a GP, dietician and speech and language therapists. Family members felt that any concerns about their relatives health had been responded to appropriately.

Staff demonstrated a good knowledge of people’s likes, dislikes and routines. This helped ensure that people received the care and support in a manner that they wished.

People had a choice of food and drinks available to them throughout the day. When required people’s food and drink intake was monitored to ensure that they ate and drank sufficient amounts to keep healthy.

People who were being cared for in bed and those who chose to spend time in their bedrooms had access to a call bell to alert staff if they needed assistance. A record was maintained of each time the call bells were activated and the length of time that it had taken for the call bell to be answered. This information was monitored on a regular basis.

People had the opportunity to attend and participate in regular activities which were made available at the service.

Each person had their own plan of care that detailed the level of care and support they needed throughout the day and night.

A complaints procedure was in place and people and their families were aware of who to contact if they wished to raise a concern or make a complaint about the service.

Systems were in place to assess any risks identified when planning people's care and support. However, we found that these systems were still not effective. For some of the people who used the service, whose care plans had been reviewed and updated, we found that their risks had not always been assessed in full and that the assessments were not always accurate.

Is the service effective?

Comments from people living at the service who were able to talk with us were positive. Relatives comments were variable and included ''We have made our concerns known but staff remain reactive rather than proactive'' and ''My relative is looked after very well but is on a special diet and sometimes they get it wrong.''

We saw that staff did not always attend to people's needs in a timely manner. For example, we saw that people waited for a considerable amount of time for staff to support them with their meals.

Is the service caring?

One relative visiting the service told us ''We are always made welcome and feel that our relative is well looked after.''

Is the service responsive?

We found that systems in place to regular assess and monitor risks to individuals and the environment were under review. However in the meantime we saw that adequate amounts of equipment needed to respond to peoples needs, such as hoists and foot stools were not always available.

Is the service well-led?

A quality assurance system was in place which included the regular monitoring of health and safety; infection control, the environment and care plans. At the time of the inspection this was still under review therefore we did not assess it in depth. The manager of the service was in the process of applying to be registered with the Care Quality Commission.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found -

Is the service safe?

Systems were in place to assess any risks identified when planning people's care and support. We found that these systems were not effective. We found that the risks to people who used the service had been assessed in full and that the assessments were not always accurate or up to date.

People who used the service, their relatives and carers felt the service was safe.

Is the service effective?

People who used the service told us that they were happy with the care and support they received. Their comments included, 'The chef is brilliant. Mum has a low potassium diet and that's what they give her' and 'There's a great atmosphere on here. They're lovely. They do my hair just how I like it."

We saw that staff did not always attend to people's needs in a timely manner. For example, we saw that people waited for a considerable amount of time for staff to support them with their meals.

Is the service caring?

People were supported by pleasant staff. People who used the service told us 'The girls are very kind' and 'All the staff are very nice and nothings too much trouble.'

Is the service responsive?

A system of review was in place to enable care plans to be updated on a regular basis. We saw that this system needed improvement. This was because a number of care planning documents had not been reviewed in line with the company's policies.

We found that whilst systems were in place to regular assess and monitor risks to individuals and the environment, these were not always effective. For example we found that recent audits had failed to identify risks to people and the environment.

Is the service well-led?

A quality assurance system was in place which included the regular monitoring of health and safety; infection control and the environment. We saw that improvements were needed to ensure the auditing processes were completed in full and action taken in any areas identified in needing improvement. This was because recent audits had failed to identify and address areas of improvement required.

During our visit we spoke with people who used the service, relatives, staff and other visiting professionals. We looked at care records to see how their needs should be met. We looked at infection control audits and information on complaints.

We observed good rapport and interaction between the people who used the service and staff. The information we gathered indicated that people were happy with the care and support provided. People and their relatives told us that they received the appropriate care and support that they needed. All residents had an individual care record. One person told us, 'Nothing is any trouble, anything I want they do'.

During our visit we found the home to be clean and observed regular checks being carried out to ensure the required standards of cleanliness and infection control.

There were sufficient qualified and skilled staff on duty to meet the needs of the people who used the service. However one person commented that there had been occasions when they had waited a while for assistance.

People told us they had no concerns about the staff and had no complaints about the care home. People benefited from a key worker system that meant staff gave people a more personalised service. People told us they felt involved in their care and had choices in what they wanted to do.

The people we spoke with told us they felt safe and that they had no concerns about the staff and had no complaints about the care home. People benefited from a key worker system that meant staff gave people a more personalised service. The people living at Arncliffe Court that we spoke with told us they felt involved in their care and that they did not do anything that they did not want to do.

We observed a good rapport between the people who used the service and staff. The information we gathered indicated that they were happy with the care and support provided. They described the staff as caring and attentive.

We found that staff presented as happy working at Arncliffe Court and that they had received relevant training for their role.

We saw that there were appropriate systems in place to monitor the quality of care that people received at the home and we were told that the manager was approachable and responded to comments and suggestions made by people, their relatives and members of staff.

We saw evidence that the provider had acted on recommendations from previous inspection reports regarding safeguarding, medicines management and records that were needed to benefit the people who used the service.