Arbory Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People were assessed by a member of the management team before moving to the service. This was usually carried out face to face if distance allowed. The manager told us they used the assessment process to assure themselves that they could meet people’s needs and that the information would form the basis of the care plan. Most relatives we spoke with were aware that their loved one had a care plan, although none that we spoke with said they were invited to be involved in the care planning or review process. Some people’s relatives added that they would like to be involved. The latest relatives survey made reference to this, and we were informed the staff were starting to invite people’s relatives to take part, but this was not fully embedded yet.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service used nationally recognised assessment tools to assess people’s risks and support needs. There were good links with external health professionals who told us staff listened to and acted on professional advice and recommendations.

There was good oversight of weight loss and malnutrition risks across the service. Weight loss was reviewed monthly and over a 6-month period and staff knew which people were having their food and fluid intake monitored. Staff also supported people who were overweight to lose weight. The chef told us “Menus are created by communicating with the residents. Asking what their likes and dislikes are. The menu is constantly being changed. We try different things and if the residents don’t like it, we’ll take it off the menu.”

We observed lunch during the inspection. Dining tables had been set, and we saw several people sat in small groups around tables; some people chose to eat in their bedrooms, and this was respected. Staff showed people plates of food so that they could choose what they wanted. Drinks and assistance were offered to people throughout the meal. Relatives were able to join loved ones for meals, and we saw some that had chosen to do this. One person’s relative told us, “I feel looked after as a visitor and I choose to have lunch with [name] every day, for a small charge. [Name] wasn’t eating well at Arbory at first, whereas now I help and it’s nice to share the same meal.”

At the time of the inspection, the weather was exceptionally warm, and we saw staff offered people drinks and ice lollies throughout the day to promote hydration.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us communication within the service was good. They said there were daily meetings, with a staff member from each department attending. This enabled key messages to be shared and then escalated to staff within the wider teams.

Staff worked with a range of health professionals, including the community nurse team, the older people’s mental health team and the Speech and Language Therapy (SALT) team. Referrals were made when needed, and staff followed up on actions and recommendations with external professionals. One health professional told us, “[Manager] is very good at reaching out to us. She knows people well and knows what’s going on.”

People’s relatives told us they were informed of any health appointments. One person’s relative said, “I was told about SALT involvement and the outcome of their assessment as well.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s healthcare needs were assessed and care plans in relation to these aspects of care were informative. People and their relatives told us they were supported to access healthcare services. One person’s relative said, “[Name] gets ill fairly regularly and is always referred quickly to the GP. The staff inform us of any changes.” Another person’s relative told us that when at home their relative was often unwell, but since living at the service, they had been much better.

The activities programme included activities to promote movement as well as activities to engage people mentally, such as chair dancing and quizzes.

Staff supported those who were at risk of weight loss to gain or maintain their weight, but support was also offered to people to lose weight. One person’s relative told us, “Since the weight loss, [name] can walk again, sometimes with a stick but sometimes not. So that is brilliant.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There was oversight of people’s needs in place. Wounds, weight loss and falls for example, were monitored and analysed for any trends or actions required. The manager told us, “We will discuss things as a group with the seniors and then we refer to the GP who is very good. For example, weight loss. If we speak to the GP, they will refer to the dietician and put people on supplements.”

People’s relatives told us staff supported people to attend healthcare appointments, and we saw this during the inspection. One person’s relative said, “[Name] has a lot of health issues. Yesterday, the district nurse took a blood test, and they phoned me as soon as they had the result.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People had been assessed for their capacity to consent to aspects of their care. When people were assessed as lacking capacity, best interest decisions had been made.

We observed staff knocking on people’s bedroom doors before entering and heard staff asking people for their consent prior to supporting them. For example, we observed 2 staff members supporting someone to move in their chair and we heard staff ask, “Is it ok if we just move you a bit [name]?”

Staff had a good understanding of the Mental Capacity Act (MCA) and knew how to seek people’s consent. DoLS applications had been submitted to the local authority in line with legal requirements. The status of DoLS applications was regularly checked by the manager. There were no conditions attached to any of the authorised DoLS.