Arbory Residential Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service remained in breach of the legal regulation in relation to good governance.

This service scored 62 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

People and their relatives spoke of a “friendly” service. Staff told us they felt supported, that communication was “better” and that morale had “improved.” We saw minutes of staff meetings that showed staff were kept informed of the direction and goals of the service.

Regular staff surveys were carried out. We viewed the latest survey results and the associated action plan, which showed staff feedback was listened to and acted on. Further staff feedback was being sought via survey at the time of the inspection.

The providers vision and values were on display in communal areas.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

People and their relatives spoke highly of the manager. People told us the manager was “very nice” and “hands on.” One person’s relative said, “[Manager name] is good. My only problem is that I would be frightened that we might lose her. She does genuinely care, she just gets on with what is needed to be done, and she is great fun too.”

The service had experienced a high turnover of managers, and this had impacted on staff morale, and on the overall leadership at the service. Staff, relatives and health professionals we spoke with, told us the current manager had improved the day to day running of the service which in turn had improved morale and trust. One staff member said, “[Manager] is always calm and comes from the angle of the residents. She really understands. With the turnover in management, it has made us staff feel a bit sad. We’re never sure what’s going to happen next and it does cause some stress and anxiety.”

The manager told us they understood the importance of being a visible presence at the service in order to support the staff team. They told us, “Staff have been here a long time, and they really do care. From a manager’s point of view, it's about knowing your residents and staff. I am very visible and I work long days, I'm here if they need me.” Staff confirmed the manager was visible and accessible, with night staff also telling us the manager often arrived at the service when they were still on duty, which meant these staff also had opportunities for 1:1 support and feedback.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff were aware of the provider’s whistle‑blowing policy, which was displayed in staff areas. Minutes of staff meetings showed staff were encouraged to raise concerns.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

There was a diverse workforce in place. All staff told us they felt supported and included. One staff member said, “We come from different places, but we work well together.” The manager told us they supported staff to have their cultural needs met. They told us, “Some staff might ask for days off for celebrations. If staff wanted to have private space to pray, we could make that happen. We have some staff who are qualified nurses in their own countries, and we are helping them get their nurse registration here.”

At our last assessment, the quality assurance systems and processes had failed to identify the shortfalls at the service. At this assessment we found that governance systems were not consistently effective and the provider remained in breach of regulation. Audits had not identified the issues we noted in relation to temperature monitoring of medicines storage areas, and although other issues relating to medicines management had been noted as part of medicines audits, improvements had been inconsistent. Inconsistencies in record keeping, such as some gaps noted in records in relation to fluid intake monitoring and personal hygiene had not been identified and the provider was not fully aware of people and their relatives’ views on staffing levels. Inconsistencies in the quality of care plans had been identified, and action had begun, but was not yet complete.

Although some improvements had been made, such as improvements in reporting safeguarding concerns and recruitment checks, and improvements to the cleanliness of the environment, further embedding was required. The manager told us “Our relationship with external health professionals is so much better now. This home has got so much potential and we are improving daily.” They told us they felt supported by the provider’s senior management team who were regular visitors to the service. Staff told us they felt the service was improving. One staff member said, “It feels happier and homelier now. The manager goes above and beyond.”

There was a compliance improvement plan in place and an environmental improvement plan to support ongoing progress.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

People living at the service were supported to be active in community events and to take part in community activities, including gaining a better understanding of local politics. The local mayor and politicians had attended the service. The manager told us about a recent falls training workshop which families and members of the local community were able to attend, in order to learn more about how to reduce the risk of falling at home. Regular community coffee mornings took place as well as an upcoming summer fair which the local community were invited to attend.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The management team acted promptly and transparently to address issues identified during the inspection and they were open to our feedback during and after the inspection. They used feedback from people using the service, relatives, staff, and professionals to drive improvements and promoted a culture of learning to reduce the risk of recurrence.

Staff told us they were invited to make suggestions for improvements. One staff member said, “When I started there was no handover and poor communication between senior care staff. I raised it with [manager] and it’s been put in place. The continuity of handover is now so much better.”