Arbour Court

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 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 made sure people’s care and treatment was assessed and reviewed, including their health, care, wellbeing and communication needs.

People and families told us their needs were assessed prior to their admission to Arbour Court. Risk assessments and care plans were in place, but did not always reflect sufficient information for staff where specific needs or risks had been identified.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The home had various areas where people could walk independently and areas outside which were secure. However, there was limited signage to help people locate their bedrooms.

People in their bedrooms did not always have access to drinks and it was not always evident that people were encouraged to drink when staff attended to them in their bedroom, especially at night-time. People were supported to eat by staff who were kind and friendly, but we noted staff did not always tell the person what they were doing before putting any drink or food to their mouth.

We found some people did not have dentures or hearing aids and it was not always clear what action the provider was taking to support access to these services. We noted on some occasions it had been deemed in the persons best interest not to follow these matters up and the registered manager told us they had good working relationships with a local dental surgery.

Processes to ensure effective oversight of how people’s needs were being met were not always being used effectively. For example, refusals of care were not always consistently being documented and followed up.

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.

People and families spoke highly of the staff team. They told us staff knew people very well and were kind and patient and made families feel welcomed when they visited the home. Several relatives commented that the staff and other people living at the home felt like part of an extended family.

Staff told us they were happy working at the home and felt supported and that they all worked together. We observed positive and supportive relationships between the staff team. We noted some staff meetings indicated some clashes in personality, but that these had been addressed by the registered manager. The home had a multi-cultural staff team and each month the staff celebrated this with a world culture day where staff prepared traditional food and would wear traditional clothing. Staff appeared to enjoy participating in these sessions and sharing their culture with their colleagues and people living at Arbour Court.

Systems for supervisions and appraisals were in place but did not reflect supportive conversations that the registered manager was having with staff, or consistently demonstrate a two way process of communication within supervision. The registered manager was responsive to feedback and looking at alternative approaches to maintain effective records.

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 and families told us they were confident that staff recognised and supported them to access the health services they needed. Relatives told us communication was good and that they were kept informed of any health issues experienced by their family member. Records did not always show how people were supported to engage in healthier lives, for example in relation to levels of personal care or engagement in physiotherapy activities, which had been recommended by health care professionals. Although there was evidence that people were supported to remain active, and activities such as dance and daily living tasks were promoted, it was not always evident how targeted work such as falls prevention exercises were used to underpin activities.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Whilst there was evidence of oversight of clinical issues and needs, the systems for day to day oversight were not always clear or embedded. The provider only ensured records of food and fluid were maintained where there was a high clinical risk; this meant there was limited evidence to show people were having regular drinks provided throughout the night and people who had modified fluids or diet but did not require monitoring of this, had no record to demonstrate appropriate fluids were provided consistently. This was fed back and the provider took immediate action to ensure the system captured records of how people’s prescribed needs were being met.

Where people needed additional support to reposition and protect their skin from pressure damage this appeared to be happening appropriately and the home did not have any pressure injuries as the time of our site visit. However, we noted records did not always evidence that appropriate skin care was being given in the form of regular baths and showers and applications of creams. Care plans did not always provide sufficient detail to direct staff on what cream to apply where and when.

People had oral assessments and care plans mostly referenced the type of support people needed for good oral care. However, we found some examples where toothbrushes were hard or not in place, and records did not indicate this was due to a person refusing or that attempts had been made to go back and provide this support.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

It was not always evident that consent to care and treatment had been given in writing within people’s records. We observed staff mostly requested consent when providing support for people, but there were some instances where this was not the case.

Where people lacked capacity there was evidence that mental capacity assessments were in place and best interest decisions were made. However, best interest decisions did not always reflect that all appropriate people, including the person or their representative, had been involved. Information for people who had made arrangements for lasting power of attorney were not always clearly documented within care records.