Archived: Arden Manor Care Home

From our previous inspection some action had been taken to improve the service to people. There are still improvements to be made.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions we had with three people who lived at the home, two members of staff who supported people, a relative, the manager and the provider who was supporting the inspection process. We looked at three people's care records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that there were no systems in place to support learning from events like accidents, incidents and complaints. We spoke with people who felt they were able to raise concerns they had with the manager, but we found that system did not allow for trends to be monitored to ensure risks to people could be reduced.

We found that people were being risk assessed but where changes to people's needs were identified this was not being recorded appropriately in care records or risk assessments. There was no evidence of reviews being carried out with people as part of any changes to their support needs. This meant that people's risks were being managed but people were not involved in the process to keep them safe.

People we spoke with told us they felt safe. One person said, "Since moving into the home I have never not felt safe".

The service had no Deprivation of Liberty Safeguards (DoLS), application in place at the time of the inspection. The manager told us that someone who was on a DoLS application had recently finished. A DoLS is where an application is made under the Mental Capacity Act (MCA) 2005 to deprive someone of their liberty in their best interest. An application is made to the local authority, who then assesses whether the application is granted or not. Training records showed that training was available in the DoLS, and MCA. Staff we spoke with had a very limited understanding of the MCA but were more familiar with DoLS and were able to explain it better. This was discussed with the manager who confirmed further training was planned in MCA and this would be extended to DoLS. We saw evidence of this training displayed in the home. This meant that people could be confident that staff had the knowledge and skills available to them to keep them safe from harm.

We found that the provider had adequate processes and systems in place to meet the requirements of the law in relation to keeping people safe.

Is the service effective?

We found that people were being supported appropriately but records were not effective. Care plans were in place but they were not consistent. Reviews were not being carried to involve people. Documentations were not accurate enough to be relied on in meeting people's needs. This meant people could be at risk due to records not being accurate.

We found that there were no checks or monitoring of records or the support people received from management. Systems were not in place to ensure the quality of the service to people. We found that appropriate quality checks on the environment in and out of the home was not being done effectively. This meant that there was no effective auditing process to ensure the quality of the service.

We found that there was not enough staff to meet people's needs. Staff we spoke with told us they felt there was enough staff if they did not have to cover the laundry area. One person said, "There is enough staff, but sometimes I have to wait for staff to support me". We raised our concerns with the manager who confirmed action would be taken to employ someone to work in the laundry and extra staff would be recruited to work between 4pm and 8pm daily. This would mean staff would have enough time to meet people's needs.

People we spoke with told us they were very happy with the service they received. One person said, "Staff are friendly and kind".

We have asked the provider to tell us what improvements they will make in relation to ensuring the service is effective in meeting people's needs.

Is the service caring?

We found that staff had a good understanding of people's needs. People we spoke with told us that staff supported them in the way they wanted. We saw staff constantly asking people if they were okay however staff were not proactive in stimulating people or recognising people had nothing to do. We discussed this with the manager and provider who was able to show some photographic evidence of activities people have been involved in, in the past. They confirmed action would be taken to improve the quality of activities available.

We saw that people were being supported in a caring environment. People were being treated within dignity and privacy and people we spoke to confirmed this. One person said, "I do like living here". People were comfortable, and staff understood people's needs and were able to support them in a friendly environment.

The provider had adequate systems in place to meet the requirements of the law in ensuring the service was caring.

Is the service responsive?

We found from our previous inspection that the provider had taken some action to improve the service to people and staff knowledge in meeting people's needs. We found that there were still areas to be improved that had not been actioned from the action plan. The manager who had recently been employed told us that immediate action would now be taken to action areas that had still not been met. One relative we spoke to told us they had confidence in the new manager as he had already met with relatives to introduce himself and discuss the plans to be implemented which involved the recruitment of more staff.

The provider had a process in place to allow people to share their views however there was no system in place to manage the actions being taken when negative concerns needed to be dealt with and trends monitored.

We have asked the provider to tell us what improvements they will make in relation to ensuring the service is responsive in meeting people's needs.

Is the service well-led?

The service was managed by a manager who had only been in post three weeks and was supportive throughout the inspection. People we spoke with told us if they had any concerns they could speak to the manager and both staff and people were happy a manager was now in post. We found the management of the home was not effective in ensuring the quality of care in the home was properly monitored. Systems were not in place to carry out the appropriate checks on how staff were supporting people. The manager confirmed these systems would be put in place as part of the new care planning process being implemented.

We found that audits were not being carried out to ensure the service to people was of the right quality and standard. The manager confirmed new systems were being implemented.

We have asked the provider to tell us what improvements they will make in relation to ensuring the service is well-led to meet people's needs.

We found that people's dignity and independence was not being promoted. We observed that people were not always respected.

People's care was delivered to meet their needs. We found that people received care and treatment from other professionals. One person told us, 'We can see a Doctor when we need.'

There were not enough staff to look after people throughout the day. One staff member told us, 'It is not enough sometimes.' We observed that some people did not always receive timely care and support.

Systems were not in place to ensure that the quality of the service was monitored so that improvements could be made. People we spoke with told us they did not have any complaints. One person told us, 'I don't have any complaints. We just get on with things together.'

Records provided basic information about people's care needs and how their conditions should be managed. We found that some records were not fit for purpose in providing the care that people had received.

We found that people were asked for their consent before care was delivered. One person told us, 'The staff ask me questions, mainly I tell them what I want, and they do listen.'

Staff were able to tell us how they would protect people from harm. People we spoke with told us they felt safe at the home.

There were enough staff to look after people at the home. Training records showed that staff had access to different training to improve their skills and knowledge. One person said, 'Staff are excellent here, I have nothing but admiration for them.'