• Care Home
  • Care home

The Arkley Care Home

Overall: Good read more about inspection ratings

140 Barnet Road, Barnet, Hertfordshire, EN5 3LJ (020) 8449 5454

Provided and run by:
Bupa Care Homes (BNH) Limited

All Inspections

30 September 2022

During an inspection looking at part of the service

About the service

The Arkley Care Home is a nursing home providing accommodation with personal care and nursing care for up to 52 older people. Some of whom are living with dementia. On the day we inspected there were 43 people living in the home.

People’s experience of using this service and what we found

People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people. Staff supported people to take medicines safely.

People's care was planned and risks to their safety and wellbeing were assessed. The service reviewed these plans regularly, involving people in these reviews and asking for their opinions.

Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.

People and staff praised the managers of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the newly recruited manager.

The staff team was committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity.

Staff consistently strived to ensure that people had the best possible care, and that they were supported in a compassionate, dignified and safe way

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.

Care plans contained information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

The provider had systems in place to monitor and improve the quality and safety of the service provided. There was a positive culture throughout the service. Staff told us they enjoyed working at the service and felt valued.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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Rating at last inspection

At the last inspection we rated this service Good. The report was published on 12 March 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe, Effective and Well Led.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

11 January 2022

During an inspection looking at part of the service

The Arkley Care Home is a nursing home providing accommodation with personal care and nursing care for up to 52 people. On the day we inspected there were 38 people living in the home.

We found the following examples of good practice.

The provider was following the current Government National Guidance regarding care home visiting. Residents had three named visitors and an essential care giver. Information was available for visitors to follow. Visitors were supported to test for COVID 19 prior to entering the home and instructed how to use PPE.

The home had alternative methods to support social contact for visitors who were not named. For example, video calling and a visiting pod which was a converted room with a giant transparent screen separating the room and an intercom for people to speak with visitors, with an external entrance.

The provider had a system in place to ensure staff had the necessary vaccinations and had completed the necessary COVID 19 testing prior to working in the home.

The layout of the service and communal areas supported social distancing. The premises looked clean and hygienic throughout. There were enhanced cleaning schedules in place and adequate ventilation.

The staff were aware of who to contact should they have a outbreak of COVID 19 and the protocols to follow.

The home had sufficient supplies of personal protective equipment (PPE). There were PPE stations available throughout the premises. Staff had received training in infection prevention and control and how to don and doff PPE.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

28 January 2020

During a routine inspection

About the service

The Arkley Care Home is a nursing home providing accommodation with personal care and nursing care for up to 52 people. On the day we inspected there were 44 people living in the home.

Systems and processes were in place to keep people safe and risks associated with people's care needs had been assessed. There were enough staff to meet people's needs and recruitment processes and procedures were safe.

The management of medicines was safe, and people received their medicines in a timely manner as prescribed. People received a healthy, well balanced and nutritious diet.

The service was extremely clean and well maintained, and there were appropriate procedures to ensure any infection control risks were minimised.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager and staff team knew people well and detailed care plans provided staff with guidance on how to meet people's needs. People were extremely well-cared for. Staff consistently strived to ensure that people had the best possible care, and that they were supported in a compassionate, dignified and safe way.

The management team had forged successful partnerships with a number of other stakeholders and worked closely with peoples’ families to provide an excellent care experience for people.

Staff respected people’s privacy and dignity and encouraged people to remain independent. People and relatives could express their views about the running of the home and their views were always taken on board.

People received personalised care and support which met their needs, reflected their preferences. People benefited from a variety of activities, events and trips out that were available to reduce social isolation, give meaning and purpose and enhance their wellbeing.

The service was well led. People, staff and relatives spoke extremely positively about the registered manager. There was a positive culture throughout the service which focused on providing care that was personalised. The management team used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role.

More information is in the full report.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was good (report published 22 August 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

24 July 2018

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 16 January 2018 at which one breach of legal requirements was found. The registered provider did not manage medicines safely.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirement in relation to the breach.

We undertook a focused inspection on 24 July 2018 to check that they had followed their plan and met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Arkley on our website at www.cqc.org.uk.

The Arkley Care Home is a nursing home providing accommodation with personal care and nursing care for up to 52 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of our inspection there were 38 people using the service.

At our focused inspection on 24 July 2018, we judged that the provider had made improvements and had now met legal requirements.

The home has a registered manager. 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 and associated Regulations about how the service is run.

We found people were protected against abuse or neglect. People had personalised risk assessments tailored to their support requirements

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We saw sufficient staff were deployed to keep people safe.

People were protected from avoidable harm and risks to individuals had been managed so they were supported and their freedom respected.

The service was clean and there were systems in place to prevent and control infection.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

Sufficient numbers of suitably qualified staff were employed to keep people safe.

Medicines were now managed safely. Staff had received relevant training and regular medicine audits were taking place.

The home was well led by an experienced registered manager. People, relatives, staff and health and social care professionals spoke highly of the registered manager; they found them to be dedicated, approachable and supportive.

The registered manager understood their responsibilities and ensured people, relatives and staff felt able to contribute to the development of the service. Staff were supported to be valued members of the organisation. The continued development of the skills and performance of the staff was integral to the success of the service. and the provider had systems in place to monitor the quality of the service, seek people's views and make on-going improvements.

The premises were safe and equipment was appropriately maintained.

16 January 2018

During a routine inspection

The Arkley Care Home is a nursing home providing accommodation with personal care and nursing care for up to 61 people. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. On the day of our inspection there were 30 people using the service.

We carried out an unannounced inspection of this service on 13 June 2017.Breaches of legal requirements were found. We saw multiple issues with stocks of medicines not matching what the recorded stock was, medicines being given at the wrong time and medicines being disposed of unsafely. We took enforcement action and served a warning notice on the provider requiring them to become compliant with this regulation by 26 July 2017.

At this inspection we found that a number of improvements had been made and the provider had been working closely with the pharmacist from the CCG. Medicines were stored and disposed of appropriately and administered by people who had received training to do so. However we found that for one person the allergy status had been incorrectly recorded and another person receiving long acting medicines did not always receive them as prescribed. This meant that the service had still not met legal requirements in this area.

At our last inspection, we also found breaches of regulations in respect of consent and governance. The service did not have a registered manager in post.

The service now had a registered manager. 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.

People were positive about the service and the staff who supported them. People told us they liked the staff and that they were treated with dignity and kindness.

Staff treated people with respect and as individuals with different needs and preferences. Relatives we spoke with said they felt welcome at any time in the home; they felt involved in care planning and were confident that their comments and concerns would be acted upon. The care records contained information about how to provide support, what the person liked, disliked and their preferences and interests.

The staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

Staff told us that a number of improvements had taken place and we found this to be the case. They enjoyed working in the home and spoke very positively about the management of the service. Staff had the training and support they needed to carry out their role. There was evidence that staff and the manager at the home had been involved in reviewing and monitoring the quality of the service to drive improvement

Risk assessments were in place for a number of areas and were regularly updated, and staff had a good knowledge and understanding of many health conditions.

There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people home.

Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

People were satisfied with the food provided at the home and the support they received in relation to nutrition and hydration.

There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.

Improvements had been made in medicines management and there was evidence of some good practice, however we found that for one person the allergy status had been incorrectly recorded and for another person receiving long acting medicines did not always receive them as prescribed.

We found improvements had been made with consent documentation. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

People, relatives, staff and health and social care professionals spoke highly of the registered manager; they found him to be dedicated, approachable and supportive. The registered manager understood their responsibilities and ensured people, relatives and staff felt able to contribute to the development of the service. Staff were supported to be valued members of the organisation. The continued development of the skills and performance of the staff was integral to the success of the service.

The provider’s governance framework ensured quality performance, risks and regulatory requirements were understood and managed. There was good use of a number of monitoring tools in support of this. The service learnt and made improvements when things went wrong.

Overall, we found that the provider had addressed the three breaches of regulations.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 related to the safe management of medicines. You can see what action we asked the provider to take at the back of the full version of this report.

13 June 2017

During an inspection looking at part of the service

The inspection took place on 13 June 2017 and was unannounced. This inspection was a focussed inspection following up on breaches in legal requirements we found at our last comprehensive inspection on 10 January 2017. The provider had written to us after the last inspection telling us how they would meet these requirements. On this inspection we found some improvements had been made in staff supervision and person centred care, but sufficient improvements had not been made in consent or governance, meaning the service was still in breach of legal requirements.

This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection by selecting the all reports link for this service on our website at www.cqc.org.uk.

The Arkley Care Home is a nursing home providing accommodation with personal care and nursing care for up to 61 people. At the time of our inspection there were 44 people living there.

The service did not have a registered manager in post; a condition of the registration of the service was to have a registered manager in post at the service. There was a manager registered with the service but they had left their post in February 2017 and were no longer working in the service. 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.

Medicines were not managed safely. We saw multiple issues with stocks of medicines not matching what the recorded stock was, medicines being given at the wrong time, medicines being disposed of unsafely and pain medicine for one person running out. We saw some evidence of good practice on one of the floors of the home where medicines were stored tidily and Medicine Administration Records were complete.

Documents around a person’s known risk of bruising were not in place to assess or mitigate the risk to this person of further bruising.

We found a continuing breach in the governance of the home. Gaps and inconsistencies in consent documents had not been picked up in care plan audits, and the extent of the medicines issues had not been identified by weekly or monthly medicines audits.

The home was not always in keeping with the principles of the Mental Capacity Act 2005. There were gaps in consent documents. Inconsistencies that were found at the last inspection were still found and sufficient improvement had not been made in this area.

Staff supervisions were now taking place and staff felt supported by the new home manager.

People were receiving person centred care and information about people’s needs had improved in files. However not all files had the same level of individualised care recorded.

Complaints recording and handling had improved. People felt confident to complain to the manager and that they would be listened to. Complaints records were in keeping with the provider’s policy.

There were overall three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

10 January 2017

During a routine inspection

The inspection took place over two days on 10 January and 18 January 2017 and was unannounced. We last inspected this service on 17 February 2016 and it received an overall rating of Good.

The Arkley Care Home is a nursing home registered to provide accommodation, nursing and personal care and treatment of disease, disorder or injury for up to sixty people.

There was a registered manager in post on the day of the inspection. 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.

People and staff told us they thought there were too many agency staff. The home was trying to recruit new nurses. We saw on the day of inspection people were having their basic needs met but the care was affected by the level of agency staff being used.

Effective support in the form of supervisions and appraisals for staff were not always taking place which meant staff were not getting the full support they needed to effectively carry out their role.

The Arkley Care Home was not complying with the Mental Capacity Act 2005. Applications for DoLS were not made in a timely manner and documentation around mental capacity were not accurately completed.

Complaints were not recorded effectively or people making complaints supported through the process.

The provider had sent in extra managers to help make improvements in the home and regular audits were taking place that picked up some issues. We saw that further improvements were required.

Medicines were being stored, administered and disposed of safely by staff who had been trained and had their competency in administering medicines tested.

People and their relatives enjoyed the food and found there was a range of food on offer and it was tasty. We saw that some people could not always reach their drinks and fluid intake for those people at risk of dehydration was not consistent.

We saw kind and caring interactions between staff and people and relatives and people said the staff were friendly and helped them.

People fed back to us they enjoyed the activities on offer and when suggestions were made they were listened to at meetings held for feeding back opinions.

We found breaches of six of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We are taking enforcement action against the registered provider and will report further on this when it is completed.

You can see what action we told the provider to take at the back of the full version of the report.

17 February 2016

During a routine inspection

This inspection took place on 17 February 2016 and was unannounced. When we last inspected on 27 May 2015 we found the service was not meeting one of the regulations relating to providing personalised care to people. At the current visit we found that this breach had been addressed.

The Arkley Nursing Home is a nursing home that is registered to provide accommodation, nursing and personal care for up to sixty people. The home did not have a registered manager, but the manager had applied to register. 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 significant increase had been made to the number of permanent staff working in the home, so that no agency staff had been used within the last two months. People living at the home and their relatives indicated that this had resulted in a marked improvement in the quality of care they received. They described staff as caring and skilled, and said that the atmosphere of the home had improved. We also found improvements made to the management of medicines as recommended at our previous inspection.

A new management team was in place for the service, and people spoke positively about their impact and approachability. The provider had systems for monitoring the quality of the service and had engaged with people and their relatives for feedback, with action plans put in place to address issues of concern. When people made complaints they were addressed appropriately.

We found some gaps in staff supervision frequency particularly for care staff, and some areas for further training. Staff were not always aware of which people living at the home were subject to a deprivation of liberty safeguard, which might place people at risk of inappropriate care.

Staff had knowledge of people’s preferences regarding their care and support needs. Personalised care plans were in place to record people’s care needs, with risk assessments where needed to minimise the risk of harm. Staff were clear about the procedures for reporting abuse. Safe systems were in place for recruiting staff, and the home was kept clean and hygienic.

People were provided with a choice of food, and were supported to eat when this was needed. People had a range of activities available to them, and access to health and social care professionals when needed.

27 May 2015

During a routine inspection

This inspection took place on 27 May 2015 and was unannounced. When we last visited the home on 7 and 8 January 2015 we found the service was not meeting eight of the regulations, and served two warning notices about care provision and staffing within the home.

The Arkley Nursing Home is a nursing home that is registered to provide accommodation nursing and personal care for up to sixty people. The home did not have a registered manager, but an acting manager was in place, while a new registered manager was being recruited. 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.

Improvements had been made to staffing numbers, medicines management and some aspects of care provision in the home. However since the previous inspection a significant number of staff had left, including management, nursing and care staff. While new staff were being recruited a high level of agency staff were working in the home on a regular basis, and this clearly had an impact on the care that people received. The provider was taking steps to minimise the disruption caused with the use of a sole agency to provide all staff cover as far as possible.

There were some improvements in people’s involvement in decisions about their care, and record keeping about people’s care and the running of the home.

The provider had systems for monitoring the quality of the service and had engaged with people and their relatives to address recent concerns. When people made complaints they were addressed appropriately. However there was still room for improvement in auditing systems to identify areas of concern.

We found improvements in staff training, however there had been a gap in individual supervision support provided following a significant number of staff leaving.

Staff had variable knowledge of people’s preferences, likes and dislikes regarding their care and support needs. They knew what to do if people could not make decisions about their care needs, and the procedures for reporting abuse. Safe systems were in place for recruiting staff, and the home was kept clean and hygienic.

People were provided with a choice of food, and were supported to eat when this was needed, some improvements had been made to food provision following a recent survey of food satisfaction. People had a range of activities available to them.

At this inspection there was a breach of regulation in relation to designing care to meet people’s preferences and needs, and four recommendations were made regarding medicines, staffing and supervision. You can see what action we told the provider to take at the back of the full version of the report.

7 & 8 January 2015

During a routine inspection

This inspection took place on 7 and 8 January 2015 and was unannounced. When we last visited the home on 21 May 2014 we found the service was not meeting two of the regulations we looked at.

The Arkley Nursing Home is a nursing home that is registered to provide accommodation nursing and personal care for up to sixty people.

The home had a manager who was in the process of applying to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with CQC 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.

Risks to people who use the service were not identified and managed appropriately. There were not always sufficient staff available to meet people's needs, and medicines were not managed safely.

People were not always involved in decisions about their care, and there were gaps in some of the records kept about their care and the running of the home.

The provider’s did not have effective systems for monitoring the quality of the service and people and their relatives did not always feel confident to raise complaints so these could be addressed. Staff did not receive all the necessary training and support to carry out their role.

Staff understood people’s preferences, likes and dislikes regarding their care and support needs.

Staff knew what to do if people could not make decisions about their care needs, and the procedures for reporting abuse. Safe systems were in place for recruiting staff, and the home was kept clean and hygienic.

People were provided with a choice of food, and were supported to eat when this was needed. People had a range of activities available to them.

At this inspection there were breaches of regulations in relation to the care and welfare of people using the service, staffing numbers, management of medicines, respecting and involving people, supporting workers, records, managing complaints and quality assurance. You can see what action we told the provider to take at the back of the full version of the report.

21 May 2014

During a routine inspection

We carried out this inspection to check whether improvements had been made since our last inspection of the service in December 2013. At that inspection we found gaps in the way care was planned and delivered. People were not protected from the risk of unsafe or unsuitable equipment, because the provider failed to ensure that these were fit for purpose. Staff were not supported to deliver care effectively. In addition, records relating to people who use the service were not accurate or up to date. This meant that people were at risk of receiving inappropriate or unsafe care and treatment.

At this inspection we found that the service had made improvements. The provider had addressed most of the areas identified in their action plan.

The inspection team who carried out this inspection consisted of an adult social care inspector and two specialist advisors a nurse and an occupational therapist, along with a second inspector. During the inspection, the team worked together to answer five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

As part of this inspection we spoke with 10 people who use the service, two relatives, the registered manager, the administrator, three care staff and healthcare professionals. We also reviewed records relating to the management of the home which included, six care plans and daily care records.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

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

Is the service safe?

The provider had ensured that the correct equipment was available and suitably maintained. However, staffing levels were not adequate to meet people's needs.

Is the service effective?

We saw that most staff were up to date with training requirements and had received recent supervision. Risk assessments for people were in place and update regularly.

Is the service caring?

Staff understood people's needs and preferences. Some people told us that staff were, 'excellent.' However, others said staff were sometimes rough and did not respond quickly to call bells.

Is the service responsive?

We saw evidence of referrals to healthcare professionals, such as Tissue viability nurse (TVN), and Speech and Language Therapy (SALT). Staff had recently completed respect and dignity training. People felt confident to make a complaint if there were not happy.

Is the service well-led?

The registered manager had completed an action plan following our inspection in December 2013. We saw that some actions had been addressed. These included, staff training and supervision and an audit of the call bell system. However, there remain concerns at the response levels for call bells, which the provider is aware of.

10 December 2013

During a routine inspection

At the time of our inspection there were 52 people using the service. We received mixed feedback from people who used the service and their relatives. One person said, 'quite nice here, I am looked after and cared for well.' Whilst another person told us, 'some (staff) are respectful whilst some are not.' Most relatives felt their relative was treated with dignity and respect. However, people's preferences and choices were not always respected.

Although care plans and risk assessments had been reviewed, we found gaps in the way care was planned and delivered. This meant that people were at risk of receiving inappropriate or unsafe care and treatment. People were not protected from the risk of unsafe or unsuitable equipment, because the provider failed to ensure that these were fit for purpose.

Systems were in place to protect people from the risk of abuse; however, staff were not supported to deliver care effectively. Appropriate arrangements were in place to manage the administering and recording of medicines. Systems were not effective in ensuring that records for people who used the service were up to date.

28 July 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience people who have experience of using services and who can provide that perspective.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

People who use the service told us that staff were kind and respected their privacy. They confirmed that staff treated them with care, respect and dignity.

One person commented, 'the staff are very discreet' another person told us, the staff, 'always knock on my door before they come in my room'. Other comments included, 'it's very good here', 'I can have my door closed. They respect my privacy' and 'when you come in first they ask you a lot of questions about your care'.

People using the service told us that they were offered a choice in relation to activities, care preferences and food and drink. People told us that they could attend meetings at the service and so could have a say in how the service was run.

There were mixed views about the quality of food provided at the service.

The manager was working with the chef and people using the service to implement improvements. People confirmed they had a choice of menu and that their religious and cultural menu requirements were being met.

People indicated to us that they felt safe at the home.

They told us they had no concerns or complaints about their care but would speak with the manager or the staff if they needed to.

People told us that the manager was approachable and listened to their problems.

People were positive about the staff who supported them and told us there were enough staff on duty to meet their needs.

Records in relation to nutrition and health care needs were up to date, reviewed with the person concerned and were kept securely. This meant that any changes in a person's nutritional requirements or possible associated health care problems were identified promptly so the manager could take appropriate action.

10 May 2011

During a routine inspection

People who use the service told us that they were 'happy here' and a person said that 'you get to know everyone'. Although few people had been directly involved in choosing The Arkley Nursing Home they all agreed that their family member (s) making the choice had made a good choice, on their behalf. At the time of the visit a major refurbishment programme was taking place. People confirmed that 'they have told us broadly what is happening' and that there would be 'a bit of choice when they get to do my room', in terms of colour schemes for soft furnishings etc.

People told us that members of staff 'listen within reason' and that the support they received met their individual needs. People felt they had some control over the service provided and this helped to make them feel comfortable and relaxed.

'They listen. I tell them what to do'. They also said that when receiving support with personal care the members of staff 'make sure that your privacy and dignity is respected'.

People could choose whether they wished to socialise or whether they wished to have privacy and said 'You can sit in places privately, you don't have to go downstairs'. For those people who liked to take part in organised activities we were told that 'the activities usually start at 1.30pm or 2pm. There are quizzes, exercises and occasional entertainers'. One person said 'I do all the activities, I like painting and bingo'.

They confirmed that staff talked to people using the service and explained what they wanted to do, before providing care. People told us

'The staff make sure that I consent' and 'They talk to you, explain what's going on'.

Although people were often unaware of their care or support plan they were satisfied with the care received and with the assistance given to enable them to maintain a healthy and contented lifestyle. They told us

'It's very good here. I like it' and 'They are looking after me well'.

Religious services took place in the home so that people who use the service were able to continue to practice their faith.

People confirmed that the menu offered alternatives and that they were satisfied with the meals served in the home. They said 'the food is good' and 'the meals are not bad at all. You have a choice every day or you can always have egg and chips". People told us that they felt safe living in the home and comfortable with the people supporting them. Names were given of who they could speak with if they were worried about anything or if they were upset. These consisted of the names of members of staff working with them or the managers. They told us 'any problem or worry, don't shoulder it, talk to her', pointing to a member of staff.

'If you're not happy you can talk to someone. You can be in touch with anyone. You only have to ask'.

People using the service said that the home was kept clean and they were satisfied with the overall standard of hygiene. They confirmed that good standards were a consistent feature of the home. Praise was given when talking about the domestics and the laundry service.

'They clean and vacuum right through every day'.

A visitor to the home said that there were no unpleasant odours in the home and said 'This really impressed me'. A visitor said that their relative was 'always clean and tidy'.

People told us that they were satisfied with the arrangements for managing their medication and that the support provided was reliable. They commented that

'I have a lot of medication. They bring it on the trolley. I'm happy about this'.

'They bring it (medication) to you. They never forget'.

People were pleased with their surroundings and appreciated having personal accommodation that included en suite facilities. They told us that it was very comfortable in the home and comments included

'It's very nice here, top notch'.

'I prefer to have my own room. I brought in some pictures and a book case'.

'I have a nice room and outlook. There is a door into the garden'.

People said that members of staff were knowledgeable about their needs. Comments made about members of staff included

'There are very good staff. A kind word helps' and 'They are decent nurses'.

A visitor told us that the members of staff were 'helpful' when assisting people living in the home and another wrote to the home and praised 'the attentive professionalism of so many'. People were satisfied with the competence of nurses and carers and told us 'They know what they are doing'. They told us that there were enough staff on duty but that it 'gets busy at times'.

People confirmed that they saw the manager as she walked through the home and told us that 'the manager comes around quite often, she's a nice lady'.

Overall people were satisfied with the quality of the service provided and said that 'I haven't got anything to complain about' although one person raised a matter with a nurse on duty who dealt with this. A person using the service told us 'I've seen a few places, this was one of the nicest' and a relative said 'This is as good as you would get'. People knew who they would speak to if they had any concerns and were aware of their right to complain if they were not happy about the service provided. Most people said that there had not been any need to make a complaint.

'I haven't got anything to complain about'.

'If you're not happy you can talk to the staff'.