We carried out a review of the data available to us about The Arc on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Arc, you can give feedback on this service.
The Assessment and Rehabilitation Centre (The ARC), is an integrated provider with health and social services working together to provide care and support for up to 33 people. The staff team consists of rehabilitation support workers, occupational therapists, physiotherapists and nurses. Accommodation is located on two floors with a lift available between floors. Twenty-three people were staying at The ARC when we made the site visit.
People’s experience of using this service and what we found
People told us they felt safe at the ARC and the staff team supported them safely. People were able to be as independent as possible because staff assessed risks and helped them manage avoidable risks. Staff demonstrated a good understanding about how to safeguard people from the risk of abuse. Staff supported people with their medicines according to national guidelines. Staff recruitment procedures were robust and there were enough staff to care for people safely.
Staff were knowledgeable about how to use PPE and how to prevent and control infection and followed national and local guidance. The infection prevention and control policy was up to date. The building was clean and hygienic, so the risk of infection outbreaks was reduced and managed. They were knowledgeable about infection and from the start of the pandemic, the service had been supporting people who were COVID-19 positive. The building was maintained and equipment serviced as required to make sure this was safe and in working order.
Care records were personalised, and it was clear they had been planned and agreed with the individual. We saw examples of person focused discussions. The provider had a complaints policy. People knew how to complain and said any concerns were dealt with promptly and to their satisfaction. Staff had assessed and knew people’s specific communication needs. The service did not support people needing end of life care.
We received positive feedback from people supported and staff about the leadership and management at The ARC. People told us they felt involved in how their care was provided and understood the restrictions in The ARC related to the COVID-19 pandemic. Staff felt well supported. The manager and senior team monitored and audited the service to make sure the quality of care was good. They understood and acted on legal obligations, including conditions of CQC registration and those of other organisations. They worked in partnership with other services and organisations to keep people safe and improve their well-being.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was requires improvement (published 1 April 2020) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating. We carried out an unannounced comprehensive inspection of this service on 03 March 2020. A breach of legal requirements was found in relation to good governance.
We undertook this focused inspection to check the service had followed their action plan and to confirm they now met legal requirements.We found improvements had been made and the provider was no longer in breach of regulations. This report only covers our findings in relation to the Key Questions safe, responsive and Well-led which contain those requirements. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The ARC on our website at www.cqc.org.uk.
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 the service can respond to coronavirus and other infection outbreaks effectively.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The Assessment and Rehabilitation Centre (The ARC), is an integrated provider with the health service and social services working together to provide care and support for up to 33 people. The staff team consists of rehabilitation support workers, occupational therapists, physiotherapists and nurses. There were 26 people staying at The ARC when we completed our inspection.
We found the following examples of good practice.
• Staff were following the latest guidance to reduce the risk of cross infection. Personal protective equipment (PPE) was easily accessible to staff who used and disposed of it correctly. All visitors were health screened and provided with PPE on entering the building.
• People were able to be admitted to the service even if COVID-19 positive or COVID-19 status unknown. Areas within the home were zoned, dependent on the COVID-19 status of each person and staff worked in specific zones. People were admitted safely and isolated in their room throughout their stay.
• Staff followed social distancing and shielding rules. Changes had been made to the layout of rooms throughout the building to assist with social distancing.
• Risk assessments relating to COVID-19 were completed and regularly updated. Cleaning schedules had been increased and were frequently monitored.
• Staff had completed infection prevention and control (IPC) training. The manager monitored and audited staff completing hand hygiene and correct use of PPE. Staff and people supported were regularly tested for COVID-19.
We were assured that this service met good infection prevention and control guidelines as a designated care setting.
Further information is in the detailed findings below.
The Assessment and Rehabilitation Centre (The ARC), is an integrated provider with the national health service and social services working together to provide care and support for 31 people at the time of inspection. The staff team consists of rehabilitation support workers, occupational therapists, physiotherapists and nurses. Accommodation is located on two floors with a lift available to facilitate access to the second floor. The service can support up to 33 people.
People’s experience of using this service and what we found
Care was not planned in a personalised way. Care files did not always contain care plans to reflect how people’s needs were to be met. Gaps in documentation meant there was not a clear record of the food and fluids people with nutritional concerns had received. Falls care plans were not always updated to reflect the mobility support people required.
We have made recommendations about risk taking management, lessons learned and care plan record keeping which can be found in the ‘safe’ and ‘responsive’ sections of this report.
Safeguarding procedures were in place to protect people from the risk of abuse and avoidable harm by staff who understood how to recognise and respond to concerns. Staff were recruited safely and there were enough staff deployed to meet people's needs. Medicines were managed safely. People were protected from the risk of infection as prevention and control measures were in place.
Staff received the training and support they needed to carry out their roles. 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 were treated with dignity and respect and said staff were kind and caring. People's right to privacy was upheld. The registered manager provided people with information about local advocacy services, to ensure they could access support to express their views if they needed to.
People’s communication needs had been assessed and where support was required these had been met. People knew how to complain, and felt concerns raised would be listened to and acted upon.
People were consulted and asked their views on the service provided. The registered provider reviewed exit surveys completed by people and relatives to assess their satisfaction with the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 27 September 2017)
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the responsive and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
The provider responded immediately during and after the inspection to effectively mitigate the risks by reviewing care planning arrangements and documentation.
Enforcement
We have identified a breach of regulation in relation to good governance at this inspection. The registered manager failed to maintain good records of care planning and monitoring and evaluation.
Please see the action we have told the provider to take at the end of this report.
Follow up:
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the last inspection the service was rated Good. At this inspection we found the service remained Good.
People staying at the ARC told us they were happy with their care and liked the staff who looked after them. We observed care practices throughout our inspection visit and saw staff were kind and patient with the people in their care. One person staying at the ARC said, “The staff are very kind and very caring.”
The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.
Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.
We saw staff assisting people with mobility problems. They were kind and patient and assisted people safely.
The service had sufficient staffing levels in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed. People staying at the ARC told us staff were responsive to their needs.
Medication procedures at the ARC were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with appropriate arrangements for storing in place.
We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.
The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People had been consulted about their care and had agreed with the support to be provided.
People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.
People staying at the ARC were supported by occupational therapists and physiotherapists with their rehabilitation. They had access to nursing staff to attend to their nursing needs and General Practitioners (GPs) visited the service daily between Monday and Friday to monitor people’s health needs.
The design of the building and facilities provided were appropriate for the care and support provided.
People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.
People’s care and support was planned with them. People told us they had been consulted and listened to about how their support would be delivered.
The service had information with regards to support from an external advocate should this be required by them.
The service had a complaints procedure in place. People we spoke with told us they were happy and had no complaints.
People told us their privacy was respected and staff treated them with respect and dignity at all times.
The registered manager used a variety of methods to assess and monitor the quality of the service. These included surveys to seek the views of people about the service provided on their discharge from the ARC.
This inspection visit took place on 03 June 2015 and was unannounced.
At the last inspection on 23 October 2013 the service was meeting the requirements of the regulations that were inspected at that time.
The Assessment and Rehabilitation Centre (The ARC) is based in a quiet residential area of Blackpool. The ARC offers social care rehabilitation for 33 people who need a short period of intensive support in a 24 hour setting. Support is accessed via an assessment of need from an Adult Social Care or Health professional. It is available to people who are discharged from hospital, any residential or nursing home, or to meet the needs of people who are at home to prevent an escalation of need. The staff team involves rehabilitation support workers, occupational therapists, physiotherapists, falls prevention workers and nurses, who all work together to identify goals to promote independence. Accommodation is located on two floors with a lift available to facilitate access to the second floor. At the time of our inspection visit there were 26 people who lived at the ARC.
There was a registered manager in place. 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.
The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices. People we spoke with told us they felt safe and their rights and dignity were respected.
The care plans we looked at described the daily support people received. This included personal care support and rehabilitation exercises undertaken with an occupational therapist and physiotherapist. One person we spoke with said, “The support and treatment I am receiving has been excellent. The staff have been very kind and patient with me.”
We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with and records seen confirmed a structured induction training and development programme was in place.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
The environment was well maintained, clean and hygienic when we visited. No offensive odours were observed by any members of the inspection team. The people we spoke with said they were happy with the standard of hygiene in place. One person we spoke with said, “No complaints about hygiene. The place is spotless.”
People were happy with the variety and choice of meals available to them. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met.
Activities were arranged to assist people with their rehabilitation. These included dressing and stair practice, falls prevention, hand therapy, relaxation and function and fitness groups.
Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.
The service had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Discussion with the registered manager confirmed she understood when an application should be made and in how to submit one. This meant that people would be safeguarded as required.
The registered manager used a variety of methods to assess and monitor the quality of the service. These included questionnaires which were issued to people on their discharge to encourage feedback about the service they had received. The people we spoke with during our inspection visit told us they were satisfied with the service they were receiving.
We were supported on this inspection by an expert by experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.
The expert by experience spoke with a number of people receiving support with their rehabilitation following discharge from hospital. Comments received were all positive about the care being provided. People told us they felt safe in the care of staff. One person said, 'They are absolutely superb here. The staff are a strange breed, they give 100% commitment and effort to everyone'. People told us they knew the names and roles of staff who supported them. One person said, 'I know all the staff, social workers and physiotherapists by their first name'.
We found people were being supported by staff who had been well trained and appropriate support arrangements were in place for them. Good care practices were observed and people were found to be having their nutritional needs met.
'I was visited initially whilst in hospital and the support I required was discussed. I then attended a meeting when I arrived from hospital with occupational therapists, physiotherapists, social workers and nursing staff. The whole process was very thorough and I was very impressed. We discussed my needs in detail and we all agreed on the support to be provided'.
'I really enjoy the exercises. They are helping to improve my health and I feel better than when I arrived. My time here has not been wasted'.
'The staff here are friendly, helpful and attentive. My stay has lived up to expectations with the care and comfort provided'.
"Perfectly happy and I have no complaints".
We spoke to people about their experiences living in the home and were told the staff team provided sensitive and flexible personal care support and they felt well cared for.
'The care I required was discussed with me when I arrived at the home. I was fully involved in the decision making process and confirmed I was happy with the support to be provided'.
'I am being very well looked after thank you. The staff are very kind and patient. I would say they are perfect'.
'I am very happy with the support being provided. The staff are all very kind and caring people'.
"The staff are brilliant. We are being well looked after"
'I can not praise the staff enough for the support and treatment they gave my mother. They are a very dedicated team of staff'.
'The care I required was discussed with me when I arrived at the home. I was fully involved in the decision making process and confirmed I was happy with the support to be provided'.
'The food is lovely. You always get plenty to eat. They have a menu on display in the dining room telling us the meals for the day. If you want something different you just have to speak to the cook. They are very accommodating'.
'I am a diabetic and have a special diet provided'.
"The staff are great. They are very responsive when you need them. You never have to wait long for attention. I am treated with great care and dignity'.
Public Protection Officers representing the Health and Safety and Environmental Health Sections of Blackpool Council's Quality Services Directorate told us the building was well maintained, kitchen and bathrooms were clean and equipment being used by the staff such as hoists etc were well maintained and in good working order when they last visited.
An Infection Control Specialist at Blackpool Primary Care Trust (PCT) told us the policies and procedures the home has in place comply with the Code of Practice on prevention and control of infections and regulated guidance. They confirmed there have been no outbreaks or concerns about infection control brought to their attention and the district nurses visiting the home had expressed no concerns about the homes hygiene procedures.
Lancashire Fire & Rescue Service told us following their recent visit to the home they had no concerns about the building.