The Arc

Updated 20 November 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at safe, responsive and well led domains and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by an inspector.

Service and service type

The ARC is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission when we inspected. The previous registered manager had left the service since the last inspection. There was a temporary manager and the organisation were recruiting for a permanent manager. Registered managers and providers are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave a short period of notice of the inspection. This was because we needed to discuss the safety of people supported, staff and inspectors with reference to COVID-19.

We started the inspection activity on 28 October 2020 and ended on 30 October 2020. This included telephone and video calls to people supported, relatives and staff. We also requested information to be sent to us by the service. We made a site visit on the 29 October 2020.

What we did before the inspection

We reviewed information we had received about the service since the comprehensive inspection. This included notifications we had received from the provider, about incidents that affected the health, safety and welfare of people supported by the service. We sought feedback from professionals who work with the service, including health and local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with two people who were receiving support at The ARC and a relative about their experience of the care provided. We spoke with the manager and seven staff. We reviewed a range of records. This included two people’s care records and several medication records. We observed staff administering medicines. We looked at Covid-19 risk assessments for people supported and staff and talked with the manager about recruitment. We also looked at a variety of management records. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead in ongoing improvements. We looked around the building to check it was clean, hygienic and a safe place for people to receive care and support.

Updated 20 November 2020

About the 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