Archived: Reach Care Services - Arden House

Updated 28 July 2023

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 the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

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

The inspection was carried out by 2 inspectors.

Service and service type

Reach Care Services – Arden House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Reach Care Services – Arden House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the start of our inspection there were 2 registered managers’, 1 of which was also the nominated individual and provider. 1 registered manager applied to cancel their registration with the Commission during the inspection, they will be referred to as the ‘registered manager’ within this inspection report. The other registered manager, who was also the nominated individual and provider, will be referred to as the 'provider'.

The provider also appointed an interim manager during the inspection time frame.

Notice of inspection

This inspection was unannounced. Inspection activity began on 13 January 2023 and ended on 3 March 2023. We visited the service on 17 January 2023 and 10 February 2023. Inspection feedback was given to the provider on 3 March 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. This also included feedback from Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During our visits we used observations to help us understand the experience of people who could not talk to us. We spoke with 7 people who used the service and 13 of their representatives. We also received feedback from healthcare professional teams who had contact with the service and provided support to people.

We spoke with 12 members of staff. These included care staff, team leaders, catering staff and domestic staff. Furthermore, we spoke with the registered manager, interim manager, the finance and operations manager and the provider. The nominated individual is the provider, and therefore responsible for supervising the management of the service.

We reviewed a range of records during the inspection, this included recruitment documentation for 2 staff. We also reviewed care records for 6 people and viewed medicine and supplementary records for multiple people during the inspection. We asked the reg

Updated 28 July 2023

About the service

Reach Care Services – Arden House is a residential care home providing personal care up to a maximum of 24 people. The service provides support to older people, people living with dementia and people who have a physical disability. At the time of our inspection there were 17 people using the service.

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

The service was not well-led, and a closed culture was present. Safe and effective governance systems were not in place which meant people were at risk of harm. The provider did not have robust oversight, and when concerns were raised, they did not appropriately respond to promote safety and improve care.

Staffing levels were not safely assessed and reviewed. There were not enough appropriately trained staff to meet peoples’ needs. Lessons were not learnt when things went wrong, and people were not protected from harm. Safety risks were not appropriately identified, reviewed and acted upon by staff, and oversight was not effective. Medicines were not managed safely, and risks relating to infection prevention and control were present.

People were at risk of dehydration and malnourishment and were not actively involved in their care planning and reviews. People’s representatives and health professionals were not able to freely visit and faced restrictions from staff. Staff undertook tasks which were outside of their scope of competence which placed people at risk of harm. The provider had failed to appropriately supervise their staff, and staff had not received effective training to keep people safe.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff did not treat people with dignity and respect. Kind and considerate care was not promoted in practice. People were not treated as individuals and their rights were not upheld.

People, or their representatives if appropriate, were not supported to be involved in the care planning process. Responsive care planning did not take place for people who experienced changing needs or health deterioration. Meaningful social opportunities, engagement and activities were limited, and people were at risk of social isolation.

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 2 May 2019).

At this inspection we found the service had deteriorated and the rating has changed to inadequate.

Why we inspected

The inspection was prompted in part due to concerns received about safe care and treatment; safeguarding; staffing; person-centred care; privacy and dignity and good governance. A decision was made for us to inspect and examine those risks.

We found evidence during this inspection that people were at risk of harm from these and other concerns.

Please see the safe, effective, caring, responsive and well-led sections of this full report.

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.

Enforcement

We have identified breaches in relation to safeguarding people from abuse; safe care and treatment; staffing; premises and equipment; nutrition and hydration; person-centred care; dignity and respect and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.