Archived: Areley House

We found the following examples of good practice.

The signing in book had been removed from the reception in order to reduce the risk of infection and visitor details were recorded in the office diary.

A separate room had been made available for new visiting arrangements in line with the latest Government guidance. The room was accessible from the car park and could only be used through an appointment system. Personal Protective Equipment was provided for visitors to use.

People were supported to keep in touch with loved ones through video calls and social media systems. Families were also encouraged to maintain contact with people by writing letters and postcards.

Cleaning schedules had been increased and additional audits had been implemented to monitor cleanliness and staff compliance with the provider’s infection control policy.

Staff felt supported. An employee of the month reward system had been re-introduced to recognise and reward the hard work of all staff in the home.

Areley House is registered to provide personal care for up to 37 older people, including people who are living with dementia. The home is a Grade 2 listed character building with a Coach House to one side, linked by an internal corridor. There are 34 bedrooms, all with en-suite facilities of a shower, toilet and wash hand basin. At the time of the inspection, 31 people were in residence.

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

People received a safe service. People were safe because the staff team had received safeguarding training and understood their role in keeping them safe. Staff knew the process to be followed to report any issues that arose. Risks to people’s health and welfare were well managed. Assessment and care planning identified any risks and plans devised to ensure the risk was reduced or eliminated. The number of staff on duty for each shift was calculated based upon each person’s care and support needs. Pre-recruitment checks ensured new staff were recruited safely. Checks included written references and a Disclosure and Barring Service check. Medicines were well managed and only administered by staff who were trained and competent. People received their medicines as prescribed.

The service was effective, and people’s care and support needs were met. New staff had an induction training programme to complete and all other staff had a programme of training to keep their knowledge and skills up to date. People had access to the healthcare support they needed and the staff team made any arrangements as required. This included when they needed to see their GP, the district nurses, speech and language therapists (SALT) and other allied healthcare professionals. People received the food and drink they needed to maintain a healthy, balanced diet. Any preferences they had regarding food and drink were accommodated.

People were encouraged to retain as much choice and control of their daily lives and staff supported them in their best interests. The service was meeting the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards.

The service was caring. People received the care and support they needed, based upon their own individual needs. The staff were kind and friendly and listened to what people had to say. The staff took account of what they were saying and interacted with them in a positive and genuine manner. The staff team were fully aware of each person’s specific needs. People looked well cared for.

The service was responsive. Each person received the care and support as set out in their care plan. These plans were reviewed monthly and amended as and when necessary, this meant any changes in care needs were taken into account. The service continued to look after people who became very ill or were receiving palliative care and worked in conjunction with family and healthcare professionals to achieve this.

The service arranged a varied range of activities for people. The registered manager acted upon feedback from people, families and other stakeholders and implemented changes where appropriate.

The service was well led. The registered manager provided good leadership for the staff team. The service had good quality assurance systems in place with regular audits being undertaken, Audits identified any action required to make improvements. There was good communication with the registered provider regarding what was happening in the service and the provider visited the service at least two weekly.

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 05 July 2017).

Why we inspected

This was a planned inspection based upon the previous rating.

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.

People continued to receive care in ways which helped them to remain as safe as possible. Staff understood the risks to people’s safety and people were protected from the risk of harm. There was enough staff to provide support to people to meet their needs and people received their prescribed medicines safely.

The care people received continued to be effective. Staff received training which matched the needs of people who lived at the home. People made their own day to day decisions about their care. Staff checked people agreed to the care offered before assisting them. Support was available to people if they needed help making key decisions about their life. People enjoyed their mealtime experiences and were supported to stay well and had access to health care services.

People had built caring relationships with staff and were encouraged to make their own choices and maintain their independence. People were treated with dignity.

People and their relatives’ views and suggestions were listened to. People’s care plans reflected their preferences and unique histories and there were opportunities for people to do fun and interesting things. Systems were in place to promote and manage complaints.

People, their relatives and staff were encouraged to make any suggestions to improve the care provided and develop the home further. The registered manager worked with people, their relatives and other organisations in an open way so people would enjoy the best well-being possible. Regular checks were in place to assess and monitor the quality of the service and action taken to drive through improvements for the benefit of people living at the home.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with five of the people using the service and five of their relatives, three care staff supporting them and looking at three people's care records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service told us that they felt safe. One person told us, "I feel safe here". One relative told us, "I feel confident that my relative is safe here". Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff were aware of the provider's whistleblowing policy.

Staff knew about risk management plans and we saw that they supported people in line with those plans. This meant people were cared for in a way that protected them from harm.

We found that medicines that people needed were stored and administered in a safe way by staff who were appropriately trained and competent. This meant people were protected from the risks associated with medicines.

The manager ensured that staff rotas were planned in advance to maintain the staffing numbers required to provide care in a safe way. The provider had robust recruitment procedures in place to ensure staff were of good character and had the skills and knowledge to support people in a safe way.

Systems were in place to make sure that the manager and staff learned from events such as accidents and incidents, complaints and checks made on the service. This reduced the risk to people and helped the service to continually improve.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that an application had needed to be submitted for one person and that this had been completed in line with legal requirements.

Is the service effective?

People's care needs were assessed with them. All of the people we spoke with told us they were involved in their care planning and reviews of care. We saw that care plans were regularly updated.

Where people had complex needs that required the input of specialist health care services, assessments had been made by the appropriate professionals. Their recommendations were carried out by the staff. This meant the provider worked well with other services to ensure people's health care needs were met.

Staff were well supported and trained to ensure they effectively met people's needs.

Is the service caring?

People were supported by care staff that were kind and caring. We saw that care staff gave people encouragement and respected their privacy and dignity. One person told us, "Everyone who works here is very kind".

People's preferences, interests and diverse needs had been recorded and care and support was provided in accordance with people's wishes.

Is the service responsive?

People had the opportunity to plan and engage in a range of different activities each day.

People were asked their views about the service and the provider acted on comments and suggestions that people made.

Where care staff had noticed people's changing needs, their care plans were updated to reflect this. This was because staff discussed people's care needs with them on a regular basis. People told us staff would always do their best to make sure they were happy.

Is the service well led?

The provider had quality assurance and risk management systems in place. We found the registered manager checked that risks were managed effectively.

The provider sought the views of people who used the service. Records seen by us indicated that shortfalls in the service were addressed

Staff told us they were clear about their roles and responsibilities and understood the quality assurance and risk management systems. This helped to ensure that people received a good quality of care. Staff told us the home was well organised and they felt supported by their manager.

People we spoke with were complimentary about the care and support that they received. One person who lived in the home told us; 'It's great'.

Staff understood people's needs and responded to them in the way the person wished.

We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People were provided with a choice of nutritious meals that they enjoyed.

We found the provider ensured people lived in a safe environment that met their needs

We found that any comments and complaints people made had been responded to appropriately and this ensured that people were listened to.

We looked at a variety of care plans for four people living at the home and found improvements had been made. The care plans described each person's needs and how staff were required to meet these. Whilst speaking with staff they told us about people's health conditions, how they preferred personal care to be delivered, and about risks and how they were minimised. This matched the information we had looked at in the care plans and ensured people were not at risk of receiving inappropriate care.

Three people were able to tell us about the care that they received from staff. One person told us, 'They (staff) are very kind' and another person said, 'They (staff) accommodate your needs.'

We saw that any incidents that involved people living at the home had been reviewed by the manager so that they could make decisions about whether these were potential abuse situations. This meant that people where appropriate were safeguarded from harm due to the improved arrangements that were put in place following our last inspection.

We identified that the manager had a satisfactory system in place to manage risks to the health and welfare of the people living at the home. This had been developed following our last inspection and helped the manager to recognise where improvements were required for the benefit of the people living at the home.