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Archived: Arden Court Requires improvement

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Inspection Summary


Overall summary & rating

Requires improvement

Updated 27 April 2015

This unannounced inspection was carried out on the 10 February 2015.

Arden Court is a care home in the Eccles area of Salford, Greater Manchester and is owned by Orchard Care Homes. The home is registered with the Care Quality Commission (CQC) to provide care for up to 47 people. The home provides care to those with residential care needs, but mainly for people who required nursing care.

We last visited the home on 7 August 2013 and found the home was meeting the requirements of the regulations in all the areas we looked at, with the exception of meeting peoples nutritional needs safely. We then conducted a follow up visit on 1 October 2013 and found the service to be compliant during that inspection.

There was a registered manager in post. 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.

We found the home was in need of refurbishment with both floors needing updating and modernising. We saw several door frames, skirting boards and hand rails were damaged which as a result, had removed parts of the paintwork. We also observed dirty marks on the walls in the upstairs lounge and a recliner chair to be stained. Additionally, we observed trolleys containing dirty bed linen which was to be stored in the upstairs bathroom/shower area of the home. These issues could potentially place people at the risk of infection. We felt this area could be improved upon. We raised these issues with the manager who, following our inspection, contacted us stating that various new furniture had been ordered and would be delivered within three to four weeks.

Although we saw some evidence of staff supervision in recent months, we found there had been no structured pattern throughout the previous year (2014). The manager told us they did these every eight weeks, although records did not support this. Additionally, we saw no evidence that annual appraisals had been carried out for each member of staff. This meant staff may not be able to discuss any concerns, training opportunities or speak with their manager confidentially. It also meant there were missed opportunities to provide staff with an annual review of their work. The manager told us they would introduce a formal supervision and appraisal system for staff following our inspection.

Staff at the home had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS are laws protecting people who are unable to make decisions for themselves. At the time of our inspection there were three people under a DoLS and we saw documentation in people’s care plans to show appropriate referrals had been made by the home manager to the local authority. Staff had received training in the MCA and DoLS which was recorded on the homes training matrix.

On the day of our inspection the staffing team consisted of the registered manager, two nurses (one covering each floor), six care assistants and various members of domestic, kitchen and maintenance staff. The evening shift was staffed by one nurse and four care assistants. This was to provide care and support to 35 people. Over the course of the inspection we found this proved sufficient to provide care to the people who lived at the home.

Staff spoken with told us they felt supported by the manager and understood the ethos and values of the home. They felt they could raise any issues and they would be dealt with appropriately.

We saw the home followed safe recruitment practices which meant people were kept safe as suitable staff were employed, with appropriate checks undertaken. Several people who lived at the home had been actively involved in the recruitment of staff where they were asked for their views and opinions before staff were formally offered the post. We saw this had been recorded on the back of application forms during the interview process.

There were systems in place to monitor and review accidents, incidents and complaints. The manager told us they monitored staff training using a training matrix, which identified when updates were required for staff and the types of training they had completed. Additionally there was a monthly auditing process in place. This covered things such as weights, bed rails, complaints, pressure sores, care plans and infection control. Where shortfalls were identified, they were added to an action plan to show how they had been addressed.

We looked at the surveys which had been sent to relatives, residents and professionals over the course of the year. We noted the feedback from these had been positive about the care provided at the home.

During the inspection we spent time speaking with the activities coordinator employed by the home. There was a schedule in place which included films afternoons, reading, name the film star, play your cards right, arm chair exercises, quizzes and visits from various singer and entertainers. On the day of our inspection we saw people who lived at the home had baked cakes in the afternoon which they appeared to take great enjoyment from.

People we spoke with and their relatives said they felt able to raise any concerns or complaints with staff and were confident they would be acted upon.

Leadership in the home was good. The registered manager worked alongside staff overseeing the care given and provided support and guidance where needed. Staff spoke favourably about the manager during the inspection. One member of staff said; “The home is very well run. We are well supported and we feel wanted here”.

Inspection areas

Safe

Requires improvement

Updated 27 April 2015

Not all aspects of the service were safe. We observed dirty marks on the walls in the upstairs lounge and a recliner chair to be stained. Additionally, we observed trolleys containing dirty bed linen stored in the upstairs bathroom/shower area of the home. We also found the home was in need of refurbishment with both floors needing updating and modernising. We saw several door frames, skirting boards and hand rails were damaged which as a result, had removed parts of the paintwork.

We saw the home followed safe recruitment practices which meant people were kept safe as suitable staff were employed, and appropriate checks undertaken.

We looked at how medicines were handled at the home and found this was done safely.

Effective

Requires improvement

Updated 27 April 2015

Not all aspects of the service were effective. Although we saw some evidence of staff supervision in recent months, we found there had been no structured pattern throughout the previous year (2014). The manager told us they did these every eight weeks, although records did not support this. Additionally, there we saw no evidence that annual appraisals had been carried out for each member of staff. This meant staff may not be able to discuss any concerns, training opportunities or speak with their manager confidentially.

We saw people had access to healthcare professionals to make sure they received effective treatment to meet their specific needs. Each person’s care plan contained a record of the professionals involved such as GP’s, dentists, district nurses and opticians.

Staff at the home had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS are laws protecting people who are unable to make decisions for themselves. At the time of our inspection there were three people under a DoLS and we saw documentation in people’s care plans to show appropriate referrals had been made by the home manager. Staff had received training in the MCA and DoLS which was recorded on the training matrix.

Caring

Good

Updated 27 April 2015

The service was caring. Staff responded to people’s needs in a kind and caring way. People we spoke with felt valued and cared for. We saw staff spoke with people in an appropriate manner and demonstrated respect for them.

During the inspection we observed staff interacting with people in a caring, polite and friendly way.

We found people looked clean and attention was given to people’s personal care needs. Some people told us they made choices for themselves with regard to their choice of clothes and jewellery which they wanted to wear each day.

Responsive

Good

Updated 27 April 2015

The service was responsive. We looked at the surveys which had been sent to relatives, residents and professionals over the course of the year. We noted the feedback from these had been positive about the care provided at the home.

During the inspection we spent time speaking with the activities coordinator employed by the home. There was a schedule in place which included films afternoons, reading, name the film star, play your cards right, arm chair exercises, quizzes and visits from various singer and entertainers. On the day of our inspection we saw people who lived at the home had taken baked cakes in the afternoon which they appeared to take great enjoyment from.

People told us they knew how to make a complaint and were confident that any issues raised would be dealt with. There was a complaints procedure in place however none had been made since our last inspection.

Well-led

Good

Updated 27 April 2015

The service was well-led. There is a registered manager in post. 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.

Leadership in the home was good. The registered manager worked alongside staff overseeing the care given and provided support and guidance where needed. Staff spoke favourably about the manager during the inspection.

There were systems in place to monitor and review accidents, incidents and complaints. Additionally there was a monthly auditing process in place. This covered things such as weights, bed rails, complaints, pressure sores and care plans. Where shortfalls were identified, they were added to an action plan to show how they had been addressed.