Arden Court

We found the following examples of good practice:

At the entrance of the home, information was displayed to inform visitors about any infection control procedures to be followed. Temperature checks were taken and questionnaires completed, asking people about any possible symptoms of COVID-19, or if they had felt unwell. Lateral flow (a COVID-19 test where the results can be obtained quickly) testing was carried out as needed.

Various methods had been used to enable people to keep in touch with their family and friends during the pandemic. This included video calls and window visits.

A ‘visiting pod’ had been installed in one of the quiet lounge areas, enabling people living at the home to see members of their family in a safe environment, whilst also following government guidelines regarding COVID-19. Prior to family members entering the home, correct procedures were followed such as carrying out a lateral flow test, waiting for the results and wearing the necessary personal protective equipment (PPE).

Zoning arrangements were used when people had tested positive for COVID-19 and needed to self-isolate in certain areas such as bedrooms within select corridors of the home. COVID-19 testing was in place for both staff and people using the service. People living at the home, where they had chosen too, had all received their first dosage of the COVID-19 vaccination.

Appropriate arrangements were in place for new admissions to the home, such as requesting confirmation of a negative COVID-19 test before each person moved into Arden Court.

Enough PPE was available and we saw staff wore it at all times during our visit. Hand sanitizers and donning/doffing (putting on and removing PPE) stations were distributed throughout the building to support correct infection control practices.

We observed the home to be clean and tidy, with domestic staff carrying out their duties throughout the day. Windows were opened at various times during the day to assist with ventilation and outdoor facilities were used when better weather allowed.

There were enough staff to care for people safely, although staff had not yet received additional infection control training from the local authority during the pandemic. We received an update following our visit that this had been arranged. Internal infection control training had been delivered internally however.

Risk assessments were completed where certain groups may be at higher risk of contracting the virus. An appropriate infection control procedure was in place and regular infection control audits were undertaken to ensure standards were maintained.

Arden Court is a care home providing personal and nursing care to 35 people at the time of the inspection. The service accommodates up to 47 people in one building split between two floors.

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

People told us they felt safe. Staff had a good understanding of how to safeguard people from abuse. The service had made improvements to the medicine’s issues and management of risks raised at the last inspection. The service worked closely with the clinical commissioning group (CCG) to implement changes and ensure medicines were managed safely. Care plans included risk assessments in relation to people’s specific care needs. Risks associated with eating and drinking and people’s pressure care were managed appropriately.

People’s outcomes were consistently good, and people’s feedback confirmed this. One person told us, “I cannot be any happier here.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff engaged with people in a friendly and caring manner and their conversations with people were good natured. Staff were also attentive to people's needs. People told us staff were kind and sensitive, and their comments included, “Staff are all lovely” and “The carers are all great.”

The service used an electronic care planning system and people's care plans were personalised, which included detailed information about their individual needs, abilities and preferences. It was evident people and their relatives had been involved in the development of people’s care plans and their reviews.

People had the option to make their end of life wishes known and detailed end of life care plans were in place. We read many compliments regarding end of life care which included, “We wish to thank you for the superb care and kindness that was shown to [person] when they were in your care. It meant so very much to them.”

The service had made improvements to their governance systems and effective monitoring systems were in place. After the shortfalls identified at the last inspection, the service had implemented a robust action plan. The service worked closely with external teams and professionals to improve standards. Quality assurance procedures were revised to ensure quality was improved throughout the service. Effective governance systems ensured the registered manager had clear oversight of 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 and update

The last rating for this service was requires improvement (published 31 January 2019) and there were two breaches 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.

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.

Arden Court is owned by Wellington Healthcare (Arden) Ltd and is located on a busy main road in Eccles, Greater Manchester. The home provides care for people with nursing, residential and continuing care needs. The home is close to local shops, bus routes and has adequate car parking facilities located at the front of the building.

At the time of the inspection there were 37 people living at the home.

Arden Court 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.

This was the first comprehensive inspection we had undertaken at Arden Court. This was because the provider, Wellington Healthcare (Arden) Ltd re-registered with CQC in April 2018 and any previous inspection ratings were not retained. This inspection was also carried out in response to information of concern we had received about the care being provided at the home.

At this inspection we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regards to safe care and treatment and good governance (two parts of this regulation). You can see what action we have asked the home to take at the end of this report.

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.

Medication was not always stored, recorded, administered and disposed of safely.

From checking records maintained within the home, it was not always clear if people were receiving foods of the correct consistency, which could place people at risk of choking and aspiration.

People’s pressure relieving equipment (to keep their skin safe) was not always being used correctly. This included pressure relieving mattresses being operated at the wrong settings.

Accurate and contemporaneous records were not always maintained by staff. This made it difficult to establish if people’s care needs were being met.

Quality monitoring systems needed to be improved to ensure the concerns found during this inspection were identified and acted upon in a timely way through the homes own internal auditing systems.

The premises were being well maintained, with regular servicing checks of equipment and the building carried out. The home was clean and tidy throughout, with infection control procedures followed as required.

People who used the service and their relatives told us they felt the service was safe. There were appropriate risk assessments in place for people, with guidance on how to minimise risk. Staff recruitment was robust with appropriate checks undertaken before staff started working at the home.

We found staff received sufficient training, supervision and induction to support them in their role. The staff we spoke with told us they were happy with the training they received and felt supported to undertake their work.

We found the home worked closely with other health professionals and made appropriate referrals if there were concerns. Details of any visits from other professionals were recorded within people’s care plans.

Appropriate systems were in place regarding Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA).

People told us they enjoyed the food and we saw people being supported to eat and drink, throughout the day.

We received positive feedback from people we spoke with about the care provided at the home. People said they felt treated with dignity and we observed staff treating people with respect during the inspection.

Each person living at the home had their own care plan in place which provided an overview of their care requirements and any associated risks. The home had recently started to use electronic care plans and staff used hand held devices to record people’s information

There were a range of different activities available to participate in and people told us there was enough to keep them occupied during the day.

We found complaints were responded to appropriately, with compliments also collated where people had expressed their satisfaction about the care provided.

Staff meetings took place, giving staff the opportunity to discuss their work and raise any concerns about practices within the home. We observed a staff handover taking place, where an update was provided about people’s care needs from that shift.

Staff spoke positively about management at the home and said the registered manager was supportive and approachable.

Policies and procedures were in place and were being reviewed regularly to ensure the information was still current.