Archived: Arundel Park Residential and Nursing Home

Arundel Park Residential and Nursing Home is a residential care home providing personal and nursing care to a maximum of 50 people aged 65 and over. At the time of the inspection the service was supporting 48 people. Care was provided over two floors for people with complex healthcare needs and those living with dementia.

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

People told us how the care at Arundel Park helped them to feel safe. Risk was assessed in appropriate detail and regularly reviewed. Staff understood their responsibility to report any concerns and we found action had been taken in response. Medicines were safely managed in accordance with best-practice guidance and regulation. Staff were safely recruited and subject to checks before they started work. However, staff were not always deployed effectively across the building. We discussed this with the registered manager who agreed to review the deployment of staff at the busiest times.

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. Most people told us they enjoyed the food and drinks available and had a good choice. The service operated in accordance with the relevant standards and best-practice guidance. Staff were given regular training and supervision told us they felt well-supported by the registered manager and provider. The building was in the process of being refurbished. Work was planned to improve the experience of people living with dementia.

The people we spoke with were very positive about the conduct of staff, the care they provided and their kindness. We saw and heard examples of staff interacting positively with people throughout the inspection. People were involved in making decisions about their care and their rights to privacy and dignity were understood. Where people had additional or different needs relating to equality and diversity, this was recorded and reflected in the care provided.

We saw clear evidence people’s individual needs and preferences were met by the service. Staff adapted the way in which they communicated with people to engage them and to ensure important information was shared. People were supported and encouraged to take part in a range of activities and to maintain relationships. Complaints were addressed in accordance with the provider’s policy and best-practice guidance.

Our observations and discussions evidenced a positive, learning culture where people were supported to reflect on performance and improve practice. The registered manager and provider constantly monitored the provision of care and the environment to further improve people’s experience of receiving care. The people we spoke with said communication with the management team was good. There was clear evidence of working with healthcare professionals and commissioners to improve outcomes for people.

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 8 March 2017).

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.

Arundel Park is registered to provide support for up to 50 people. At the time of our inspection 45 people were living there of whom 26 were receiving support with nursing care and 19 receiving support without nursing care. Situated in the Sefton Park area of Liverpool the home is near to local amenities and bus routes. All of the bedrooms provide en-suite facilities. Accommodation is over two floors with a passenger lift available for people to use.

The home did not have a registered manager. 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. An appointed manager was working at the home and aware of the need to apply to CQC for registration as manager.

During the inspection we spoke with 17 of the people living at the home and with six of their visitors. We also spoke individually with nine members of staff who held different roles within the home and with two visiting professionals. We examined a variety of records relating to people living at the home and the staff team. We also looked at systems for checking the quality and safety of the service.

People living at the home told us that they liked and trusted the staff team. They told us that staff treated them kindly and were responsive to their needs. Staff received appropriate training and were aware of how to carry out their role safely and well.

Staffing levels were adequate with plans in place to increase these as more staff were recruited. Robust recruitment procedures were in place and followed to ensure staff were suitable to work with people who may be vulnerable.

Polices and procedures were in place for safeguarding vulnerable adults. Staff were aware of these and senior staff ensured they were followed.

People’s medication was safely managed and people received the support they needed with their health care.

Support was provided to people to ensure their rights under the Mental Capacity Act were protected.

People received the support they needed to eat and drink and were regularly asked their opinions of the meals provided. Information about the home and how it operated was readily available to people living there and their visitors. In addition, systems were in place to formally obtain the views of people living at the home and their relatives.

A number of activities and events were arranged that people enjoyed taking part in. People were confident in raising any concerns or complaints that they had. Individual care plans were in place to guide staff on how to support people.

The home had a recently appointed manager who was aware of the need to registered with the CQC.

Systems for auditing the quality of the service and planning improvements were in place and effectively used.

We spoke with a number of people who used the service and with a relative and visiting professional and the feedback we received was that people were being provided with a good service. People who used the service told us they felt well supported with their personal care and their health care. They also told us staff were respectful towards them and protected their privacy and dignity and their independence.

Each of the people who used the service had a care plan which provided a good description of the person's needs and how to meet these. We saw some good examples whereby staff had referred for specialist advice and support to meet people's needs.

We found significant improvements had been made to how medicines were managed and overall we found medicines were now being safely and appropriately managed.

The quality of the service was being checked on a regular basis by the provider and people who used the service had been asked for their views on the home as part of this.

We found that improvements had been made to the service since our last inspection visit. However, in a number of areas these were not sufficient to achieve compliance with the regulations.

We found that improvements had been made to how people were involved in decisions about their care and support. People had been given the opportunity to attend 'resident and relative' meetings and had been asked their views about the quality of the service through questionnaires. People's care and support had been reviewed and care plans updated. Staff had been provided with up to date training in a range of topics including safeguarding people from abuse. Staff had been supervised and regular team meetings had taken place. We also found that new staff had been recruited into a number of roles.

We found that although people's care plans had been reviewed we saw a number of examples whereby the information in them was inaccurate or not sufficiently detailed. We also found a number of concerns with how medicines were managed. We also found that the provider's systems for assessing and monitoring the quality of the service had not been effective enough to identify these concerns and to protect people from the risks of receiving inappropriate or unsafe care and treatment.

We were able to speak with eight people who used the service and five of their relatives. Most of the comments made expressed concerns about the standard and quality of care, such as:

'I just want to get out of here.'

'I'm cheesed off being here, I want to leave.'

'Sometimes I just feel I'm a nuisance to people.'

"I feel safe, staff treat me nice."

During our visit we found evidence that the care plans for the people who used the service were not detailed enough and did not contain enough information for people to be cared for safely and effectively. We also found that there were not enough staff to provide safe and effective care and staff who worked at Arundel Park had not received appropriate supervision or support.

We found that appropriate arrangements were not in place for the management of the medicines. We also found that there were insufficient quality assurance systems in place to ensure people received safe and appropriate care, treatment and support.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

We used a number of different methods to help us understand the experiences of people living at Arundel Park, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We were able to speak with six people who used the service who told us the care they had received at Arundel Park had 'improved a lot lately', and they had been "well looked after".

During our visit we observed that staff treated people in a kind and caring way and were respectful towards the people they cared for. There were enough skilled and experienced staff on duty to be able to meet the needs of the people who lived at Arundel Park in a timely manner.

We also saw evidence that the organisation was monitoring the quality of the service provided on a regular basis.