Archived: Arbury Lodge

Updated 6 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This comprehensive inspection took place on 31 July2018 and was unannounced. Opportunity for people, relatives and staff to give us feedback following our visit, was given by us leaving a poster displayed in the home about our inspection. One inspector, an assistant inspector and a specialist advisor undertook the inspection. The specialist advisor who supported this inspection visit had experience and knowledge in nursing care.

A completed Provider Information Return (PIR) was returned to us, as requested, during March 2018. This is information that we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. However, during our inspection visit, we gave the provider the opportunity to give some key information about the service, what the service does well and improvements they planned to make.

We spent time with people and observing communal areas where people interacted with staff. This helped us judge whether people’s needs were appropriately met and to identify if people experienced good standards of care.

During the inspection we spoke with 10 people at the service. We spoke with two care staff, the activities co-ordinator, one nurse, the clinical lead nurse, the manager, the quality support manager. We also spoke with two healthcare professionals who were visiting the service. Following our inspection visit, we spoke with the regional manager.

We reviewed three people’s care plans, daily records and medicine administration records. This was so we could see how their care and support was planned and delivered. We also looked at other records, these included three staff recruitment files and supervision records, and the provider’s quality assurance audits. This was so we could see how the manager and provider assured themselves people received a safe and well led, quality service.

Updated 6 September 2018

We inspected this service on 31 July 2018 and the inspection was unannounced. The inspection was carried out by one inspector, an assistant inspector and a specialist advisor. A specialist advisor is someone who has current up to date practice in a specific area. The specialist advisor who supported this inspection visit had experience and knowledge in nursing care.

The local Clinical Commissioning Group (CCG) commissioned Arbury Lodge, on behalf of George Eliot Hospital, from Sanctuary Care Limited as a short- stay nursing service located within George Eliot Hospital. Arbury Lodge opened in 2016, the service continues to be operated by Sanctuary Care Limited, who are a large provider of care services.

Arbury Lodge provides accommodation with personal and nursing care for up to 16 adults. All 16 beds, funded by George Eliot Hospital, are for in-patients who have been assessed as ‘medically optimised.’ This means people admitted to Arbury Lodge are ‘medically stable’ but need an additional short-stay to assess their future care and support needs. The average length of short-stay at Arbury Lodge is six weeks, and assessments include whether people require ongoing support care packages and for some people end of life care is required.

At the time of this inspection, 13 people were receiving a short-stay placement at Arbury Lodge, with a further two admissions during the day of our inspection.

A requirement of the services’ registration with us is that they 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. There was a manager registered with us for this location, at the time of our inspection visit. However, they had applied to us to de-register because they had changed their role within Sanctuary Care. A new manager was in post at Arbury Lodge and, at the time of our inspection visit, was in the process of applying to become registered with us.

We last inspected this service on 4 May 2017 and gave an overall rating of Requires Improvement. At this inspection we found the provider continued to provide a caring, effective, and responsive service and improvements had been made to how well led the service was. Some further improvements were required to ensure the service was consistently safe. We gave an overall rating of Good.

There were sufficient trained staff on shift who had, overall, been recruited in a safe way so as to ensure people were not placed at risk of abuse, harm or injury. The provider had not, however, always undertaken a risk assessment as a part of their recruitment process when needed.

Risks management plans were in place and actions described for staff to take so that risks of harm or injury were mitigated. However, actions to mitigate risks were not consistently followed by staff. This posed risks to some people of potential harm or injury.

Medicines were stored and handled safely. People had their prescribed medicines available to them. Some medicine recording errors had occurred and timely action had not always taken to address these with nursing staff. Further improvements were planned for by the manager to address such delays.

Staff on shift met people’s individual needs. Staff worked closely with George Eliot Hospital healthcare professionals in meeting people’s nursing, health and rehabilitation care needs.

Staff received training and, overall, used their skills, knowledge and experience to provide safe, effective and responsive care to people.

The manager and provider had systems in place to monitor the quality of the service people received. The manager had plans in place to make continued improvements.

Further information is in the detailed findings below.