CQC report explained · a nursing home
What the CQC found at Arboretum Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found safe and effective care in many areas, but complaints records and communication with professionals needed improvement.
This was an unannounced focused inspection on 25 August 2022. Inspectors spoke with people using the home, relatives and staff, and reviewed care, medicines, recruitment and management records.
The home was rated Good for Effective. People had their needs assessed, received support with food, drink and healthcare, and staff understood consent and best-interest decisions. The home was clean, staff were suitably recruited, and there were enough staff to meet people's needs.
Safe and Well-led were both rated Requires Improvement. Medicines safety had improved, but complaints were not always recorded or answered properly. Records did not always show what action had been taken, and communication with health and social care professionals was not always timely.
The overall rating remained Requires Improvement. The provider had improved since the previous inspection and was no longer in breach of the regulations identified then.
Medicines had improved
The home had improved its medicines systems. Care plans included instructions for medicines given when needed, and staff had training and competency checks.
“People's care plans detailed how they preferred to take their medicines including clear protocols for medicines given 'as and when' required.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks, including references and DBS checks, had been completed.
“There were sufficient numbers of staff on duty to meet people's needs.” from the report
Good consent practice
DoLS renewal requests were sent on time, and requests were made only after assessing whether people lacked capacity. Staff had received relevant training.
“People were asked for their consent before they received any care and treatment.” from the report
Good support with health and nutrition
People received support to eat and drink enough, and staff worked with health professionals to respond to changes in people's health.
“People had choice and access to sufficient food and drink throughout the day, food was well presented, and people told us they enjoyed it.” from the report
Complaints were not fully recorded
needs fixingNot every complainant received a written response. Records also did not clearly show the action taken or lessons learned.
“Records viewed during our visit demonstrated complaints were not always managed in line with the providers policy.” from the report
Communication with professionals
needs fixingHealth and social care professionals said the home did not always reply to emails or provide information promptly. The manager accepted that improvements were needed.
“They don't come back to you, they don't respond to emails. When we ask for information, we don't receive it in a timely manner, you are constantly chasing.” from the report
Records of actions needed improvement
needs fixingSome records did not show what had been done after people raised concerns. This included a concern about a bedroom call bell, although the home later provided evidence that checks had been completed.
“Some records required improvement, as they failed to include the actions taken to resolve issues raised by people.” from the report
- 01How will you make sure every complaint receives a written response and that actions and lessons learned are recorded?
- 02How quickly do you respond to health and social care professionals who request information?
- 03How do you check that concerns about call bells and other safety equipment are acted on and recorded?
- 04What current rating or evidence can you provide for Caring and Responsive, which were not reviewed in this inspection?
- 05How are you checking that the improvements to medicines and DoLS processes continue to work?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and the report says the overall rating used previous ratings for key questions not inspected. This explanation was written from the published report of 29 October 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2021
Rated Requires Improvement; inspectors found kind and respectful care, but medicine safety, consent and quality checks needed improvement.
Inspectors visited on 19 and 20 July 2021. They spoke with people, relatives, staff and health professionals. They also reviewed care records, medicine records, staff files and management records.
The home was rated Good for Caring and Responsive. People were treated with kindness and dignity. Care plans were personalised, communication needs were understood, and people were supported to keep in touch with relatives.
The home was rated Requires Improvement for Safe, Effective and Well-led. Inspectors found gaps in medicine information, medicine storage and staff competency checks. Some DoLS authorisations had expired, and two people with full capacity had DoLS requests or urgent authorisations.
The overall rating means the home was not consistently providing safe, effective and well-managed care. The provider responded to the concerns on the inspection day. CQC asked for an action plan and said it would monitor progress and return to inspect again.
Kind and respectful staff
People were treated with kindness and consideration. Staff supported privacy, dignity and independence.
“People were supported by a team of staff who were kind, caring and considerate.” from the report
Clean and safe environment
The home was clean, well maintained and adapted to people's needs. Inspectors were assured that infection control arrangements were in place during the Covid-19 pandemic.
“People lived in an environment that was clean and well maintained.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks had been completed safely.
“There were sufficient numbers of staff on duty to meet people's needs.” from the report
Personalised care
Care plans recorded people's individual needs, backgrounds, likes and preferences. Staff supported communication in suitable formats.
“Care plans were personalised and recorded details about each person's specific needs and how they liked to be supported.” from the report
Medicine safety
seriousStaff did not have all the information needed for PRN medicines or medicines given through feeding tubes. Some storage, application and competency-check arrangements were also not safe enough.
“Information to aid staff in administering medicines that had been prescribed on a when required basis (PRN) was not in place” from the report
Consent and DoLS
seriousThree DoLS authorisations had expired without timely renewal requests. Two people with full capacity had DoLS requests or urgent authorisations.
“We found two people had DoLS requests and urgent authorisations even though both were assessed as having full capacity.” from the report
Weak quality checks
seriousThe home's audits did not reliably find problems with medicines, DoLS records or staff competency. This meant important improvements were not made promptly.
“The provider's audits to monitor the quality of the service were not consistently effective in identifying and driving forward improvements.” from the report
Care reviews did not include families
needs fixingCare plans were in place, but people, relatives and representatives were not sufficiently involved in reviewing them.
“However, care plan reviews lacked involvement from people, their relatives and representatives.” from the report
- 01What has been changed so staff have clear instructions for PRN medicines and medicines given through feeding tubes?
- 02How are medicine storage, opening dates, pain patches and topical cream competency checks now monitored?
- 03How do you check that every person's DoLS authorisation is current and legally appropriate?
- 04How are people, relatives and representatives now included in care plan reviews?
- 05What evidence can you show that your audits now identify and fix medicine, consent and care record problems promptly?
This was an inspection of the whole service covering all five key questions, including infection control, care records, medicines, staffing and management systems. This explanation was written from the published report of 16 November 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Arboretum Nursing Home
6 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- October 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2017Requires improvementdown from GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2021
Registered with the Care Quality Commission on 16 June 2021.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Walsall
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £950 to £1,200 a week. 85 can care for a couple. 9 years' experience on average.
“I have never met a person who is so kind and thinks about others before himself to such an extent as Chris Malagala.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.