CQC report explained · a residential care home
What the CQC found at Arbory Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, October 2023
Arbory Residential Home is rated Requires Improvement; inspectors found ongoing safety, staffing and care concerns, while leadership was rated Inadequate.
This was an unannounced focused inspection after concerns about care quality, safety, cleanliness and staffing. Inspectors visited on 14, 15 and 23 August 2023. They spoke with people, relatives and staff, and checked medicines, care plans, recruitment records and management records.
The home remained in breach of rules about safe care, staffing, consent, premises and governance. Inspectors found medicines were sometimes unavailable or not properly planned for, risks were not always managed, staffing was not always sufficient, and parts of the home were dirty or poorly maintained.
People did not always receive personalised care or regular meaningful activities. Care records were sometimes incomplete or conflicting. The rating for Effective fell from Good to Requires Improvement, while Well-led fell from Requires Improvement to Inadequate. Safe remained Requires Improvement.
People felt safe
People and relatives generally said they felt safe and well looked after. Staff understood how to protect people from abuse.
“Overall relatives felt their family member was safe.” from the report
Some medicine practices
Medicines were stored securely. People and relatives generally felt medicines were managed well.
“Medicines were appropriately stored and secure.” from the report
Training response
Most staff were up to date with the training offered. Practical workshops after a choking incident helped staff respond more confidently.
“Staff had subsequently been able to respond confidently when another choking incident occurred.” from the report
Food and drink
People and relatives generally spoke positively about the food. Fluid records showed people received drinks in line with their assessed needs.
“Records we reviewed showed people received fluid in line with their assessed needs.” from the report
Risks and medicines
seriousRisks such as pressure damage were not always managed. Medicines were sometimes unavailable, allergies were often missing from records, and staff were not trained to give one emergency medicine.
“10 service users had missed a total of 24 doses in July 2023 due to medicines not being available.” from the report
Not enough staff
seriousThere were not always enough care, housekeeping or activity staff. Inspectors found people needing continence care and mealtime support, and activities were limited.
“There were not always sufficient numbers of staff deployed to meet people's needs.” from the report
Cleanliness and maintenance
seriousSome areas and equipment were dirty or poorly maintained. Inspectors found soiled items, a strong smell of urine, unsafe garden areas and an unreliable nurse call system.
“One person's bed rail bumpers were soiled, and we found 4 people's mattresses were heavily soiled increasing people's exposure to infection.” from the report
Consent procedures
seriousThe home did not consistently follow legal requirements for consent and mental capacity decisions. In most reviewed cases, consent forms had been signed by people without the legal authority to do so.
“In relation to the 10 people we reviewed, we found in all but 3 cases, consent forms had been signed by third parties who did not have a legal right to provide consent.” from the report
Weak oversight
seriousManagement checks had not led to the improvements required after the previous inspection. Records and policies were incomplete, and feedback was not consistently listened to or acted on.
“These new and continuing regulatory breaches indicated a provider failure to identify and address concerns and deliver an improvement culture through their own internal monitoring systems.” from the report
- 01What has changed in staffing levels, including housekeeping and activities staff, since the inspection?
- 02How do you now check that medicines are available, allergies are recorded and emergency medicines can be given safely?
- 03How are mental capacity assessments, best-interest decisions and consent forms being checked?
- 04What repairs and cleaning work has been completed, including the nurse call system, garden, bathrooms and mattresses?
- 05What regular, personalised activities are now available for people living with dementia?
This was a focused inspection of Safe, Effective and Well-led only; the Caring and Responsive ratings were carried forward from the previous inspection. This explanation was written from the published report of 14 October 2023 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, February 2023
Rated Requires Improvement; inspectors found risks from staffing, the environment, consent and management systems, with six breaches.
This was an unannounced focused inspection on 7 and 9 December 2022. Inspectors spoke with people, relatives, staff and health and social care professionals. They observed care, checked records and looked at medicines, staffing, infection control, the building and management systems.
The home was not always safe or well managed. Staffing levels did not always meet people's needs. Some risks, medicines records, care plans, consent assessments, cleaning and repairs needed improvement. Inspectors also found that some required notifications had not been sent to CQC.
There were positive findings. Staff were generally kind, knew people well and promoted independence. Staff worked with health professionals, infection control arrangements were mostly satisfactory, and visiting was flexible. However, the overall rating fell from Good at the previous inspection to Requires Improvement.
Kind and familiar staff
Staff generally knew people well, promoted independence and showed kindness. People and relatives gave positive feedback about the care and companionship.
“We saw that overall, staff knew people well, promoted their independence and as time allowed, took a genuine interest in providing support” from the report
Healthcare support
Staff worked with community health professionals and usually acted quickly when people became unwell.
“There was evidence that staff worked with a range of community healthcare professionals.” from the report
Infection arrangements
Inspectors were assured about most infection prevention arrangements, including preventing outbreaks and supporting people to reduce infection risks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Flexible visiting
Relatives could visit flexibly without booking, and feedback about the arrangements was positive.
“Visiting could take place flexibly and booking was no longer required.” from the report
Investment in the building
The provider had started refurbishment and installed a new lift, laundry and kitchen. Staff said the work was beginning to make a difference.
“Since we last inspected, a new lift, laundry, and well equipped kitchen had been installed.” from the report
Staffing and supervision
seriousThere were periods when communal areas had no staff present and people could not get help promptly. Inspectors found that basic needs were not always met.
“There were not always sufficient numbers of staff deployed to meet people's needs.” from the report
Unmanaged safety risks
seriousSome risk assessments were incomplete. Fire safety actions, legionella checks and electrical remedial work were not all completed.
“Risks to people's health and wellbeing and those arising from the environment had not always been managed safely.” from the report
Medicines safety
seriousOne pain medicine was past its expiry date. Records did not always show that creams were applied as directed, and thickening powders were not stored securely.
“One person had been administered a pain relieving medicine that was past its expiry date.” from the report
Consent and capacity
seriousThe home did not consistently assess whether people could consent to their care. Some mental capacity assessments lacked enough detail to support the decisions made.
“A number of people using the service lived with advanced dementia, but there was a lack of evidence of people's capacity to consent” from the report
Cleanliness and repairs
seriousParts of the building and equipment were dirty, worn or in need of repair. Inspectors also found problems with crockery, bathrooms, gardens and some equipment.
“The provider had not ensured that the premises and equipment within it were clean and properly maintained.” from the report
Limited activities
needs fixingInspectors saw no organised activities during either inspection day. People sometimes spent long periods with little interaction, and staffing pressures affected meaningful engagement.
“During both days of the inspection, we did not see any organised activities taking place” from the report
- 01How many permanent and agency staff are currently deployed on each floor, including at night?
- 02What checks now make sure people receive prompt help and are not left unsupervised?
- 03Have the outstanding fire safety, legionella and electrical works been completed?
- 04How are mental capacity assessments and best-interest decisions now recorded and reviewed?
- 05What activities are currently available for people who spend much of their time in their rooms?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the previous ratings were used when calculating the overall rating. This explanation was written from the published report of 8 February 2023 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 Arbory Residential Home
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- October 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- February 2023Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Inspected but not rated
- December 2020Goodstayed GoodSafe: Requires improvementWell-led: Good
- April 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- February 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
26 live-in carers within about an hour of Hampshire
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 £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.