CQC report explained · a residential care home
What the CQC found at Arbour Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found that risks, safeguarding, medicines, infection control, staffing checks and learning from incidents were managed appropriately.
- Effective?
- Good
- This area was not inspected during this focused inspection. Its previous rating was carried forward.
- Caring?
- Good
- This area was not inspected during this focused inspection. Its previous rating was carried forward.
- Responsive?
- Good
- This area was not inspected during this focused inspection. Its previous rating was carried forward.
- Well-led?
- Good
- Inspectors found stronger governance, regular audits and an open management approach. People, relatives and staff gave positive feedback about the management.
What inspectors found, December 2023
Rated Good; inspectors found safe care and stronger management, but this was a focused inspection and did not assess all five areas.
The inspection was unannounced and took place on 30 November 2023. Two inspectors and an Expert by Experience spoke with people, relatives and staff. They reviewed care records, medicines records, quality checks and staff recruitment files.
The inspection followed concerns about how people's health needs were managed. Inspectors found no evidence that people were at risk of harm from this concern. They rated Safe and Well-led as Good.
The home had improved since its previous inspection, when it was rated Requires Improvement and was in breach of Regulation 17. The provider was no longer in breach. The overall rating changed to Good, partly because the other areas kept their previous ratings.
People felt safe
People and relatives told inspectors they felt safe. Staff understood safeguarding and knew what action to take if someone was at risk.
“People told us they felt safe living at Arbour Lodge.” from the report
Risks were managed
Care plans and risk assessments were detailed and reviewed at least monthly. Staff followed guidance for falls, skin care, moving people and dietary needs.
“Risks to people's safety and health were assessed and managed.” from the report
Medicines were handled safely
Inspectors found effective medicine procedures. Staff gave medicines at people's own pace and explained what they were giving.
“We observed staff supporting people with their medicines and saw this was done at the person's own pace, unhurried with an explanation of which medicines the person was receiving.” from the report
Management had improved
The home had regular audits and an improvement plan. The provider had addressed the earlier governance problems and was no longer in breach.
“At this inspection improvements had been made and the provider was no longer in breach of this regulation.” from the report
Open communication
The manager encouraged people, relatives and staff to raise questions or concerns. Relatives said management listened and acted on feedback.
“The registered manager encouraged an open-door policy which gave people, relatives, and staff the freedom to ask questions and discuss any concerns.” from the report
Some staff wanted more cover
minorPeople and relatives said staffing was sufficient and inspectors saw enough staff during the visit. However, some staff said there were times when they would benefit from more staff.
“Staff told us they felt there were times when they would benefit from more staff members.” from the report
- 01How do you currently identify and manage changes in a person's health needs?
- 02What cover is available when staff feel more staff members are needed?
- 03What were the main actions in the service improvement plan, and have they all been completed?
- 04How will you keep families informed if something goes wrong with a person's care or treatment?
- 05What current information can you provide about the home's care, activities and response to individual needs, since these areas were not assessed in this inspection?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection. This explanation was written from the published report of 16 December 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, June 2020
Rated Requires Improvement; inspectors found kind, effective care, but weaknesses in safety checks and management systems increased the risk of harm.
This was an unannounced inspection over two days in March 2020. Inspectors spoke with people using the service, staff and health professionals. They reviewed care records, medicine records, recruitment files and management records.
People were generally treated with kindness and respect. They received support with meals, healthcare, activities, communication and personal choices. Staff were trained, there were enough staff, medicines were given safely and the home was clean.
However, safety checks and care records were not reliable enough. Some risks were not assessed or followed up properly. Equipment used to prevent pressure ulcers had faults that were not identified through regular checks. Records of care, including repositioning and fluid intake, were incomplete.
The overall rating was Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement. The previous overall rating was Good, published in November 2017.
Kind and respectful staff
People were supported by staff who were caring, attentive and respectful. Staff noticed verbal and non-verbal signs that people needed help.
“People were supported by caring staff who were attentive to their needs.” from the report
Safe medicines support
Inspectors found that staff administered medicines correctly and that medicines were stored safely. Guidance was available for medicines given only when needed.
“People received their medicines safely. Staff received training to administer medicines and were observed following the correct procedures.” from the report
Good food and healthcare support
People could choose their meals and drinks and received help to maintain a healthy diet. Staff worked with healthcare professionals and followed their advice.
“People were supported to have enough to eat and drink.” from the report
Personalised activities and choices
People received person-centred care and could take part in activities they enjoyed. The home supported personal interests and relationships.
“People had access to a range of social activities.” from the report
Risk assessments were not consistent
seriousSome people's risks were not assessed or monitored properly. One person was at risk of slipping from a chair without a risk assessment or care plan, although action was taken on the inspection day.
“People did not consistently have risks to their safety assessed or monitored.” from the report
Equipment checks were missing
seriousTwo pressure-relief mattresses displayed fault messages. There was no system to check this equipment, creating a risk that safety problems would not be found promptly.
“There were no systems in place to check or record the functioning of air flow mattresses and we found two with faults.” from the report
Management checks missed gaps
seriousThe home's audits did not identify missing or incomplete information in care records, risk assessments and care plans. CQC found that the governance systems were not robust enough.
“The governance systems were not robust enough to demonstrate safety was effectively managed, placing people at risk of harm.” from the report
Some care records were incomplete
needs fixingRecords did not always show that planned care had been delivered, including regular repositioning. The report also said fluid intake monitoring had not been reliably recorded.
“Records of care delivery were not consistently completed in line with people's care plans.” from the report
- 01What changes have you made to check pressure-relief and air-flow mattresses for faults?
- 02How do you make sure every person's risks are assessed, updated and followed by staff?
- 03How do you now check that repositioning, fluid intake and other planned care are recorded every time?
- 04What action plan did you send to CQC after the Regulation 17 breach, and what progress has been made?
- 05How are care plans being improved so they give staff clearer information about communication needs?
This was an unannounced inspection of the care home that considered all five CQC questions and reviewed both the premises and the care provided. This explanation was written from the published report of 17 June 2020 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 Arbour Lodge
5 rated inspections over 9 years: the service has improved, from Requires improvement to Good.
- December 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 16 March 2011.
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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