The inspection took place on 8 and 9 September 2015.
Arundel Park Lodge is a care home with nursing for up to 30 older people that require support and personal care. People maybe living with conditions associated with advancing age, including dementia. The home is located in Saltdean and is one of two provided by Whytecliffe Limited.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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.
Not everyone could tell us of their experiences, but those that could spoke positively of the home and commented they felt safe. People had confidence in the staff to support them and we observed positive interactions throughout our inspection. Our own observations and the records we looked at found some concerns. A person was not supported to eat and drink in a safe manner following the guidelines set out by a health care professional. We also found cross infection risks identified in two areas. Staff did not have the opportunity to wash their hands before leaving the staff bathroom because it lacked a hand basin. We looked at equipment used by people and saw that a commode was rusted and corroded.
Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place.
Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) that applies to care homes. The registered manager had identified that applications were outstanding but had not made the appropriate applications as people’s needs changed. Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.
People enjoyed the facilities that the home offered such as the lounges and garden. We saw the newly erected summerhouse provided with the help of a dementia funded grant. However, the environment had not made other reasonable adjustment for the many people living with dementia. The premises did not meet the needs of people living with dementia. There was a lack of signage to help people find their way around the building. There were no signs to identify bathrooms and other rooms in the home which may add to orientation for people with cognitive impairment. Corridors, walls, doors and rails were all well maintained but were painted in similar shades, when colour contrast is known to be helpful for people with dementia and others to help to distinguish borders.
People were not always listened to or provided with care that was suited to individual people’s preferences and needs. A radio played music during lunchtime, we asked people what they thought about the choice and were told, “It’s dreadful but it’s what the girls want.”
When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector.
Accidents and incidents were recorded appropriately and steps were taken by the home to minimise the risk of similar events happening in the future. Emergency procedures were in place in the event of fire.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service. All staff received one to one meetings with their manager. Nurses received clinical supervision and formal personal development plans. Three monthly appraisals were in place for nursing and care staff.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals. People were able to give feedback and have choice in what they ate and drank and special dietary requirements were met.
People felt well looked after and supported and were encouraged to be as independent as possible. Health care was accessible for people and appointments were made with GP’s and therapists to maintain people’s health and welfare.
We observed friendly relationships between people and staff. One person told us, “One of the best things is the caring attitude of the staff’.” People told us the staff supported them to maintain their independence as it was important to them.
People could choose how to spend their day and they took part in activities in the home when they wanted to. Activities and opportunities for social engagement were offered throughout the week. One person told us, “We spend our time in the lounge, the [activities coordinator] comes in and does activities, quizzes and all that. She’s very good.”
People were encouraged to express their views. People also said they felt listened to and any concerns or issues they raised were addressed. One person said, “If there is anything wrong, I tell the staff.” Another said, “The manager is approachable and makes time to talk.”
Staff were asked for their opinions on the service and whether they were happy in their work. Staff enjoyed their work. They felt supported within their roles and described a caring and ‘open door’ management approach. They described how management were always available to discuss suggestions and address problems or concerns.
The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.
We have identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told this provider to take at the back of this report.