Enter and view: Arkley Nursing Home (Safeguarding)

Healthwatch Barnet carried out an announced safeguarding-focused Enter and View visit to Arkley Nursing Home on 21 January 2019. Arkley Nursing Home, part of the BUPA UK group, had 49 residents living in the home at the time of the visit and provided care for people with complex nursing needs, including residents with Parkinson’s disease, stroke-related disabilities and those receiving end-of-life care. 

The inspection found that the home was well managed and had responded positively to recommendations made during previous Healthwatch visits. Improvements were evident in mealtime arrangements, with more residents eating together in communal dining areas. The home had also introduced a sensory room used for arts, crafts and therapeutic activities, supported by increased investment in activities and an additional activities staff member. 

Safeguarding arrangements appeared strong. Care plans, known as “My Day, My Life, My Portrait”, were reviewed monthly, and staff discussed residents’ needs daily through regular team meetings. The manager operated an open-door policy and encouraged staff, residents and relatives to raise concerns. All staff interviewed demonstrated a good understanding of safeguarding responsibilities and reported feeling well supported by management. 

Staffing levels were considered appropriate, with 10 staff on duty during the day and seven at night. Recruitment processes included DBS checks, references and comprehensive safeguarding training. Staff turnover had been relatively low, and staff spoke positively about the leadership and support provided by the manager. 

The home maintained clear systems to manage health and wellbeing. Residents’ weights were monitored regularly, dietitians were involved where necessary, and pressure ulcers were closely managed. Four safeguarding alerts had been raised since the manager took up post, including two relating to pressure sores acquired in hospital. The home also had five approved Deprivation of Liberty Safeguards (DoLS) authorisations and six applications awaiting assessment. The manager expressed concern about delays in receiving responses from safeguarding teams and obtaining DoLS decisions. 

Residents and relatives generally described staff as caring, respectful and compassionate. Residents said they felt safe and well looked after, while relatives praised staff communication and the quality of care. Staff were described as professional, gentle and responsive to residents’ needs. Although minor issues were reported regarding misplaced clothing and the cost of care, there were no significant concerns about safety or safeguarding. 

The home demonstrated good practice in addressing risks of physical, emotional, financial and discriminatory abuse. Residents were encouraged to maintain independence, safeguarding concerns were reported appropriately, and staff showed awareness of how to respond to challenging behaviour or inappropriate language. Personal finances were managed through structured systems overseen by the finance team, and efforts were made to quickly replace lost items such as hearing aids. 

Healthwatch found that staff worked hard to prevent social isolation and self-neglect. Residents who were reluctant to participate in activities were encouraged through personalised approaches based on their interests and life histories. The activities coordinator was particularly well regarded by residents and staff for promoting engagement and wellbeing. 

Overall, Healthwatch concluded that Arkley Nursing Home provided a caring, well-run and safe environment with a strong safeguarding culture. Inspectors praised the positive impact of the manager, the supportive staff culture and the home’s commitment to continuous improvement. Recommendations included considering a larger sensory room, sharing assessment responsibilities with the deputy manager, improving awareness of snacks available between meals, and ensuring residents and relatives received information about potential financial support when needs changed.