Archived: Arthur House

Updated 6 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection, which took place because we carry out comprehensive inspections of services rated ‘Good’ at least once every two years. The inspection took place on 4 April 2017 and was unannounced. The inspection team consisted of one inspector and an Expert by Experience. This is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. This included reports from previous inspections and statutory notifications submitted by the provider. Statutory notifications contain information providers are required to send to us about significant events that take place within services.

During our inspection we spoke with three people who lived at the home and four visitors. We also spoke with the registered manager, deputy manager, a senior care support worker, three care support workers, the activities coordinator, the chef and a member of the housekeeping team. We looked at records which included three people’s care records, six medicines administration records (MAR), three staff files and other records relating to the management of the service.

We undertook general observations throughout our visit and used the Short Observational Framework for Inspection (SOFI) during the lunchtime meal service. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 6 May 2017

Arthur House is a small care home which provides accommodation and personal care to older people, some of whom are living with dementia. The home is registered to care for up to 12 older people. At the time of our inspection there were nine people living at the home.

At the last Care Quality Commission (CQC) inspection in January 2015, the service was rated ‘Good’ overall and was meeting all the regulations we checked. At this inspection we found the service not only continued to meet the regulations and fundamental standards, they had also identified specific areas where they could further improve people’s lives and experiences of receiving care and have acted on these.

Since our last inspection, the provider had appointed a new registered manager and deputy manager for the service. A registered manager is a person who has registered with the CQC to manage the service. 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.

The registered manager and deputy manager had had a positive impact at the service and were highly regarded by people and staff. Both ensured the provider’s values and vision for the service were fully embedded in the service’s systems and processes and demonstrated by staff through their behaviours and actions. Managers used the well-established quality assurance system to ensure all aspects of the service were regularly monitored. This helped them to check that people were consistently experiencing good quality care and support. Any shortfalls or gaps identified through these checks were addressed promptly. Managers encouraged and supported staff to deliver high quality care and recognised and rewarded them when they demonstrated excellence in the work place. Staff said they were well supported by managers and all told us Arthur House was a good place to work.

The managers continuously sought ways in which the service could be improved for people. They stayed abreast of best practice and current research in the field of dementia care and brought new ideas and techniques into the service in order to enhance people’s quality of life. People and staff were encouraged to provide feedback which was used to make changes and improvements that people wanted. The provider ensured appropriate arrangements continued to be maintained for dealing with people’s complaints if they were unhappy with any aspect of the support they received. People were confident any concerns they had would be appropriately dealt with.

People were supported to live an active and fulfilling life. Since our last inspection the service continued to remain focussed in finding new and creative ways to continuously improve peoples’ wellbeing, to enhance their quality of life. Improvements had been made and people had access to a wide range of activities and events tailored to meet their specific needs. Staff were focussed and committed to people achieving positive and rewarding outcomes from these.

People continued to receive personalised support which met their specific needs. Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly. Staff continued to receive regular and relevant training and supervision to help them to meet people’s needs effectively. Staff communicated with people using their preferred methods of communication. This helped them to develop good awareness and understanding of people's needs, preferences and wishes.

People said they were safe. Staff knew how to protect people from the risk of abuse or harm. They were kind and caring and ensured that people received care and support in a dignified, respectful way and which maintained their privacy at all times. Staff supported people, where appropriate, to retain as much independence as possible, when carrying out activities and tasks.

There were enough staff to support people and keep them safe. Staff followed appropriate guidance to minimise identified risks to people's health, safety and welfare. The provider continued to maintain their arrangements for checking the suitability and fitness of new staff employed to work at the service. All staff were aware of their duties under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff sought people's consent before providing any care and support and followed legal requirements when people did not have the capacity to do so.

People said Arthur House was homely and comfortable. People were supported to maintain relationships with those that mattered to them and relatives and visitors were warmly welcomed when they came to the home. Managers ensured the environment continued to be safe and hygienically clean for people. Regular maintenance and servicing of the premises and equipment was undertaken. Since our last inspection, the service had improved their food hygiene rating issued by the food standards authority from ‘4’ to ‘5’. We observed the environment was clean and staff demonstrated good awareness of their role and responsibilities in relation to infection control and hygiene.

People were supported to eat and drink enough to meet their needs. The provider ensured mealtimes were an enjoyable and personalised experience. Staff regularly monitored people's general health and wellbeing. Where there were any issues or concerns about a person's health, they ensured they received prompt care and attention from appropriate healthcare professionals such as the GP. People who had suffered an illness or injury were supported to recover as quickly as possible so that they could regain their health and improve their quality of life. Suitably trained staff continued to follow the arrangements in place to ensure people received their prescribed medicines when they needed them.