Arbrook House Care Home

Updated 26 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 inspection site visit took place on 9 January 2019 and was unannounced. The inspection team consisted of three inspectors.

Prior to the inspection we reviewed the information we had about the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed notifications sent to us about significant events at the service. A notification is information about important events which the provider is required to tell us about by law. We also gained feedback from six health care professionals before the inspection.

During the visit we spoke with the regional director (and other members of the senior management team), the registered manager, eight people, one relative and 11 members of staff. We looked at a sample of five care records of people who used the service, medicine administration records and training and supervision. We reviewed records that related to the management of the service that included minutes of staff meetings, surveys and audits of the service.

Updated 26 February 2019

Care service description

Arbrook House Care Home is a care home that provides care, support and accommodation for a maximum of 42 older people some of whom are living with dementia. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection 41 people were living at the service.

Rating at last inspection

At our last inspection we rated the service good. At this inspection we found the evidence supported the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. We found the service had improved in the Caring, Responsive and Well Led domain.

Why the service is rated outstanding

Staff and the management team took great steps to ensure that people and their families were at the heart of the care they provided. People were treated as individuals whose life and experiences mattered to the staff. The manager and staff went out of their way to ensure that people and their relatives were comforted and looked after in a kind and compassionate manner. People were treated with dignity and respect. People and relatives were at the centre of decision making about their care.

Staff at the service went the extra mile to find out what people had done in the past and evaluate whether they could accommodate activities that there important to people. There were a range of activities available within the service and within the community. Staff ensured that people’s lives that were near to the end were provided with care and compassion and that people’s last wishes were provided where possible. Complaints were used as a way of improving care to people.

The service had a strong, visible person-centred culture and was exceptional at helping people to live their lives to the fullest. People, their relatives and staff told us the registered manager and all of the senior staff were supportive, valued their input and ensured that they were included in any changes to the service provision. The registered manager and senior management took a personal interest in people and knew them well. The registered manager worked in partnership with people's families and outside organisations to improve the care and support people received. The registered manager had systems in place which monitored health and safety and the quality of people's support. The systems were responsive and had led to changes being made. The registered manager was proactive with regard to how people's support could be improved.

People told us that they felt safe and secure with staff at the service. Staff understood risks to people’s care and what they needed to do to reduce the risks of injuries to people. Staff had received training in how to safeguard people and what they needed to do if they suspected abuse. Before staff started work checks were undertaken to ensure that they were suitable.

The provider had procedures in place ensure people remained safe in an emergency. Staff understood what they needed to do to prevent the risk of infections to people.

People were supported with their health needs including nutritional and hydration needs. When people were at risk of dehydration and malnutrition this was managed well by staff. Staff worked well together to ensure appropriate care was delivered. Staff understood the principles of the MCA and what they needed to do if they suspected a person lacked capacity. People’s consent was gained by staff before they delivered care.

Staff received appropriate training and supervision in relation to people’s needs. Clinical support was provided to staff and where health care professional advice was sought staff followed their guidance.

People's needs had been assessed both before and after admission to the service. Care plans reflected people's needs and preferences. Care plans were evaluated regularly so they contained information about people's current needs. The environment was set up to meet the needs of people so that they could live safely.

Further information is in the detailed findings below