Archived: Arnold House

Updated 16 November 2018

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 was 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 took place on 09 October 2018 and was unannounced. The inspection team consisted of an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at the information we held about the service. This included statutory notifications that the provider had sent to CQC. A notification is information about important events which the service is required to send us by law. We also 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 also asked the local authority commissioning the service for their views of the service and used this information to help inform our inspection planning.

During the inspection we spoke with eight people using the service, one relative, four members of care staff, two social care professionals, the registered manager and deputy manager. We reviewed records, including the care records of four people using the service, recruitment files and training records for five staff members. We also looked at records related to the management of the service such quality audits, accident and incident records, and policies and procedures.

Updated 16 November 2018

This unannounced inspection took place on 09 October 2018. Arnold House is a care home for up to twenty adults with learning disabilities. People in care homes receive accommodation and 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 our inspection there were 16 people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. People using the service lived in their own rooms within four smaller flats with a communal kitchen, living room and a garden.

At the last inspection on 24 May 2016, the service was rated Good overall and Requires improvement in Well led because the provider had not supported staff by carrying out regular supervisions. At this inspection we found that the provider had made the required improvements and was compliant with regulations. However, we also found that improvements were required in that systems to monitor the quality and safety had not identified that fire risks assessments reviewed on a yearly basis to minimise the risk of fire were not carried out by an expert.

At this inspection there was a registered manager who had been registered with the Commission since April 2016. A registered manager is a person who has registered with the Care Quality Commission 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.

There were appropriate safeguarding procedures in place to protect people from the risk of abuse. Staff understood the different types of abuse and knew to who contact to report their concerns. Risks were assessed and identified and appropriate risk management plans were in place. Medicines were safely managed and people were protected from the risk of infection. There were systems in place for monitoring and investigating accidents and incidents. There were enough staff deployed to meet people’s needs and the provider followed safer recruitment practices.

Staff completed an induction when they started work and were supported through a programme of regular training and supervisions to enable them to effectively carry out their roles. People's needs were assessed prior to moving into the home to ensure their needs could be met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. We saw staff asking for people’s consent before offering support. People were supported to have enough to eat and drink and were offered a choice. People had access to healthcare professionals when required to maintain good health and the service worked with them to ensure people received the support they needed. The environment had been adapted to meet people’s needs.

People told us they were treated with kindness and that staff respected their privacy and dignity. People had been consulted as far as possible about their daily care and support needs. People were supported to be independent wherever possible. People were provided with information about the service when they joined in the form of a 'service user guide' so they were aware of the services and facilities on offer. The provider supported people when they moved between services through effective communication to ensure their care and support were coordinated well.

People’s support plans were reviewed on a regular basis and were reflective of their individual care needs. There was a range of appropriate activities for people to partake in if they wished to. Information was available to people in a range of formats to meet their communication needs. Staff had completed equality and diversity training and said they would support people according to their individual diverse needs. People were aware of the home’s complaints procedures and knew how to raise a complaint. Where appropriate people had their end of life care wishes recorded in care plans.

Regular staff and residents' meetings were held where feedback was sought from people. Staff were complimentary about the manager and the home. Resident and relatives’ annual surveys had been carried out and people views taken into account.

The provider worked in partnership with the local authority and other external agencies to ensure people’s needs were planned and met. The manager was knowledgeable about the requirements of a registered manager and their responsibilities about the Health and Social Care Act 2014. Notifications were submitted to the CQC as required. There was a clear ethos of providing good quality person centred care at the service. Staff said they enjoyed working at the service and they received good support from the registered manager.