Arlington House

Arlington House is a residential care home providing personal care to a maximum of 33 people. The home is an adapted building combining four terraced houses with care provided over three floors. At the time of the inspection 23 people were living at the home. The people living there are older people with a range of health and mental health needs including people living with dementia.

People’s experience of using this service and what we found

People and their relatives told us they were happy with the service they received. They described the care workers as kind and caring, and said the management team were visible, proactive and committed. One person said, “It’s a family business and the home is like a family.”

The registered manager had addressed the areas identified for improvement following the last inspection. For example, systems for safeguarding people from abuse had been reviewed and were now robust. Incidents were reviewed and safeguarding concerns had been appropriately identified and escalated in line with the provider’s policy.

Systems for monitoring quality and managing risks had been improved and embedded. There were robust arrangements to support governance and to provide management oversight. People told us they were happy with the care they received, and that staff helped them to feel safe.

Risk assessments and care plans guided staff in how to provide care safely and in the way the person preferred. There were enough suitable staff employed to ensure people were safe.

Appropriate infection control procedures for the Covid 19 pandemic were in place to keep people safe. Staff had received additional training and used appropriate Personal Protective Equipment.

People and relatives were happy with how responsive staff were to their needs. Staff and management knew people well and were proactive in responding to changing health and care needs.

People and their loved ones were happy with the managements approach to their relatives care and told us they were approachable, dedicated and caring.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement, report published 16 May 2019. They were in breach of regulation 13 (Safeguarding) and 18 (Staffing) of the Health and Social Care Act 2008. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, enough improvement had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Responsive which contain those requirements. We also looked at the Key Question of Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arlington House on our website at www.cqc.org.uk.

Arlington House is a residential care home providing personal care to a maximum of 33 people in an adapted building combining four terraced houses over three floors. At the time of the inspection 25 people were living at the home. The people living there are older people with a range of health and mental health needs including people living with dementia.

People’s experience of using this service:

• People were not always protected from abuse. The action staff may need to take to identify and raise safeguarding concerns had not always been taken and was not consistently understood.

• People and their relatives told us they felt safe. A relative told us, “My relative is safe because it’s secure. I feel confident with the people looking after them. I also feel if they have concerns they get the doctor in.”

• People’s access to timely care and support, and access to meaningful activities that reflected their diverse needs was not always supported by a sufficiently deployed staffing. The provider had implemented changes that required further time, guidance and training for staff before they could be introduced and the impact on people’s day to day experiences minimised.

• There were proactive quality assurance processes in place to drive improvements to the service. A relative told us, “The home is definitely getting better, you can see the improvements. They’re doing a grand job.” These improvements needed further embedding to robustly address inherited environmental and restrictive practice in relation to the use of CCTV as identified at the inspection.

• We have made a recommendation that the service seek suitable guidance on the use of CCTV.

• There was no registered manager at the time of the inspection. The provider had put measures in place to support the day to day management of the home.

• The provider needed to make further improvements to their oversight of the governance of the service to ensure the changes they were making continued to support safe practices in relation to recruitment, medicines administration and care planning for people with diverse needs.

• People were cared for in a clean and hygienic environment. The provider had worked hard at resolving inherited environmental health issues. A health professional told us, “The environment is improving, it was tired before, now it’s really improving.”

• Systems were in place for the recording of incidents and accidents. They were monitored and analysed over time to look for any emerging trends and themes.

• People’s needs, choices and preferences were known by staff and their care plans were personalised.

• People were comfortable with staff and were cared for in a safe, friendly and calm manner. Staff and managers were approachable and knew people well.

• People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

• People and relatives were encouraged to express their views. Staff were asked for their opinions on the service and felt supported within their roles.

• People were supported to maintain a healthy nutritious diet and had access healthcare services and professionals as and when needed.

• The provider and care manager were keen to develop team work, reflective practice and training in relation to dementia and end of life care.

• The physical environment was under a continual cycle of refurbishment with a clear focus to improve people’s day to day experiences at the heart of the home’s value base.

Rating at last inspection:

This was the first inspection of Arlington House since Montesano Care Ltd became the provider of the service and registered it with the Care Quality Commission on 4 June 2018.

Why we inspected:

This was a scheduled comprehensive inspection based on our methodology to inspect newly registered services within a year of registration. At this inspection we identified areas that required improvement, including breaches of regulation.

Follow up:

We will be in contact with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk