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Arbory Residential Home Good

Inspection Summary


Overall summary & rating

Good

Updated 21 April 2018

The inspection took place on 26th February 2018 and 5th March 2018 and was unannounced.

The Arbory Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The Arbory Residential Home accommodates up to 60 people who are living with dementia. Accommodation is in two adjoining buildings, the Court, a purpose built three storey extension and the Lodge, an adapted building over two floors both were accessible with stairs and passenger lifts. There are extensive accessible grounds and gardens. When we inspected 58 people were living at the service.

There was a registered manager in post. A registered manager 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.

People were kept safe from harm and staff were trained in safeguarding and knew how to report concerns. Risks were assessed and actions taken to minimise residual risks without impacting on people’s rights.

There were sufficient trained staff deployed to support people and provide high quality care. Recruitment practices were robust and appropriate checks and training were in place before staff commenced in post.

People were supported to maintain their health and well-being and their nutritional needs were met.

People were given choices and control over their lives. The service complied with the principles of the Mental Capacity Act and Deprivation of Liberty Safeguarding. Controls in place were in the best interest of people and were the least restrictive option.

Positive working practices were in place with other professionals such as district nurses, community psychiatric nurses and GP’s. A multi-disciplinary approach was taken when risk assessing and care planning.

Medicines were safely managed. Staff were trained in giving medicines and were checked for competence before administering them unsupervised.

There were activities to involve and entertain people both within the home and the local community that were appropriate to their needs.

People received person-centred care that was delivered with kindness and compassion. Staff were caring and empathetic towards people. Behaviours were managed as ‘fear behaviours’ and staff changed their approach to support people.

There was a positive and inclusive culture in the service. The service’s ethos was to provide a home, not a care home and people were friends and not patients. This was embedded in and evident in staff practice.

Inspection areas

Safe

Good

Updated 21 April 2018

The service was safe. Previous concerns about risk assessments had been addressed and there were detailed and regularly reviewed risk assessments reducing the risk of harm to people and staff.

There were sufficient, well trained staff deployed to effectively meet the needs of people and to offer support on a 1-1 basis. Staff recruitment practices were safe and relevant checks were completed before staff commenced in post.

Medicines were managed safely. Medicine cabinets were secure, clean and uncluttered. Care plans were in place and people told us they received medicines as prescribed.

There was an infection control champion who raised awareness of infection control and ensured staff were aware of good practice guidelines.

Effective

Good

Updated 21 April 2018

The service was effective. Staff were trained to provide effective, compassionate and person-centred care. Staff received regular training and supervision and were aware of current best practice guidelines.

Nutrition and hydration were monitored and there was access to snacks and drinks at all times. People and staff had meals together and support was given in a respectful way. Mealtimes were a social event which encouraged people to eat.

There was good access to healthcare and the service worked in partnership with district nurses in providing end of life care. Weights were monitored using the MUST tool.

A pressure care champion had been appointed and had promoted good practice in the prevention and management of pressure sores.

The service was suitably adapted to meet people�s needs. All areas, including the gardens were accessible and people were able to move around the service as they wished.

Caring

Good

Updated 21 April 2018

The service was caring. People, their relatives and visiting professionals told us that staff were caring and treated people with dignity and respect.

People were involved in developing their care plans. Staff knew people well and provided care that reflected their preferences, likes and dislikes.

Staff were unhurried when providing care and were encouraged to spend quality time with people chatting and reassuring them.

Responsive

Good

Updated 21 April 2018

The service was responsive. People had clear care plans that were regularly reviewed and adjusted to meet their changing needs..

People and their relatives were involved in developing their care plans.

People participated in a varied range of activities relevant to their interests.

Information on how to make a complaint was available and complaints were responded to in a timely and thorough manner.

Partnership working with district nurses provided people with a dignified end of life. If there were no relatives, staff would sit with people and no-one was alone at the end of their life.

Well-led

Good

Updated 21 April 2018

The service was well-led. There was an open culture and the management team were accessible to people and staff.

There was a strong registered manager who led by example and ensured the services values were embedded in staff practice.

Staff told us they were supported and encouraged to make suggestions to improve the service.

There were quality assurance systems in place and questionnaires completed by people and their relatives provided positive feedback.

There was a commitment to �make each day the best it could be� and to provide excellent dementia care.

The registered manager shared his expertise with staff, relatives and the community through information sessions.