Archived: Aranlaw House Care Home

Aranlaw House Care Home is a purpose-built home that specialises in the care of older people who are living with dementia. The home is registered to accommodate a maximum of 47. There were 45 people living there at the time of our inspection. The home is divided into three separate living units, one on each floor. There is also shared communal space on the ground floor including a large dining room which is also used for various activities.

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

At this inspection we found overwhelming evidence that demonstrated people received outstanding caring, kind and positive support. This was due to excellent leadership from the registered provider and registered manager as well as a strong, well trained team of staff.

Everyone we spoke with provided exceptional feedback about how caring, professional and supportive the staff were and so often went the extra mile to ensure people were happy and felt well cared for.

The atmosphere throughout the home was exceptionally positive, welcoming and homely. Feedback from people who used the service, their relatives and staff was consistently very positive and the management at the home exceeded people’s expectations. They were also full of praise for the staff.

People received a consistently high standard of care because staff and management put people first and at the heart of the service, while continuously looking for new ways to improve their care and quality of life.

Care was personalised and met individual needs. Staff knew people very well, cared about them and understood their care and support needs as well as the risks people faced, and were motivated to support them to live full lives. There was no sense of task-oriented practice in the home.

We saw people were very relaxed and content in the company of staff throughout our visits. Peoples needs were regularly assessed and reviewed in detail and action was taken to respond to people’s changing needs.

The service supported people nearing the end of life to have a comfortable and dignified death by working closely with health care services and through consulting people about their end of life wishes. Staff talked with pride about the care they were able to give to people in their final days.

There was a very strong emphasis on the provision of activities that were meaningful to the people living in the home. People told us they were happy with how they spent their time. Staff told us how they believed that being fulfilled and entertained promoted people’s overall wellbeing.

Staff took great pride in creating an atmosphere that welcomed people and promoted their independence whilst respecting their privacy and dignity. Peoples wishes were respected with the daily choices they made or were supported to make.

People had help from safely recruited and appropriately trained staff. Staff also understood their role and responsibilities to protect people from abuse. Staff and the senior management team advocated for people to promote their safety and human rights.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received their medicines when they were needed and in ways that suited them. There were systems in place to check that medicines were administered correctly and safely.

The registered manager was very proactive in encouraging staff to look at how they could improve people’s health and wellbeing and to look at innovative ways to do this. People were supported to maintain their health and told us they had access to health care any time they wished. People's nutritional and hydration needs were being met and the standard of catering and meal time experience at the home was very good and often exceeded people's expectations.

People and staff were proud of the home and its facilities. The home was well equipped, and staff said that if ever the need for equipment was identified all they had to do was report this to the registered manager and it was provided. Staff understood the importance of infection control. The home was clean and well maintained throughout.

The service recorded and analysed accidents and near misses to understand what had happened, identify trends, and help prevent them happening again.

The service had a quality assurance system in place to enable the monitoring of the quality of care people received. There were numerous quantitive and qualitive audits and checks carried out. Information from these was analysed and records showed where any issues or concerns had been identified, action had been taken to address these and this was continuously evaluated.

Rating at last inspection

The last rating for this service was outstanding (published 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

Aranlaw House Care Home is a purpose-built care home that specialises in the care of older people who are living with dementia. Most people there have complex needs associated with their diagnosis of dementia. The service is registered to provide care for up to 46 people. People are accommodated in individual en-suite bedrooms located on all three floors of the building. There are communal lounges and dining areas on each floor, and the three floors are connected by stairs and a passenger lift. There is an enclosed garden, and some parking at the front of the building. At the time of our inspection there were 45 people living there, with someone due to move into the only vacant room the following week.

The registered manager had been in post since 2014. 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.

Care was planned in partnership with people and their families, and people received the care and support they needed to meet their individual needs. People and their visitors spoke highly of the quality of care they and their loved ones received, and said they were kept informed about the person’s wellbeing. Staff supported people in a proactive way, recognising where additional assistance might be required.

Creative ways were found to enable people to live full lives. People were encouraged to do things they enjoyed and found meaningful, and this included social activities based on people’s interests.

Risks were assessed and managed in the least restrictive way possible. Staff were skilled in intervening when people were at risk from behaviour that could challenge others. They intervened calmly and positively when they noticed anything that could cause a person to become distressed.

The environment had been designed, based on research evidence, to promote the independence and wellbeing of people who lived with dementia. People who liked to move around were positively encouraged to use communal areas throughout the building.

Managers and staff at all levels were committed to working in a person-centred way, respecting people’s wishes and preferences and treating them with kindness and compassion. People, including those who had difficulties communicating or who could become upset and present challenges to staff, responded positively to the manner in which staff approached them.

Visitors valued the relationships they and their loved ones had with the staff team, and told us they always felt welcome. All spoke highly of how caring the staff and managers were. Staff knew people and understood their care needs and preferences. They spent time with people, both during care tasks and at other times. Care and support was not rushed, staff working at the person’s pace.

The whole staff team were attuned to needs of people living with dementia, with a recognised and respected model of dementia care in use. The registered manager and director of care services kept up to date with best practice in dementia care and ensured this was adopted by the staff. Staff were skilled in communicating with people and supporting them to express their views, even where people had difficulties with communication.

People’s rights were protected because the managers and staff understood their responsibilities in relation to the Mental Capacity Act 2005, and were confident in putting these into practice. People were supported to express their views and were involved in decisions about their care, even if they did not have the mental capacity to make these decisions for themselves. Where best interests decisions needed to be made on the person’s behalf, these took into account what was known of the person’s preferences, values and beliefs in relation to this care. Relatives, friends and relevant professionals were involved.

There was a strong emphasis on the importance of eating and drinking well. Mealtimes were relaxed and congenial. The staff were organised and attentive; they recognised why some people might find mealtimes challenging and provided the support they needed to be able to enjoy a meal. Food was attractively presented and people were able to choose what they wanted to eat. Special dietary requirements were understood and provided for. Food and drink was available whenever people needed it, even if this was not at regular mealtimes.

Visitors told us they felt their loved ones were safe at the service. People looked relaxed with staff. Staff understood their responsibilities for safeguarding adults, including recognising signs of abuse and how to report any concerns. Medicines were stored and managed safely, and were administered as prescribed. The premises were well maintained, with regular health and safety checks and up-to-date servicing.

There were enough staff to provide the care and support people needed. Staffing levels were based on people’s needs and were kept under review. Staff were recruited safely, checks being undertaken before they started work to ensure they were suitable to work in a care setting.

Whilst people received very good care, there was a strong emphasis on continually striving to improve the service. There were active endeavours to involve people, their relatives and staff in this, whether through informal conversation or more formally through reviews, meetings and surveys. As well as consulting with people, the service strove for excellence through reflective practice at all levels, from care staff to senior management. There were systems in place to monitor the quality and safety of the service and bring about any improvements that were needed. The service worked in partnership with other organisations to make sure they were following current practice and providing a high quality service.

The service had a clear management structure, with an established registered manager and director of care services. They and other members of the management team worked closely with staff, frequently observing and providing care. People, visitors and staff were confident in the leadership of the service. They were encouraged to raise any issues of concern, which were taken seriously and the appropriate action taken.

People's dignity and privacy was respected. Staff focused on individuals when they were supporting them. People living at Aranlaw house were positive about their experience of living in the home. One person told us "Its good here, the staff are nice".

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had suitable quality assurance procedures in place to manage the health and welfare of people living in the home. People were able to comment on the service provided.

We used a number of different methods to help us understand the experiences of people using the service. This was because they had complex needs which meant they were unable to tell us about their experience.

We used the Short Observational Framework for Inspection (SOFI). It is a specific way of observing care to help us understand the experiences of people who could not talk with us.

We observed that people were in positive or neutral moods and frequently smiled with each other and staff. People freely approached staff and had good relationships with them. Staff gently redirected, reassured and supported people when they became unsettled.

People living at Aranlaw House were very positive about their experience of living at the home and no one had any complaints or concerns about how the home was run and managed. They told us that they had good relationships with the staff, who were described as 'good and know how to help'. They told us that the home was kept clean. They told us that there was a range of food and drinks available. There were activities arranged to keep people occupied. People told us that they were involved in decisions about how they were looked after and that they could choose when they got up and when they went to bed.