29 February 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
The inspection team on the first day consisted of two inspectors and an assistant inspector. The second and third days of the inspection were carried out by one inspector.
Service and service type
Aranlaw House Care 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and six relatives about their experience of the care provided. We spoke with 12 members of staff including the nominated individual, registered manager, assistant manager, senior care workers, care workers, support and activities staff and the chaplain. We also spoke with two health and care professionals during their visits to the service.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from one relative and eight health and social care professionals who know and regularly visit the service.
29 February 2020
About the service
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.
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