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Arcot House Residential Home Outstanding

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Outstanding

Updated 18 May 2017

This inspection took place on 2 and 3 March 2017, the first day was unannounced and second day announced. This was the first inspection since a new provider, Doveleigh Care Limited, registered this service on 11 February 2015.

Arcot House is a 23 bed residential home for older people who are physically frail and require help with personal care, it does not provide nursing care. The home is a grade two listed Georgian manor house set in lovely gardens. When we visited, 22 people lived there.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff developed exceptionally positive caring and compassionate relationships with people. The ethos of the home was that of an extended family. Staff knew each person as an individual and what mattered to them, they treated people with the utmost dignity and respect. A relative said, “Nothing is too much trouble, I can’t speak of them highly enough. Its home from home.” The service used the national ‘Dignity in care’ initiative ten good practice steps to guide their practice. A ‘Dignity Tree’ created by people, relatives and staff provided a tangible reminder to uphold those values at all times.

People living at the home with expertise and knowledge of particular conditions such as diabetes and epilepsy, worked in partnership with staff who valued their experience and contributions on ways in which their care could further be improved. For example, they advised on medicines used for epilepsy, on ‘low sugar’ specialist diabetic foods and obtained health information leaflets to inform staff about their condition. People and staff had lead roles, known as “Ambassadors” worked together and promoted improved healthcare outcomes for people. For example, in pressure area care, diabetes, epilepsy, falls management, dementia, dignity and end of life care.

People living with dementia received best practice care because staff understood the different types of dementia, Staff had signed up to the Alzheimer’s society Dementia Friends initiative and undertook ‘Dementia Friends’ training. A staff member had a lead role for promoting best practice in caring for people living with dementia, and had undertaken training and received a qualification in dementia. The promoted people, staff and relatives to learn about various types of dementia, and how it affected people, and encouraged and supported people living with dementia to live well.

People received exceptionally effective care, based on best practice by staff with an in-depth knowledge of their care and treatment needs, who were skilled and confident in their practice. Staff worked with people, other professionals and continually developed their skills. The service used innovative and creative ways to train and develop staff to put their learning into practice to provide outstanding care that met people’s individual needs. Photographs showed how staff used sensory glasses which simulated visual impairment to experience what it was like to be guided by a member of staff to navigate their way around the home using a walking frame. This helped staff appreciate how those people weren’t aware of trip hazards such as steps and how it affected their sense of balance.

Staff followed national best practice such as ‘One chance to get it right’ and NICE guidelines for end of life care (2015). They worked with hospice and community nursing staff during an ‘End of Life’ project to implement best practice end of life care for people. A staff member championed excellent end of life care and helped staff have the skills and confidence to discuss death and dying with people, families and staff in order to help them have a goo

Inspection areas

Safe

Outstanding

Updated 18 May 2017

The service was safe.

People were safe because a safety culture was embedded at the service. Staff had exceptional skills in managing and reducing risk whilst promoting people to lead fulfilling lives and minimise restrictions on their freedom.

Staff used best practice to proactively identify and minimise risks for people. Equipment and technology was used to continuously improve safety for people.

People's safety and wellbeing was promoted because staff understood the importance of promoting people’s physical and mental wellbeing and of people keeping active and maintaining their independence. staffing levels meant there were enough staff to meet all their needs.

People were actively involved in a robust recruitment process to ensure they were cared for by suitable staff.

Staff knew about their responsibilities to safeguard people, how to recognise signs of abuse and report suspected abuse. Any concerns reported were acted on.

People were supported to take their medicines on time and in a safe way.

Effective

Outstanding

Updated 18 May 2017

The service was effective.

People received exceptionally effective care, based on best practice evidence by staff with an in-depth knowledge of their care and treatment needs.

People’s health had improved because staff used innovative ways to promote their health and wellbeing through good nutrition and hydration.

People and staff worked in partnership and had lead roles to promote best practice care.

People's health and mobility were improved by staff who worked with a range of professionals to support them to lead a healthy lifestyle and access healthcare services.

Staff confidently used the Mental Capacity Act (MCA) and its principles, which was embedded in day to day practice at the home. Comprehensive records of 'best interest' decisions were kept for each person.

Caring

Outstanding

Updated 18 May 2017

The service was caring.

Staff demonstrated person centred values, which placed an emphasis on respect for the individual being supported.

People were treated with dignity and respect. A 'dignity' advocate promoted and championed dignity issues within the team. Staff protected people's privacy and supported them sensitively.

Staff had excellent communication skills developed exceptionally positive, kind, and compassionate relationships with people.

People’s rights and choices were promoted and respected. People mattered, and staff ‘went that extra mile’ to meet their needs and wishes.

People were part of their locally community, because staff supported people to establish and maintain local networks.

People experienced a high standard of end of life care which enabled them to experience a comfortable, dignified and pain-free death. Staff comforted, reassured and empathised with people and families.

Responsive

Outstanding

Updated 18 May 2017

The service was responsive.

People received exceptionally person centred care from staff who knew each person, about their life and what mattered to them. The level of care experienced promoted their health and wellbeing and enhanced their quality of life.

The ethos of the service was individualised and person centred. Staff used innovative ways to involve people and respond to their needs.

People were encouraged to socialise, pursue their interests and hobbies and try new things in a variety of inspiring and innovative ways.

People were partners in their care and people’s care plans were personalised and comprehensive. They described positive ways in which staff could support each person.

People’s views were actively sought, listened to and acted on. People and relatives knew how to raise concerns, and further actions were taken in response to improve.

Well-led

Outstanding

Updated 18 May 2017

The service was well led.

People received a consistently high standard of care because senior staff led by example and set high expectations about standards of care.

People were partners in the day to day running of the home. Their views, experience and contributions were sought and valued.

Staff understood their roles and responsibilities, and were accountable for their practice, and felt valued and appreciated for their work.

The culture was open and honest and focused on each person as an individual. Staff put people first and were committed to continually improving each person's quality of life.

In pursuit of excellence, the service kept up to date with best practice evidence. They read other services ‘outstanding’ rated CQC inspection reports as a way to benchmark their quality of care and for ideas and innovations.

The provider had robust quality monitoring arrangements through which they continually reviewed, evaluated and improved people's care. These showed the service was consistently high performing.