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Inspection carried out on 7 January 2019

During a routine inspection

Arbor House is a care home for a maximum of 40 people with a range of care needs, including needs associated with ageing, dementia, sensory impairment and physical disabilities. The service is located in Evington Village. The building has two floors and all bedrooms are single rooms. There are a number of communal lounges within the home and one large dining room, although people can eat in smaller rooms if they wish. At the time of our inspection visit, 39 people lived at the home.

At our last inspection we rated the service as ‘good’. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service continued to be safe. Staff understood the risks to people’s health and wellbeing and acted to reduce each risk. There were enough staff on duty to meet people’s needs; and checks had been made on staff before working for the service to make sure they were safe to work with people. People received their medicines as prescribed. The home was clean and tidy and staff understood infection control practice. The premises were well-maintained.

The service continued to be effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The principles of the Mental Capacity Act (MCA) were followed. Staff received training to support them to work effectively with people who lived at the home. People had access to different health and social care professionals when required, and good relationships had been formed between the service and those professionals. People received food they enjoyed, and choices with each meal.

The service continued to be caring. People received care from staff who were kind, treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. The service supported people to maintain and develop relationships with their family.

The service continued to be responsive. People’s needs were assessed and staff were responsive in ensuring those needs were met. The activities programme had improved since our last inspection. The small number of complaints had been responded to well. The service ensured people’s end of life care needs were met.

The governance of the service had improved, and it was now well-led. The new registered manager worked hard to ensure a good quality of service was maintained. They provided good support to the staff group, and to people who lived at the home. Checks were made to ensure the service met its obligations to provide safe accommodation to people and to deliver care and support which met people’s individual needs.

Further information is in the detailed findings below.

Inspection carried out on 27 July 2016

During a routine inspection

This inspection took place on 27 July 2016 and was unannounced. We returned on the 28 July 2016 announced to complete the inspection.

Arbor House is a care home that provides residential care without nursing for up to 40 people. At the time of our inspection there were 39 people in residence.

A registered manager was in post. 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.

The provider’s quality governance and assurance systems were not used effectively and consistently to ensure people’s health, safety and welfare. Internal audits carried out were not always completed in full which made it difficult to monitor the quality of service provided. The provider has taken steps to support the service and implement the quality monitoring systems and audits and ensure actions are taken in a timely manner to bring about improvements to the service.

People felt safe at the service and were protected from abuse because staff were trained in safeguarding procedures and understood their responsibility in protecting people from the risk of harm.

People’s care needs were assessed including risks to their health and safety. Care plans were updated and centred on people’s needs, which included the measures to help promote their safety and independence. Care plans provided staff with clear guidance about people’s needs which were monitored and reviewed regularly.

People lived in an environment that was safe and comfortable and had access to a secure garden, which people could use safely. The premises and equipment were routinely serviced and maintained.

Staff were recruited in accordance with the provider’s recruitment procedures. People’s needs were taken into account to ensure there were sufficient numbers of staff to promote their safety and wellbeing. Staff were supported through regular supervisions and meeting to ensure they had the knowledge and skills to support people.

People received their medicines at the right time and medicines were stored safely. People had access to health support and referrals were made to relevant health care professionals where there were concerns about people’s health. People told us they were provided with a choice of meals that met their dietary needs and preferences.

People’s consent had been appropriately obtained and recorded. Staff understood the principles of the Mental Capacity Act and made appropriate referrals to the local authority when people had been assessed as being deprived of their liberty.

People told us staff were caring and showed kindness towards them. People had developed positive relationships with staff and were confident that they would address any concerns or complaint they might have.

People were involved and made decisions about their care and support needs. Care plans were focused on the person and tailored to their needs. People were supported to maintain their independence and take part in hobbies and activities that were of interest to them.

The views and opinions of people who used the service, people’s relatives and staff were sought in a number of ways including meetings and surveys.

Staff felt supported by the management team and understood their role and what was expected of them in providing quality care to people who used the service.