Archived: Arnold House

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. People using the service lived in their own rooms within four smaller flats with a communal kitchen, living room and a garden.

At the last inspection on 24 May 2016, the service was rated Good overall and Requires improvement in Well led because the provider had not supported staff by carrying out regular supervisions. At this inspection we found that the provider had made the required improvements and was compliant with regulations. However, we also found that improvements were required in that systems to monitor the quality and safety had not identified that fire risks assessments reviewed on a yearly basis to minimise the risk of fire were not carried out by an expert.

At this inspection there was a registered manager who had been registered with the Commission since April 2016. 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.

There were appropriate safeguarding procedures in place to protect people from the risk of abuse. Staff understood the different types of abuse and knew to who contact to report their concerns. Risks were assessed and identified and appropriate risk management plans were in place. Medicines were safely managed and people were protected from the risk of infection. There were systems in place for monitoring and investigating accidents and incidents. There were enough staff deployed to meet people’s needs and the provider followed safer recruitment practices.

Staff completed an induction when they started work and were supported through a programme of regular training and supervisions to enable them to effectively carry out their roles. People's needs were assessed prior to moving into the home to ensure their needs could be met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. We saw staff asking for people’s consent before offering support. People were supported to have enough to eat and drink and were offered a choice. People had access to healthcare professionals when required to maintain good health and the service worked with them to ensure people received the support they needed. The environment had been adapted to meet people’s needs.

People told us they were treated with kindness and that staff respected their privacy and dignity. People had been consulted as far as possible about their daily care and support needs. People were supported to be independent wherever possible. People were provided with information about the service when they joined in the form of a 'service user guide' so they were aware of the services and facilities on offer. The provider supported people when they moved between services through effective communication to ensure their care and support were coordinated well.

People’s support plans were reviewed on a regular basis and were reflective of their individual care needs. There was a range of appropriate activities for people to partake in if they wished to. Information was available to people in a range of formats to meet their communication needs. Staff had completed equality and diversity training and said they would support people according to their individual diverse needs. People were aware of the home’s complaints procedures and knew how to raise a complaint. Where appropriate people had their end of life care wishes recorded in care plans.

Regular staff and residents' meetings were held where feedback was sought from people. Staff were complimentary about the manager and the home. Resident and relatives’ annual surveys had been carried out and people views taken into account.

The provider worked in partnership with the local authority and other external agencies to ensure people’s needs were planned and met. The manager was knowledgeable about the requirements of a registered manager and their responsibilities about the Health and Social Care Act 2014. Notifications were submitted to the CQC as required. There was a clear ethos of providing good quality person centred care at the service. Staff said they enjoyed working at the service and they received good support from the registered manager.

Arnold House is a residential home for up to twenty adults with learning disabilities. At the time of our inspection there were seventeen people using the service.

There was a registered manager in place at the time of our inspection. 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.

Records showed that supervision did not take place regularly in line with the provider’s policy and this required improvement.

Medicines were managed, stored and administered safely. Staff had completed medicines training and the home had a clear medicines policy in place which was accessible to staff. There were regular medicine audits in place.

The home maintained adequate staffing levels to support people both in the home and the community. Policies and procedures relating to safeguarding people from harm were in place and accessible to staff. Staff had completed training in safeguarding adults and knew how to raise safeguarding concerns.

Risks to people using the service were assessed reviewed, recorded and managed appropriately. Risk assessments contained guidance on how to mitigate risks to people using the service.

Staff received annual appraisals of their work and were supported to access appropriate training specific to their roles.

We saw friendly, caring and supportive interactions between staff and people and staff knew the needs and preferences of the people using the service. People were treated with dignity and respect.

People’s capacity and rights to make decisions about their care and treatment where appropriate were assessed in line with the Mental Capacity Act 2005 (MCA 2005). These safeguards are there to make sure that people are receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.

People were supported to eat and drink. People were involved in planning their weekly menus and were supported to prepare their own meals. People were supported to maintain good health and have access to healthcare services when they needed them.

People received personalised support to meet their individual needs, and people's support plans reflected their views and preferences .

People’s concerns and complaints were investigated and responded to in a timely and appropriate manner. There was evidence that regular compliance audits took place and issues identified were actioned appropriately. The registered manager was seen to be accessible to people, and staff spoke positively about the support available to them.

We found that people were involved in making decisions about their care and treatment. People needs had been assessed with relevant risk assessments and action plans in place to mitigate any risk. There were policies and procedures in place to safeguard vulnerable adults. We found that support was in place for staff through induction, training, supervision and team meetings. The provider had appropriate plans in place to monitor the quality of the service through surveys and audits.

On our visit we found that people were treated with respect and dignity, were involved in their care and appropriate risk assessments had been undertaken for various aspects of care delivery. There were appropriate number of staff and they were suitably trained. The care plans were maintained adequately.