24 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 15 September 2018 and was unannounced. One adult social care inspector carried out this inspection. Prior to the inspection, we reviewed the information we held about the home, including notifications of events the service is required by law to send us. We also reviewed the provider information return (PIR) which is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We did not, on this occasion, conduct a SOFI. SOFI (Short Observational Framework for Inspection) is a specific way of observing care to help us understand the experience of people who are unable to talk to us. This was due to the three people present in Arthur at the time of our inspection going in and out of the home regularly and spending time in their bedrooms. Three people had gone away to visit their relatives for the weekend. We used the principles of SOFI when conducting our observations around the home.
We spent time with all three people who were living in Arthur on the day of our inspection. We were unable to verbally communicate with people but spent time observing their interactions with staff to best understand their experiences. We spoke with three members of staff on the day of our inspection and received feedback from a further three. We spoke with the registered manager and the day to day manager. The day to day manager was in the process of applying to the CQC to become the new registered manager. We also received feedback from two relatives. We requested feedback from a number of external healthcare professionals but did not receive any responses.
We looked around the home and spent time with people in the lounge. We observed how staff interacted with people throughout the inspection and spent time with people over the lunchtime period.
We looked at the ways in which medicines were recorded, stored and administered to people. We also looked at the way in which meals were prepared and served.
We reviewed in detail the care provided to three people, looking at their files and other records. We reviewed information about the recruitment and supervision of three staff members and other records relating to the operation of the service, such as risk assessments, complaints, accidents and incidents, policies and procedures.
24 October 2018
Arthur is a residential care home providing personal care for up to seven people. Nursing care is not provided at the home. This is provided by the community nursing service. At the time of our inspection there were six people living in Arthur.
At the last inspection in February 2016 the service was rated Good overall. 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.
Why the service is rated Good.
Dame Hannah Rogers Trust is a charity organisation which provides both children and adults with safe, effective, compassionate and high-quality care from a number of sites in south Devon. Arthur was run by Dame Hannah Rogers Trust and provided care to young adults who had access to the Trust’s facilities and activities.
The people who lived in Arthur had a wide variety of needs and health conditions. All the people living in Arthur at the time of our inspection were young adults with learning disabilities and complex physical disabilities. Some people required more significant support than others and most were wheelchair users. The people who lived in Arthur were provided with high quality, safe, caring, person centred support which was responsive to their needs. People received highly personalised support and there was a clear understanding of seeing each person as an individual, with their own social needs.
The service focussed on wellbeing and ensuring people had a sense of purpose and enjoyment. The care service had been developed and designed in line with the values that underpin “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 could live as ordinary a life as any citizen.
Staff demonstrated to us they cared strongly about people’s wellbeing in every aspect of their lives and worked towards improving each person’s happiness and wellbeing. Staff promoted people’s equality, diversity and ensured their human rights were upheld. Staff spoke confidently to us about how they fought for people’s rights and gave us examples which demonstrated they put people’s individuality and personal wishes before all else.
Staff received thorough training in all areas relating to people’s individual health needs and holistic activities. Staff also received support from external healthcare professionals to best care for people. People were encouraged to socialise, pursue their interests and hobbies and try new things in a wide variety of innovative ways. For example, one person was supported to create their own celebrity fashion page in the organisational newsletter as this was an interest of theirs.
People were involved in all aspects of their care and were supported by staff to communicate their wishes, likes, dislikes and decisions. People were supported through the use of verbal communication, pictorial forms and electronic aids.
People were protected from risks relating to their physical and mental health and possible abuse. Staff had assessed individual risks to people and had taken action to seek guidance and minimise identified risks. Staff knew how to recognise possible signs of abuse.
Recruitment procedures were in place to help ensure only people of good character were employed by the home. Staff underwent Disclosure and Barring Service (police record) checks before they started work. Staffing numbers at the home were sufficient to meet people’s needs. Staff received regular supervision and appraisal. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and put this into practice.
Staff treated people with respect and kindness. There was a warm and pleasant atmosphere at the home where people and staff shared jokes and laughter. Staff knew people and their preferences well. People were supported to have enough to eat and drink in ways that met their needs and preferences. Meal times were social events and people were supported individually to ensure their specific needs around food and drink were met.
Where accidents and incidents had taken place, these had been reviewed and action had been taken to reduce the risks of reoccurrence. Staff supported people to take their medicines safely and staffs’ knowledge relating to the administration of medicines was regularly checked. Staff told us they felt comfortable raising concerns.
People, relatives, staff and healthcare professionals were asked for their feedback and suggestions in order to improve the service. There were systems in place to assess, monitor and improve the quality and safety of the care and support being delivered.
Further information is in the detailed findings below.