Arcot House Residential Home

Updated 2 April 2020

The inspection

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.

Inspection team

The inspection was carried out by one inspector and one assistant inspector.

Service and service type

Arcot House Residential 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 on the first day.

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 12 people and three relatives about their experience of the care provided. We observed how people were spending their time and the interactions between them and the staff team. We spoke with nine members of staff including the registered manager, assistant manager, deputy manager, senior care workers, care workers, domestic, activity co-ordinator and the chef. We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three 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 received feedback from a further four relatives by email. We also received feedback by email from nine staff including staff ambassadors for dignity, safeguarding, continence, hydration, staff well being, oral care and Parkinson’s disease. We also received feedback from the hairdresser, activity co-ordinator, the local authority quality assurance team, community speech and language therapist and a GP.

Updated 2 April 2020

About the service

Arcot House Residential Home provides personal care and support for up to 23 people aged 65 and over. The home does not provide nursing care. The home is a grade two listed Georgian manor house set in lovely gardens. At the time of the inspection there were 17 people living there.

People’s experience of using this service and what we found

Those people who used the service expressed unreserved satisfaction and spoke highly of all staff and services provided. Comments included, "It’s the little things and attention to detail that always make a big difference” and “[Person’s name] is [over 100] and in better health than when they came here five years ago. The attention to details, the care provided and the communication is second to none. Staff are always attentive and welcoming. It’s a huge relief [person’s name] lives in such an outstanding care home.”

People and their relatives agreed the service was safe saying, “We are completely confident in their care. We know they are safe at Arcot.”

Risks were assessed and extremely detailed plans put in place to keep people safe. Staff and people worked together, regularly reviewing risk and balancing risk with independence so people could live their best life. The provider over recruited to ensure there were enough staff to safely provide care and support to people, including monthly one to one sessions for people with their keyworkers.

Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed. People were protected by the home's infection control policy and procedures.

The service provided an extremely effective service, taking into account small details to ensure people felt as well as they could and maintained mobility and independence. Training and development was based on research and best practice guidelines to enhance quality and safety of the service provision. Staff felt constantly supported, valued and praised. They told us, "We all strive to give outstanding care. It makes us so proud. Who wouldn’t want to work here” and “I’m so happy to have the opportunity to spend time with the people here. I love it.”

People continued to receive a nutritious, healthy diet that met individual preferences in an extremely personalised, sociable way. Staff all aimed to ensure people ate well and enjoyed their meals, including having fun trying out new foods.

The home was decorated and maintained to a very high standard whilst maintaining a homely feel. People were consulted about the adaptation and design of their home and new extension and choice and preferences were respected. There were various areas to enjoy activities, events and personal private time. The service had been creative in developing areas of the home that would enhance people's wellbeing, such as hair salon, art therapy room and nail bar.

The service was exceptionally caring and put people at the heart of everything they did. People told us, “I think everyone’s wonderfully friendly and caring, staff sat with [person’s name] the other day when she was unwell, it's a very friendly atmosphere here, it's special.” People were relaxed, comfortable and confident in their home. People were valued, had key workers they had become friends with and often had meaningful roles in household chores, received training and held ambassador roles.

Staff had an excellent awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that people's life experiences remained meaningful. The commitment of the staff was excellent. They told us, “We are building up a good trusting relationship and [person’s name] is talking more. Today I've discovered we've both got a love of the lake district, we talked all about the walks and rocks, next time I’ll find a book we can look at together.”

The service was exceptionally responsive to people's health and social needs. People received extremely person centred care and support. Relatives told us, “[Staff name] is our care plan lead. She's superb, it's like a family really.”

Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing.

People were offered a vast array of activities both at the service and in the local community. People, staff and relatives all came together as a community and built friendships.

The whole team were proud and privileged to support people with end of life care.

People benefitted from a service that was very well led. The provider, registered manager, deputy and staff team maintained a clear focus on continually seeking to improve the service people received. Staff told us the registered manager led by example and they had tremendous respect for her and their commitment.

Everyone demonstrated strong values and, a desire to learn about and implement best practice throughout the service. Good quality assurance systems were in place and based upon regular, scheduled audits, which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was outstanding in all areas. (published 18 May 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.