Archived: Arlington House

Updated 23 July 2016

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 is 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 inspection took place on 1 June 2016 and was unannounced. The inspection team included an inspector and a specialist adviser, who had experience of working with people who were living with dementia.

Before the inspection we reviewed the information that we held about the home. This included previous inspection reports, information which had been shared with us by the local authority, and by health care professionals who had involvement with the home. We looked at safeguarding concerns that had been raised and notifications that the provider had submitted. A notification is information about the important events which the provider is required to tell us about by law. The provider had completed a Provider Information Return (PIR). This 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. This helped us to plan so that we looked at relevant areas during the inspection.

During the inspection we spoke with eight people who lived at the home, four visiting relatives, four members of staff, the registered manager, the chef and two visiting health care professionals. We looked at areas of the home including people’s bedrooms, the kitchen, bathrooms, and communal dining room, lounges, conservatory and garden. We spent time sitting with people, talking and observing the delivery of care and support. We observed people receiving their medicines, the lunchtime meal and an organised activity in the afternoon. We reviewed the records of nine people, and 'pathway tracked' three people. This is when we looked at their care documentation in depth and obtained their views. This was an important part of our inspection as it allowed us to capture information about a sample of people receiving care. We looked at a range of records including quality assurance audits, staff records and training schedules and policies and procedures.

The last inspection at Arlington House was in October 2013 when there were no concerns.

Updated 23 July 2016

This inspection took place on 1 June 2016. Arlington House is a care home without nursing that is registered to provide care and accommodation for up to 33 older people. The home is located close to Hove seafront and the building was converted from four terraced houses and has a stair lift, a conservatory and garden. At the time of the inspection there were 25 people living at the home and many of them were living with dementia, some people also had mental health problems.

The home had a registered manager. 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.

People were not consistently supported with meaningful activities. Some people who were living with dementia had little to do to occupy their time, particularly in the morning when staff were busy. There were some organised activities and some people were supported to go out. However people told us they were bored and some people said they would like to go out more often or have more to do in the home.

People spoke highly of the staff and the care they received, one person said, “The staff are really super, the care is fantastic,” and a relative told us “The staff are all nice, but some are really special.” Staff knew the people they were caring for well and spoke about them knowledgeably. People appeared happy and relaxed in the company of staff and told us that they had confidence in them, one person said, “The staff are well trained, they understand my needs and they know exactly what they are doing, I have complete confidence in them.” Staff received regular supervision and their training was up to date. Staff told us they felt well supported within their roles.

People were protected from harm with robust risk assessments by staff who understood their responsibilities with regard to safeguarding procedures. There was an effective recruitment procedure in place to ensure the right sort of people were working in the home, and only staff who were trained and competent were able to give people their medicines. People received support to ensure they had enough to eat and drink and if they were identified as being at risk of malnutrition or dehydration suitable monitoring systems were used to maintain their health. Referrals were made to health care professionals in a timely way when required and people were supported with a range of health care services to maintain good health.

Staff understood the importance of obtaining people’s consent to care and treatment and where people lacked capacity staff acted in line with legislation and guidance to ensure decisions were made in people’s best interests. Staff showed a high regard for people’s dignity and privacy and treated them with respect, one staff member said, “We want people to feel comfortable in their home and they need to know we respect their privacy.” People told us they were included in decisions about their care and support, one person said “I was asked about what I like to do and what was important to me.” Records were personalised and gave a clear sense of the person. People’s preferences, wishes and views were recorded as well as their life history. We saw that staff were aware of this information and that they used it to provide person centred care to people.

People and their relatives told us that the registered manager was approachable and that they felt comfortable raising any concerns or complaints they had. The complaints log showed that issues were recorded and actions were taken to resolve any complaints, people said they felt confident that their concerns were listened to. Regular feedback was sought from people and relatives as well as from staff and professionals who visited the home. The registered manager used this information together with other quality monitoring to make improvements to the service.

People, relatives, staff and visiting professionals spoke highly of the registered manager, saying that the service was well led. One visiting professional said the registered manager was “Receptive to new ideas and very motivated to offer the best for the residents.” Staff described an open culture where practice was discussed and challenged and they received clear guidance and leadership from the registered manager.