Arrowsmith Lodge Rest Home

Arrowsmith Lodge Rest Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Arrowsmith Lodge Rest Home provides accommodation and care and support for up to 35 people, including people living with dementia. The service does not provide nursing care. There were 24 people accommodated in the home at the time of the inspection.

Arrowsmith Lodge Rest Home is an extended detached property which is situated in a residential area of Houghton on the outskirts of Bamber Bridge, Preston. There are a range of amenities close by including a bus link to Preston and Bamber Bridge village centre. Accommodation is provided on two floors with a passenger lift and chair lift access. Car parking is available for visitors and staff.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection carried out on 19 and 20 July 2017, the service was rated as 'Requires Improvement'. We found four breaches of the regulations in respect of risk management, safe recruitment and a lack of effective monitoring systems and a continued breach in relation to people's needs not being recorded clearly. This was the second occasion the provider had failed to meet the regulations as they were also rated as requires improvement in July 2016.

At this inspection, we found the rating had improved to 'Good'.

Monitoring of the service had improved. Effective quality assurance and auditing processes helped the provider and the registered manager to identify and respond to matters needing attention. The management team were aware further improvements were needed and there was a plan in place to support this. There were systems to obtain the views of people, their visitors and staff. People felt their views and choices were listened to.

Recruitment procedures had improved. A safe and robust recruitment procedure was followed to ensure new staff were suitable to care for vulnerable people. Arrangements were in place to make sure staff were trained and competent. We observed people's calls for assistance were promptly responded to but we received mixed views in relation to the availability of staff. Following the inspection, we were told action had

been taken to improve the staffing numbers.

Records relating to people's care and support had improved. The information in people's care plans was sufficiently detailed to ensure they were at the centre of their care. People's care and support was kept under review and, where possible, people were involved in decisions about their care. Risks to people's health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people's needs changed.

People's medicines were managed in a safe manner. People had their medicines when they needed them. Staff administering medicines had received training and supervision to do this safely.

The home was clean, safe and comfortable although further improvements were needed to provide a pleasant environment that was suitable for people living with dementia. There was a plan in place to ensure improvements were ongoing. Appropriate aids and adaptations had been provided to help maintain people's safety, independence and comfort.

People were happy with the personal care and support they received. They told us they felt safe in the home and that staff were caring. Staff understood how to protect people from abuse. People told us they did not have any complaints and knew how to raise their concerns.

Where possible, people were supported to have 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. Staff respected people's diversity and promoted people's right to be free from discrimination.

People had access to a range of activities both inside the house and in the local community. People living in the home, their visitors and staff told us this felt this could be improved. People were given a choice of meals and staff knew their likes and dislikes. We discussed how the dining experience could be improved for people. People's nutritional needs were monitored and reviewed and appropriate professional advice was sought when needed.

The five questions we ask about services and what we found