Inspection on 12/10/05 for Arthur House

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Arthur House 18/12/08

Arthur House 12/05/06

Arthur House 21/04/05

Arthur House 28/09/04

Arthur House 20/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Arthur House 110 Arthur Road Wimbledon Park London SW19 8AA Lead Inspector Liz O`Reilly Unannounced Inspection 12 October 2005 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Arthur House Address 110 Arthur Road Wimbledon Park London SW19 8AA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208 947 1218 020 8944 5390 arthur.house@craegmoor.co.uk Parkcare Homes Limited Mrs Noreen Cecil-Purvis (nee Goodwin) Care Home 15 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (13) of places Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: Arthur House is a registered care home offering accommodation and care for up to fifteen older people, including up to three people suffering from dementia. This home does not offer nursing care. Arthur House is owned by Parkcare Homes Ltd, a subsidiary of Craegmoor Healthcare. Accommodation is arranged over two floors with a small passenger lift available to access the upper floor. Local shops, cafes, places of worship, parks and other community facilities are close by. Central Wimbledon is within easy reach. No parking facilities are available at the home. Restricted metered parking is available in the surrounding area with rail, tube and bus networks very close by. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 12th October 2005 over five hours. At the time of this inspection nine residents were living at Arthur House. The inspector had the opportunity to speak with six residents and examine a sample of the records held. What the service does well: What has improved since the last inspection? What they could do better: As noted in previous inspection reports the number of care staff on duty in the afternoons is insufficient to meet any social needs of residents who are less independent. The hours worked by the manager should not be included in the care hours. The manager did inform the inspector that plans were being made for a second carer to be on at all times from early next year. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 6 The locks on bedroom doors need to be replaced. The present locks do not allow for staff to get into the room in the event of an emergency should a resident lock their door when they are inside. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Residents are provided with information on the home via the homes’ Statement of Purpose and Service User Guide. The pre admission assessment process ensures that staff are aware of the needs and wishes of individuals prior to their arrival at the home. This home does not provide intermediate care. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide. A copy of the Service User Guide is supplied to each resident. These documents give present and prospective residents information on the home and the service they can expect. At the time of this visit the organisation was in the process of updating these documents. Once completed copies of each document must be provided to the Commission. Before any resident moves into the home staff carry out an assessment of individual needs and wishes. Where a resident is placed via the local authority a copy of the care management assessment is also provided to the home. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 9 These assessments ensure that staff are aware of the needs of any resident before they move into the home and ensures that the home can meet the needs of the person. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Each resident is provided with an individual care plan which sets out individual needs and wishes. Improvements have been made in the care plans seen at this visit. The health care needs of residents are met. Medication is well managed in the home which protects the health and safety or residents. Residents confirmed that staff take care to respect their privacy and dignity. EVIDENCE: Staff have made improvements in the care plans since the last inspection of the home. Plans were seen to include good information on the personal and health care needs of each person along with social interests. Residents or their representatives are requested to provide a brief personal history for the file. This information ensures that staff are aware of the needs and preferences of each person and an understanding of the past experiences of the residents in their care. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 11 Care plans are complied in consultation with residents and or their representatives. Each care plan seen had been signed by the resident or their representative. Staff are provided with written guidance on the daily routine in the home which also includes some of the basic needs and wishes of individual residents such as who generally likes to take their breakfast in bed, who likes to take their meals in the lounge and who needs assistance with their mobility. This document clearly states that it is guidance and is subject to changes however this information is useful, particularly to new staff. Arrangements are in place for residents to receive regular health care checks. Each resident is registered with a local GP of their choice. District nurses will visit the home if required. Arrangements are in place for optical, dental and chiropody services to be provided either in the home or in the community. Residents are free to make their own arrangements for health care checks. Medication was found to be well managed in the home. At the time of this visit one resident was holding and administering their own medication. Risk assessments were in place and regular checks are carried out to ensure the health and safety of any resident who is self medicating. Staff who administer medication have taken part in accredited training on the management of medication. The records of administration of medication were found to be well maintained. Medication was seen to be safely stored. Residents confirmed that staff were careful to protect their privacy when assisting with personal care. Staff were seen to offer assistance in a discreet manner. Residents also confirmed that they meet with health care professionals, friends and relatives in the privacy of their own room. Staff were seen to knock on bedroom and bathroom doors before entering. Two residents hold a key to the front door. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 15 Residents confirmed they have the opportunity to make their own choices in relation to food, activities, religious observance and social relationships. As noted in previous inspection reports further work should focus on individualised activities for those residents who are less independent. Residents were very complimentary on the quality and quantity of food on offer in the home. EVIDENCE: Staff support residents who wish to do so attend local places of worship. One resident regularly attends a local day centre. Residents are encouraged to continue with their individual interests within and outside the home. Activities in the home include a weekly music and movement class and visits from an aromatherapist. The home arranges parties to celebrate a variety of events to which friends and families are invited. As noted previously the individual care plans have been improved by the inclusion of more information on the individual interests of residents. It was noted in the last inspection report that the low staffing levels in the afternoons restricted the opportunities for staff to engage in one to one activities with those residents who are less independent. At the time of this visit the manager informed the inspector that plans were in place for additional staff to be available in the afternoons from the beginning of next year. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 13 Residents made very positive comments on the food provided. Comments included :- “the food is lovely here”, “the meals are very nice”, “ I enjoy my food”. Residents confirmed that meal times can be flexible to take into account their activities and preferences. Residents said they could take breakfast in bed and could have their meals in their rooms if they wanted to. Residents discuss the menu at regular meetings and when changes are made the new menu is provided to each resident for their comments. Information is kept in the kitchen on the particular preferences of individual residents to ensure that staff are well informed and do not need to keep asking residents about their wishes. The menu showed a good variety of meals on offer with alternatives available at each meal time including a vegetarian choice. Residents stated they enjoyed the roast dinners which were provided twice a week and the soup which is offered each evening. Residents said they had “plenty to eat” and that they could have a snack at any time. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents expressed confidence in the staff to deal with any complaint or concern they may have. A clear complaints procedure is in place. Staff training and procedures are in place for the protection of residents from abuse. EVIDENCE: The complaints procedure is on display in the home. The manager maintains a record of any complaint with information on actions taken and outcomes. This record showed that staff report complaints and are open to improving the service. None of the residents spoken to had any complaints or concerns about the home. Residents felt that if they had a complaint they would speak to the home manager who they had confidence in to deal with any issues. All staff are provided with training on the protection of vulnerable adults. The home has a copy of the local authority procedures to be followed should there be any allegation or suspicion of abuse. At the time of the last inspection a review of the homes’ policies and procedures in relation to the protection of vulnerable adults was to take place. This review has not been completed. A copy of the updated documents must be provided to the Commission once completed. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 & 26 The majority of the home is well maintained. Certain areas, particularly bathrooms and windows are in need of refurbishment. An assessment of the home has been carried out by an occupational therapist. Residents are provided with a comfortable lounge and a small very well maintained garden. The home was found to be clean and tidy. EVIDENCE: Residents are provided with a communal lounge on the ground floor. This room is comfortably furnished and was seen to be well used by residents. There is a small garden to the rear of the home with seating and raised beds. Three residents spoken to said they enjoyed sitting out in the garden. An assessment of the premises has been carried out by an occupational therapist to ensure that the appropriate aids and adaptations are in place for residents. A copy of the report has been supplied to the Commission. The Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 16 registered persons must confirm that any recommendations made will be implemented. At the time of the last inspection it was noted that the bathing facilities in the home were in need of updating. The manager informed the inspector that the refurbishment of the bathrooms on the ground and first floor had been booked and would be carried out in the near future. A rolling programme for the replacement of windows around the home has now been set up. The kitchen for the home is also to be refurbished. Once completed these changes will improve the environment and facilities available to residents. At the time of the last inspections the home had significant problems with the hot water supply throughout the home. Action has been taken to remedy these problems. However it was noted that problems were still being experienced in two of the bedrooms. The registered persons must confirm to the Commission that further action has been taken to ensure the supply of adequate hot water in all areas of the home. As noted in the previous inspection report a height adjustable sink should be installed to allow residents to have their hair washed in a more comfortable manner. A rolling programme needs to be commenced to replace the locks on the bedroom doors. The present locks do not allow for staff to access rooms in the event of an emergency. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 For the majority of the day sufficient staff are available in the home. Between the hours of 1pm and 5pm Monday to Friday, the staffing levels and insufficient to meet the personal and social care needs of the resident group. Staff have increased their skills and knowledge by taking part in NVQ training. Residents benefit from a staff team who have good opportunities for training. EVIDENCE: Two care staff are on duty in the mornings and in the evenings. One member of staff is available awake during the night with a second person sleeping on the premises who can be called on for assistance. During the hours of 1pm and 5pm Monday to Friday when the manager is on duty only one carer is on duty. The staffing levels at this time are not sufficient to meet the needs of the resident group. This issue has been the subject of a requirement from previous inspections and remains outstanding. The manager informed the inspector that action was being taken to ensure that two carers will be available in the home throughout the day as from January of next year. The registered persons must confirm to the Commission that this requirement will be met. Two staff have completed NVQ level two, one member of staff has completed NVQ level three and two members of staff are commencing level two training. Staff are provided with good opportunities for training which ensures that residents are cared for by a well informed staff group. Recent training has Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 18 included ; first aid, the protection of vulnerable adults, fire safety, food hygiene, dementia care and manual handling. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 & 38 Residents benefit from a well managed home. Further work needs to be done to ensure that the views of residents are included in an annual review of the home. Work has started on the staff supervision system which will make sure that residents are cared for by a well supported and well informed staff group. Staff make regular checks on the home and equipment to ensure the health and safety of residents. EVIDENCE: Residents made positive comments on the manager of the home. The manager was viewed as approachable and to be available to residents. One resident stated that the manager “is always there if you need her” another resident said that the manager “works very hard for us”. Records showed that the manager is provided with regular training to update and develop their knowledge and skills. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 20 The organisation needs to further develop the quality assurance and monitoring systems to ensure that residents, relatives, friends and other professionals connected with the home are consulted as part of an annual review of the service. The results of residents surveys must be published, an annual development plan must be produced with a copy of the report supplied to the Commission. In order to maintain a consistent, quality service to residents staff are provided with regular one to one supervision. It was noted that the documentation supplied by the organisation for staff supervision provided very little space for the recording of discussion on aspects of practice, the philosophy of the home and the career development needs of the member of staff. The manager will need to consider in consultation with their line manager how these main aspects of supervision will be recorded. Regular checks are carried out on the home and equipment to ensure that health and safety of residents. Staff receive training in first aid, food hygiene and moving and handling. Suitably stocked first aid boxes are available. Weekly checks are carried out on the fire alarm system with regular fire drills to make sure that all staff are aware of what action to take should the fire alarms by activated. Regular maintenance checks are carried out on equipment in the home. The manager keeps a record of any accidents in the home along with details of any actions taken and outcomes. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 2 3 X 2 X 3 STAFFING Standard No Score 27 2 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 3 X 3 Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 1 Regulation 4&5 Requirement The Registered Persons must ensure that copies of the updated Statement of Purpose and Service User Guide are provided to the Commission. The Registered Persons must supply a copy of the updated policy and procedure in relation to the protection of vulnerable adults to the Commission. (timescale of 01.08.05 not met) The Registered Persons must provide written confirmation that the repairs required to the bathrooms in the home have been completed. The Registered Persons must provide written confirmation that any recommendations made following the assessment of the home by the occupational therapist have been implemented. The Registered Persons must confirm in writing that the necessary repairs have been carried out to the hot water system and that all bedrooms are supplied with sufficient hot water. The Registered Persons must DS0000027218.V262950.R01.S.doc Timescale for action 10/01/06 2 18 13(6) 10/01/06 3 19 & 21 23 (2) 10/01/06 4 22 23(2)(n) 10/01/06 5 19 & 25 23(2)(j) 13(3) 13(4)© 10/01/06 6 24 13 & 10/01/06 Page 23 Arthur House Version 5.0 12(4) 7 27 18(1)(a) 8 33 24 carry out a rolling programme to replace the locks on bedroom doors to ensure that staff can access rooms at any time in the event of an emergency whilst respecting the privacy of residents. The Registered Persons must ensure that sufficient care staff are on duty at all times to meet the health, welfare and social needs of residents. The Registered person must ensure that an annual review of the quality of care provided at the home is carried out. A copy of the report in respect of the review must be supplied to the Commission. The results of residents surveys must be published and made available to current and prospective residents. (timescales of 01/02/04 and 01/08/04 not met) 10/01/06 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 22 Good Practice Recommendations The Registered Persons should consider the instalment of an adjustable height basin with shower attachment for hairdressing. Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Arthur House DS0000027218.V262950.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!