Inspection on 18/12/08 for Arthur House

This inspection was carried out on 18th December 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Arthur House 12/05/06

Arthur House 12/10/05

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 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Arthur House 110 Arthur Road Wimbledon Park London SW19 8AA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elizabeth OReilly     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Arthur House 110 Arthur Road Wimbledon Park London SW19 8AA 02089471218 02089445390 arthur.house@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Parkcare Homes Ltd care home 15 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 15 0 The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Arthur House is a registered care home offering accommodation and care for up to fifteen older people. 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. Care Homes for Older People Page 4 of 28 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was carried out by one Regulation Inspector and included a visit to the service on 18th December 2008. The inspector had the opportunity to speak with five people who use the service, two care staff, the cook and the manager. Five completed surveys were returned to us by people who use the service. The manager completed an assessment of the service (AQAA) which detailed the service provision, improvements made over the last twelve months and areas where improvements could be made. We have used information from all of the above sources as well as our own observations to reach the judgements made throughout this report. Care Homes for Older People Page 6 of 28 Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get Care Homes for Older People Page 8 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before anyone moves into the service a full assessment of their individual needs and preferences is carried out. This information is used to make sure that this is the right place for them and provides staff with information on the person from day one of their stay. People who use the service feel they were provided with enough information on what they could expect before they moved in. The presentation of the Service User Guide could be improved, expanded and be made more easily accessible. This service does not provide intermediate care. Evidence: People who use the service told us they were very happy here and described the service they received as excellent. Five people who use the service returned completed surveys and they all said they had been given enough information to make the decision about moving in. A copy of the Service User Guide is given to each person Care Homes for Older People Page 11 of 28 Evidence: who uses the service. This document provides basic information on the service. People who use the service confirmed they were given a contract which sets terms and conditions. A copy of the contract was seen on file. We looked at the information available for one person who had moved in approximately eight weeks ago. The files showed that pre admission assessments had been carried out and that staff had taken time to find out the things and people which were important to the person as well as their physical needs. This information along with a short family history assists staff in tailoring the support provided and viewing the person as an individual. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff produce care plan for each person using this service. Care plans are person centred and provide good information on the needs and wishes of each individual along with details of how staff will support the person to meet these needs. The needs of individuals and the effectiveness of the support provided are re evaluated on a regular basis. The health care needs of people who use the service are met. Medication is well managed and safely stored. Evidence: People who use the service told that they always receive the care and support they need. One person described the care provided as excellent. Another person stated that they cant fault the excellent care received since they moved in some years ago. One person told us the staff know my needs. We looked at a sample of care plans and found examples of excellent care planning. Individual needs, wishes and preferences are noted along with detailed information for Care Homes for Older People Page 13 of 28 Evidence: staff on how people should be supported. Staff have taken time to gather good information on the past history and experiences of each individual where possible. Records showed that staff are reviewing care plans carefully, recording what has worked well for the person and making adjustments to the way support is given where needed. Care planning is person centred and places as much emphasis on meeting the social, cultural and emotional needs of the person as their physical needs and wishes. The manager informed us that care plans are compiled in consultation with the individual concerned and or their representatives. We did not see evidence of this on the records we looked at. However one person we spoke to confirmed that staff had spoken to them about this. Risk assessments are carried out to a very good standard and address the risks relevant to the individual. We saw that these were also reviewed on a regular basis by staff. Everyone who competed a survey felt they received the medical support they needed. The service has good relationships with local health care services and individuals are supported to attend appointments. Records showed that staff monitor the health of individuals and contact GPs, community nurses or consultants when needed. We observed staff providing support to individuals in a considerate and discreet manner. The privacy of individuals was seen to be protected. All staff who administer medication have received accredited training. We looked at a sample of medication records. These were found to be well maintained, up to date and accurate. We observed staff administer medication in a safe manner. Medication is stored appropriately. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have the opportunity to take part in a variety of activities. Staff understand the importance of engaging people, maintaining skills and offering informed choices. Improvements could be made with the provision of more person centred activities and occupation in the service. Consideration should be given when appropriate to offering stimulation through tactile or visual aids. The food provided is varied and people who use the service enjoy their meals. Evidence: People who use the service and staff told us that a weekly music and movement class is held in the lounge and an aromatherapist visits to give massages on a regular basis. Individuals go out to a lunch club in the community and two people attend services and activities at a local church when they wish. Arrangements are made for representatives of religious centres to visit the service when requested. Individuals go out to the local shops and for trips and meals with family and friends. One person who uses the service told us that the care they receive includes support and conversation. At the time of this visit people informed us that they had recently had a Christmas party and a play had been performed. We saw that people have access to newspapers, magazines, books and a variety of games. Care Homes for Older People Page 15 of 28 Evidence: During our visit to the service we saw that the majority of people spent the afternoon in their room with only one or two people using the main lounge area. We were informed that two people who use the service spend all of their time in their room, one person is cared for in bed and one person is unable to spend time with other people in the lounge. We observed that one person who spends most of their time in their room had very little to stimulate them while on their own. We observed this person using their food to provide some stimulation. People who use the service who completed surveys gave mixed responses when asked if there were activities available which they could take part in. These ranged from always to rarely. Both care staff and the manager informed us that they felt the service could improve the activities on offer. The manager informed us that additional staffing hours would be used to provide a more varied activity programme. Staff have gathered very good information on the likes, dislikes and previous interests of individuals which has been included in the care planning. People who use the service enjoy the food on offer. In surveys one person said they usually enjoy their meals all the others said they always enjoy the food. People we spoke to told us the food is very good and quite enough for me, I enjoy the excellent meals served and the food here is first class. Everyone we spoke to felt they had plenty to eat and staff confirmed that they can make sandwiches and snacks at any time. Consideration should be given to providing the menu in a variety of formats including photographs. Visitors to the service told us they were made to feel welcome by staff and that staff were always available to answer questions. We spoke with the cook who has a very good understanding of individual preferences and diets. The menu is on display in the service and is changed seasonally. People who use the service are consulted whenever the menu is changed. The cook does make adjustments when it is clear that certain meals are no longer popular. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are confident that complaints or concerns are listened to and acted upon. Staff are provided with regular training on safeguarding adults and the service understands the procedures to be followed to safeguard people. Evidence: People who use the service told us they know who to speak to if they have a complaint. Everyone is provided with a copy of the complaints procedure and is also on display in the service. One person told us that if they had any problems they are dealt with by talking to the staff or manager. Systems are in place to record any complaint received along with details of any actions taken and outcomes. The service has received no complaints over the last twelve months. The manager also records any concerns brought to her attention which assists in reassuring individuals that they are listened to and action is taken . Records showed that staff receive training on safeguarding people. Staff told us that this area was also covered in their induction training. Staff have a good understanding of their responsibility to report any allegations or suspicions of abuse. The service reports any allegations or suspicions of abuse to the local authority as well as their own organisation. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are provided with a comfortable, homely environment. A rolling programme for re decoration and up grading ensures that the building is well maintained. All areas of the service are kept clean and fresh. Evidence: People who use the service told us that the environment is always clean and fresh. Comments included I find the home very clean and homely, and always extremely fresh and clean. All areas of the building seen during this inspection were clean and free from offensive odours. People told us they liked their bedrooms. We saw that individuals had been encouraged to bring to the service their own things, including furniture to personalise their room. The manager informed us that over the last twelve months improvements have been made to the kitchen and bedrooms have been redecorated. New dining room and garden furniture have been purchased. The lounge has been fitted with a new wide screen television and a hairdressing basin has been installed. Care Homes for Older People Page 19 of 28 Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service express high levels of satisfaction with the approach and attitude of the staff group. The service places a high level of importance on training and staff reported that they are supported to take part in a variety of training sessions. The variety and levels of training could be developed further. The service takes care to carry out checks on staff before they start work to ensure the safety of people who use the service. Evidence: People who use the service and their relatives told us that staff were very helpful and friendly, very attentive and caring. Staff were also described as excellent. Everyone who completed a survey said that staff always listen to them and act on what they say and that there are always staff available when they need them. One person told us that staff were never not around and that there was excellent continuity of staff. Staff told us they were given good opportunities to take part in training courses. Records showed that staff are provided with training on statutory courses such as health and safety. Regular refresher training is provided which ensures that staff keep up to date with good practise. A list of forthcoming training included infection control, Care Homes for Older People Page 21 of 28 Evidence: dementia, manual handling and food hygiene. We noted that staff did have the opportunity to take part in training on dementia but that these courses lasted only four hours. Consideration should be given to providing more courses which relate to the support needs of people who use the service. Consideration should also be given to staff having the opportunity for more in depth training. The majority of staff have completed NVQ training relevant to their role in the service. One person we spoke to had received their level 2 certificate that day and the cook informed us that he had completed NVQ training in hospitality and catering. All new staff follow a structured induction programme during their first few weeks. Staff informed us that they felt this was a useful and comprehensive course. We looked at a sample of staff files. We found the appropriate checks, including Criminal Records Bureau checks are carried out before anyone starts work in the service. This assists in safeguarding people who use the service. Sufficient staff were seen to be available to meet the needs of the present people using the service. Staff informed us that there were always enough staff on duty and visitors told us they never felt the service was short staffed. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service benefit from a well managed establishment. The manager has a clear understanding of the needs of the individuals who use the service and the skills and knowledge of individual staff members. The manager ensures that all staff are trained in health and safety matters and records show regular checks are made to protect people who use the service, staff and visitors. Evidence: Individuals made positive comments about the way the service is managed. People who use the service told us that if they had any problems or concerns they could speak to the manager. The manager was described as very good, approachable and a kind person. Visitors to the service commented on the accessibility of the manager or a senior member of staff to answer any questions when they arise. Staff told us they feel well supported in their work by the manager. Care Homes for Older People Page 23 of 28 Evidence: Systems are in place for consultation through meetings with people who use the service and or their representatives. The last meeting was held in May 2008 and the manager informed us that further meetings were not carried out due to sickness. More frequent meetings are planned for this year. The organisation carries out regular surveys and audits to make sure that people are receiving a good quality service. We looked at a sample of the records kept of the health and safety checks carried out. Staff make weekly checks of the fire alarm system. Fire drills are carried out throughout the year to ensure that staff know what to do should the fire alarms be activated. Staff are checking and recording the temperature of the water before helping people into a bath which reduces the risk of scalding. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Consideration should be given to increasing the information provided, the presentation and accessibility of the Service User Guide. A review of the activities on offer should be carried out to ensure that they meet the needs and wishes of people who use the service. Consideration should be given to providing a more person centred activities and occupation programme. Key staff should be provided with training on engaging people in meaningful daily living activities. Consideration should be given to producing the menu in other formats. To further develop the service consideration should be given to improving access to training relating to the needs of people using this service. Consideration should also be given to providing more in depth training on these issues, such as supporting people living with dementia and engaging people in meaningful occupation. More frequent meetings with people who use the service and their representatives should be carried out to ensure Page 26 of 28 2 12 3 12 4 5 15 30 6 32 Care Homes for Older People everyone has the opportunity to affect the way in which the service is given. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!