Inspection on 28/03/09 for Arthur`s Court

This inspection was carried out on 28th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arthur`s Court 29/12/09

Arthur`s Court 13/02/08

Arthur`s Court 21/08/07

Arthur`s Court 21/11/06

Arthur`s Court 18/07/06

Arthur`s Court 31/01/06

Arthur`s Court 14/06/05

Arthur`s Court 25/02/05

Arthur`s Court 14/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Arthur`s Court 27 Highfield Road Street Somerset BA16 0JG     The quality rating for this care home is:   two star good 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: Shelagh Laver     Date: 2 8 0 3 2 0 0 9 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 23 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Arthur`s Court 27 Highfield Road Street Somerset BA16 0JG 01458442319 01458447254 AC1Europeancare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): European Care (UK) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 40 Number of places (if applicable): Under 65 Over 65 40 0 old age, not falling within any other category physical disability Additional conditions: 0 40 Persons of either sex, not less than 60 years, who require general nursing care Places for up to 30 clients for nursing care Places for up to ten clients for personal care Registered for a total of 40 places in categories OP and PD Up to four persons in the age range 18-59 years who require general nursing care Date of last inspection Brief description of the care home Arthurs Court is an established care home providing nursing and personal care for up to 40 service users. The care home can be found near to the centre of Street and within walking distance of the shops. The care home is in an area surrounded by domestic housing. There is limited parking on the home premises. Care Homes for Older People Page 4 of 23 Brief description of the care home The care home can provide accommodation in single and shared rooms over two floors. The bedrooms and communal rooms can be reached by stairs from the reception area or by passenger lift from the reception area.There are adequate well equipped bathrooms and toilet facilities around the home. There is a choice of communal areas including a large lounge / dining area on the ground floor and a smaller lounge/diner on the upper floor. There is also a conservatory to the rear of the home. The main lounge on the ground floor can accommodate residents who wish to watch television. The care home provides twenty four hour nursing and personal care services to older persons and can offer general nursing services for up to four persons between the ages of eighteen and fifty nine years. The care home aims to provide nutritious meals to suit peoples wishes. The current fees charged are 487 - 640 pounds for nursing care and 361 - 530 pounds for personal care Pauline Purnell is the registered manager. Care Homes for Older People Page 5 of 23 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: two star good 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: We made two visits to the home. The first was unannounced on the 26th March when we met people who lived in the home and spoke to staff. We looked at care plans and staff records and reviewed the home environment. We made a second visit to the home on 17th April to talk with the manager and review further records. We sent comment cards to the home and received 13 replies. The cards indicated that generally people were satisfied with the care that they received in the home. People we spoke to during the inspection also said that they were well cared for. Care Homes for Older People Page 6 of 23 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 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 8 of 23 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. People receive a comprehensive assessment before coming to the home. Information is available to enable people to make an informed choice. Evidence: The home has produced an up-dated Statement of purpose and Residents Guide that is clear and easily read. There was evidence in the files of people recently admitted to the home that an assessment had been carried out before they arrived at the home. Comment cards received from people in the home indicated that most had received enough information about the home before they arrived. Families had assisted some people to move and had visited the home on their behalf. Care Homes for Older People Page 9 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has systems in place to meet the personal and health needs of people in the home. There is a safe system of medication administration in place. People feel that they are treated with respect and kindness. Evidence: People observed during the inspection were comfortable and attention had been paid to their appearance and hygiene. Everyone has a care plan in place. At the last inspection it was required that one care planning system was used and that care plans were made more accessible for care staff. The new system is due to be implemented this summer. People who returned a comment card said that they always or usually received the medical support that they needed. There were records in care plans of visits from health professionals and arrangements for people to visit medical consultants and specialist health care professionals. There were records in peoples rooms that indicated that when required drinks and food Care Homes for Older People Page 10 of 23 Evidence: taken were monitored and position changes were made to prevent pressure damage. In some cases recording was not comprehensive. Carers were using both the twelve and twenty four hour clock. In order to improve the system it would be helpful if trained staff wrote on the charts the target amount of fluid to be taken and give additional guidance as to why the fluid and food quantities are being recorded. Records of night care were good showing regular monitoring and care throughout the night. Medication systems and recording in the home are safe and an audit system is in place. The home has a good supply of nursing beds and appropriate pressure relieving equipment was seen. People who spoke to us during the inspection said that staff treated them with kindness. staff were seen knocking on peoples doors and were heard to speak to people with kindness and respect. people who returned comment cards before the inspection said that staff listened to them and acted on what they said. Care Homes for Older People Page 11 of 23 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 are able to make choices about how they spend their days. People enjoy a choice of wholesome food each day. The home should continue to develop the programme of activities offered to people in the home. Evidence: People seen were able to make choices about how they spent their time in the home. Some people chose to spend time in their rooms while others were seen sitting in the communal rooms. There is a bell available in the sitting room but on the day of inspection this area was not continuously staffed. The manager confirmed that this was unusual and it was policy to have a member of staff allocated to the lounge. A monthly newsletter is published that includes news of people in the home and a programme of activities. The activities programme was quite basic due to absence of key staff. The activities programme and social events offered should be improved beginning with an analysis of what people would like to do. There were home-made cakes on display in a covered container. The lunch menu was displayed on the tables. On the day of the inspection there was a choice of minestrone soup or fruit juice to start . This was followed by a choice of gammon and pineapple or Care Homes for Older People Page 12 of 23 Evidence: cheeses and onion pastry. there is a choice of desserts that includes fresh fruit. People spoke very positively about the food saying it was enjoyable and choice was good. We met with three visitors to the home who said that they were always welcome and could visit at any times to suit them and the person who lived in the home. Care Homes for Older People Page 13 of 23 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. There are policies and procedures in place to protect people who live in the home. People felt confident that any complaints would be addressed. Evidence: The majority of people who returned comment cards said that they knew how to make a complaint. People who spoke to us during the inspection said that they felt confident that any concerns would be taken seriously. There is a complaints folder kept although no complaints had been received since the last inspection. There is a company Whistle Blowing policy. Most staff have received Safeguarding Adults training and up-dates are planned. The home works with other agencies well to resolve any concerns raised. Care Homes for Older People Page 14 of 23 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 live in a a safe, well maintained environment. The home is adapted to meet the needs of people living in the home and is supplied with sufficient appropriate facilities. Evidence: The environment is bright and clean with evidence of upgrading and investment and good care by the housekeeping staff staff in the home. Since the last inspection a programme of redecoration and refurbishment has included both bathrooms,shower room and a new hairdressing salon. New toilet facilities have been installed on the both floors. Two sluices have been developed however the equipment needs to be installed as soon as possible. The main lounge and dining room and all corridors have been redecorated. Individual bedrooms are redecorated as they become available and carpets in bedrooms are replaced when required. The vast majority of people who returned comment cards said that the home was always fresh and clean. One person wrote that the home was very clean and pleasant to live in. Care Homes for Older People Page 15 of 23 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. The home plans to have sufficient staff on duty at all times. There is an appropriate mix of staff to meet peoples needs. The staff in the home receive training and supervision. Evidence: Staff rotas indicated that there were usually sufficient staff on duty to meet peoples needs. The manger has increased the number of staff on duty in the mornings. People who returned comment cards said that they always or usually received the care that they needed. One person thought that there were not always enough staff on duty and another said that sometimes the bells took a while to answer. There is a system in place to record the time taken to answer a bell and this could be used to reassure people or to confirm that there is an issue. All people spoken to praised the staff for their kindness and attention. One comment was that staff provided any support needed. There is a staff training programme at the home and up-dates for all mandatory training are planned and booked. It is good practise to plan training in advance and ensure funding is available when needed. The manager should include in the training plan trained nurse development and the training needed in order to progress areas of home operation that need attention. One new member of staff spoken to said that the induction had been very good. They Care Homes for Older People Page 16 of 23 Evidence: had been working with an experienced member of staff and had completed a Skills for Care Induction booklet. Four staff recruitment files were seen. These contained completed records and demonstrated that all appropriate pre-employment checks had been undertaken. undertaken to promote peoples safety. Currently all senior care staff have National Vocational Qualifications at level 3 and there is a programme of NVQ training in place. The march newsletter congratulated three members of staff who had achieved NVQ Level 2 and one who had achieved level 3. Care Homes for Older People Page 17 of 23 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 in the home benefit from a home that is well run and in the interests of the people who live there. There are established systems in the home that promote the health and safety of staff and people who live in the home. Evidence: The manager Pauline Purnell is an experienced manager and a qualified nurse. People in the home said that they would be happy to speak to her about any concerns that they had. The AQAA states that monthly meetings are held for Residents and Relatives which are minuted and provide a platform for discussion of a range of issues. There is a system of staff meetings and staff appraisals and supervisions. The record keeping for these should be more formal as it was not clear when these had occurred. There is a system of maintenance and health and safety checks and monitoring in place. Some training and supervision records were not easily accessible. We discussed Care Homes for Older People Page 18 of 23 Evidence: with the manager the need to delegate some tasks such as filing and organising staff files to other competent staff. This would ensure tasks are completed in a timely manner and would enable the manager to concentrate on key responsibilities. The manager is supported by a regional manager who completes comprehensive Regulation 27 visit forms. Some essential equipment for the new sluice rooms had not arrived at the time of the inspection and these must be installed promptly to avoid health and safety problems. The manager and administrator are undertaking a large archiving task removing and storing old records so that current information is easily available. There is a business plan in place for 2009 that identifies areas of operation where the home could improve with specified targets and opportunities for review. The appropriate insurance certificate was displayed in the home and an up-dated CQC certificate will be displayed following the successful completion of the managers registration with CQC. There are corporate financial systems in place and it is important that these operate smoothly to ensure funding is available in the home when required to meet regulations regarding training and the provision of essential equipment. . Care Homes for Older People Page 19 of 23 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 20 of 23 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 1 7 15 There must be a clear and comprehensive care plan for each person. The care plan is the basis on which care staff provide care in the home. It must give clear instructions to them that can be easily accessed and understood. 01/08/2009 2 38 13 The manager must ensure that the work to the new sluices is completed and includes functioning bedpan cleaning equipment. Current arrangements do not facilitate best practise in infection control. 30/05/2009 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 12 People who live in the home should have improved opportunities for leisure and recreational activities. Page 21 of 23 Care Homes for Older People 2 30 There should be a staff training and development programme in place that meets the needs of the workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of the people who live in the home. There should be a formal staff supervision system that meets National Minimum Standard 36. Records required to show staff training should be kept in an effective and efficient system. 3 4 36 37 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 23 of 23 - 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!