Inspection on 01/09/05 for Arundel House

This inspection was carried out on 1st September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 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

Arundel House 13/11/06

Arundel House 27/01/05

Arundel House 05/08/04

Arundel House 26/03/04

Arundel House 08/12/03

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Arundel Victoria Road Barnstaple Devon EX32 9HP Lead Inspector Susan Taylor Announced 1 September 2005 10:00 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 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 and Care Homes for Adults 18 – 65*. 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. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Arundel Address Victoria Road Barnstaple Devon EX32 9HP 01271 343855 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) paultutt@clara.co.uk Mr Paul Martin Tutt Mrs Barbara Tutt Mr David William Crick Mrs Barbara Tutt Care Home 18 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18), Mental disorder, excluding of places learning disability or dementia - over 65 years of age (18) Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The maximum no of placements will be 18 (Eighteen) The category of registration will be Mental Disorder The six service users named in the notice of proposal may continue to live at the home. On termination of their residency the home will revert to its registered categories and the Registered persons must notify the Commission of the fact. Date of last inspection 19/5/05 Brief Description of the Service: Arundel House provides 24-hour care for 18 adults between 18 and 65 years of age with mental illness, some of who may have a learning disability. Conditions in place allow six service users who are over aged 65 years to continue residing at the home. The accommodation consists of two large, Victorian house linked to form one home. The home is within level walking distance of the local park and facilities in Barnstaple. Bedrooms are single and spacious, with the exception of one which is small. The bedrooms have views of the adjacent road and gardens. Several of the bedrooms contain a sitting area. To the rear is a large walled garden. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one day. During a tour of the building, the inspector met residents who made comments about their care, health and safety procedures, and attitudes and behaviour of staff working in the home. In addition to this, records were inspected and staff were interviewed. Residents made positive comments such as “I have a lot of freedom here. There are few rules”, “We have a monthly residents meeting and are always encouraged to give our views and suggestions to get things changed”, “People go to see the Doctor when they need to”, “the staff are caring and kind”, “We don’t discuss each other’s business here. The staff are very mindful of that and respect people’s privacy”, “the difference here is that its one big family, not a regime like some places” and the home is “well run”. Intermediate care is not provided at the home. What the service does well: The needs of residents are clearly stated and known by staff at Arundel. The philosophy of care at Arundel is inclusive, encouraging residents to fully engage in planning and reviewing their own care. Risks and quality of life issues are carefully managed so as to ensure that residents have few restrictions in the lives. Confidentiality is maintained for residents. Staff make good use of health and social care resources available in the community to ensure that residents receive the best care available. Residents are treated with dignity and respect. The home has a competent team of staff that are in sufficient numbers to meet the needs of residents. There is a training and development culture at Arundel, which ensures that residents are cared for by properly qualified and experienced staff. The quality assurance systems in the home ensure that residents, their relatives and other stakeholders fully take part in the process. Health and safety is promoted at Arundel. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: 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. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Standards Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitablity of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Adults; 3, 6 Older People The needs of residents are clearly stated and known by staff. Intermediate care is not provided at Arundel. EVIDENCE: Three files demonstrated that the admission procedure was thorough. Comprehensive assessments were seen on files, completed by a care manager. A copy of the care plan produced for care management purposes was also on file. The deputy manager verified that an intermediate care service is not provided at Arundel. This relates to standard 6 for Older People. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14, and 33 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 Adults; 7,14,33 Older People The philosophy of care at Arundel is inclusive, encouraging residents to fully engage in planning and reviewing their own care. Risks and quality of life issues are carefully managed so as to ensure that residents have few restrictions in their lives. Confidentiality is maintained for residents. EVIDENCE: Care plans were well-maintained, accessible to residents and had been kept under review. Comprehensive risk assessments had been completed with every resident, which clearly identified strategies for minimising the risks highlighted. During the inspection, five residents told the inspector that the care was very good. Positive care outcomes were also observed. The assistant manager explained that a resident had been admitted to hospital immediately before the inspection when the resident’s health suddenly deteriorated. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 10 Residents told the inspector that the staff had dealt with this incident in a calm and professional manner. One person told the inspector that the staff had helped them to identify triggers that would affect their mental health, which were recorded in a risk assessment. The same person went on to say that the community psychiatric nurse visited them regularly and that is very pleased with their progress. Records demonstrated that Arundel had good relationships with other social and healthcare professionals. Residents made positive comments such as “I have a lot of freedom here. There are few rules”, “We have a monthly residents meeting and are always encouraged to give our views and suggestions to get things changed”, “People go to see the Doctor when they need to”, “the staff are caring and kind”, “We don’t discuss each other’s business here. The staff are very mindful of that and respect people’s privacy”, “The records are kept in a locked cabinet in the office” and “the difference here is that it’s one big family, not a regime like some places”. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. Service Users find the lifestyle experiencd in the home matches their expectations and preferences and satisfies their social, cultural, religious and recreational interests and needs. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 12 EVIDENCE: Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 Adults; 8, 10, 11 Older People Staff make good use of health and social care resources available in the community to ensure that residents receive the best care available. Residents are treated with dignity and respect. EVIDENCE: The majority of residents at Arundel are self-caring with regard to personal care. Care plans clearly identified those who do require assistance and outlined exactly what needed to be done. Equipment was seen in one bedroom that had been used by a resident to enable them to breathe more easily. With regard to healthcare needs, residents said “People go to see the Doctor when they need to” and “We get excellent care here. My mental health has Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 14 improved greatly. I see my psychiatrist regularly. If I’m ever ill, I usually make my own appointment to see my GP”. Half of the residents and staff were enabled to attend the funeral of a long standing resident, with refreshments afterwards, on the day of the inspection. The assistant manager told the inspector that the deceased resident’s wishes had been followed to the letter. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16, 18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are sageguarded. (OP NMS 35) The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 16, 18 and 35 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 34 and 35 (Adults 18-65) and Standards 27,29 and 30 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35, 36 Adults; 29, 30 Older People The home has a competent team of staff that are in sufficient numbers to meet the needs of residents. Minor amendments are required to the home’s application form for prospective staff, which will ensure that residents are protected from being cared for by unsuitable people. There is a training and development culture at Arundel, which ensures that residents are cared for by properly qualified and experienced staff. EVIDENCE: Residents told the inspector that their needs were well met. The duty rosters accurately recorded the names of staff, and duties that had been worked. The inspector observed that staff attended to resident’s needs in a timely and unhurried manner. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 18 Three personnel records were audited. The home had obtained satisfactory references including CRB and POVA checks as required. The application form did not require prospective employees to provide sufficient information about their employment history or to make a declaration regarding any convictions that they might have. This was discussed with the assistant manager and is to be reviewed. A recommendation is made in respect of this. A wide range of training had been provided over the last 12 months. Records demonstrated that 33 of the care staff had achieved the NVQ level 2 award in care, and a further four staff were due to start. The inspector saw individual training files, which contained further evidence of specialist training having been provided e.g safe handling of medicines. Staff told the inspector that they felt well supported, and had been appraised. Management staff verified that they had undertaken supervisory management training before being given a caseload of staff to manage. The assistant manager showed the inspector an induction training pack. Induction records seen demonstrated that training meets the appropriate standards set out by the ‘Skills for Care’ organisation. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 39 and 42 (Adults 18-65) and Standards 33,35 and 38 (Older People) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 Adults; 33, 38 Older People The quality assurance systems in the home ensure that residents, their relatives and other stakeholders participate fully in the process. Health and safety is promoted at Arundel. The upgrading of the electrical system has ensured the safety of residents. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 20 EVIDENCE: Residents were contented living at the home, and made a number of positive comments including: “I’ve done 2 surveys in 12 months that has asked for my views of the quality of food, care etc.” “We have regular residents meetings held every month. The minutes are well documented and displayed in the dining room”. There is “a real sense of getting things done here. They make the management of the home unobtrusive, which is really nice”. “The home is very well run”. The inspector read the results from surveys, which were reflected in the annual development plan for the home. Staff commented that the home “runs smoothly” and told the inspector that meetings were held with staff on a bimonthly basis. As a matter of follow up to a requirement, the electrical conformity certificate was inspected, which demonstrated that the system was safe. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 Score x x Score ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x x x x x x x x Standard No 24 25 26 27 28 29 30 STAFFING x x x x x x x Score 11 12 13 14 15 16 17 Standard No 31 32 33 34 35 36 x 3 3 2 3 3 x x 3 x x 3 x Version 1.40 Page 22 CONDUCT & MANAGEMENT PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arundel Score 3 3 x x 37 38 39 40 41 42 43 D54-D07 S22089 Arundel V236253 010905 Stage 4.doc NO Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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 OP 29 YA 34 Good Practice Recommendations Review the homes application form to ensure that prospective employees provide explicit details of current and previous employment or to make a declaration regarding any convictions that they might have. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Arundel D54-D07 S22089 Arundel V236253 010905 Stage 4.doc Version 1.40 Page 24 - 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!