Inspection on 25/02/09 for St Wilfred`s - Arundel Priory

This inspection was carried out on 25th February 2009.

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

St Wilfred`s - Arundel Priory 22/06/06

St Wilfred`s - Arundel Priory 09/01/06

St Wilfred`s - Arundel Priory 31/05/05

St Wilfred`s - Arundel Priory 25/02/05

St Wilfred`s - Arundel Priory 22/06/04

St Wilfred`s - Arundel Priory 16/02/03

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St Joseph`s

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Wingham Court

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St Wilfred`s - Arundel Priory 2 London Road Arundel West Sussex BN18 9BZ     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: Jo Hartley     Date: 2 5 0 2 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 26 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 26 Information about the care home Name of care home: Address: St Wilfred`s - Arundel Priory 2 London Road Arundel West Sussex BN18 9BZ 01903882079 01903883904 managerarundel@osjctwilts.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Order of Malta Homes Trust care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide the following category/ies of service only: Care home only - (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 (OP). Date of last inspection Brief description of the care home St Wilfreds is a care home registered to accommodate 20 residents in the category of older people (OP) over 65 years of age not falling within any other category. The home is within the converted old priory building situated close to Arundel castle and is owned by the Orders of St.John Trust. Accommodation is provided over two floors with all rooms occupied on a single occupancy basis. A lift is installed to allow access to the first floor. Due to the age and layout of the building parts of the home are accessible Care Homes for Older People Page 4 of 26 Over 65 20 0 Brief description of the care home via short flights of steps. This is referred to in the homes Statement Of Purpose. The home is set in attractive well-maintained gardens, which are only partially accessible to the residents. Care Homes for Older People Page 5 of 26 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: The quality rating for this service is 3 star. This means the people that use this service experience excellent quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. It was carried out by Jo Hartley. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, surveys received from residents and staff, and an unannounced visit to the home, which was carried out on the 25th and 27th February 2009. During the visit we looked at policies and procedures, staff records and residents records. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. Care Homes for Older People Page 6 of 26 The last inspection on this service was completed on the 22nd June 2006. 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 8 of 26 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 9 of 26 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. Prospective residents are provided with the information they need to make an informed choice about where to live. Residents needs are assessed prior to moving into the home to ensure that the home can meet their needs and they are able to stay for a trial period before making a decision to stay. The home does not provide Intermediate Care, therefore Standard Six does not apply. Evidence: St Wilfrids has a detailed Residents Guide that is available to all prospective residents. We received eleven completed surveys from residents at the home. They all said that they received enough information about the home to enable them to decide if it was the right place for them. We looked at the records of three residents. They all contained assessments that were undertaken before the resident moved in. This enables the home to ensure that they Care Homes for Older People Page 10 of 26 Evidence: will be able to meet individual needs before offering a place. This assessment covers areas such as medical, social and personal history; individual preferences, likes and dislikes. Residents are able to stay at the home for a trial visit before they make a decision to stay. One resident told us, I was able to come for a month to see if I liked the home before actually moving in. This was very helpful. Care Homes for Older People Page 11 of 26 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. Residents health, personal and social care needs are set out in their plan of care. They are able to make decisions about their lives. The home has policies and procedures in place regarding the safe use of medication. Residents feel that they are treated with dignity and respect. Evidence: We looked at three residents care plans in detail during the visit. The home has recently introduced new care plan documentation that is very detailed. Clear guidance is given to staff on how residents want their care to be provided. For example they include step by step guidance on how individuals wish to be assisted with their personal care. It was clear in the documentation that care plans had been drawn up with residents, however they had not been signed. The home needs to ask residents to sign their care plans to say that they agree with the content. We also saw evidence that care plans are reviewed monthly with residents, and their family if the resident wishes. A detailed handover is held at the change of every shift. Daily care notes including general well being, appointments and requirements are Care Homes for Older People Page 12 of 26 Evidence: discussed and any changes that are needed to care plans are identified. Nine members of staff responded to our surveys. Six of these said that they are always given up to date information about the people they support, and three said they usually are. One member of staff told us, Any change in residents needs are put in straight away. All care plans otherwise are updated monthly where needed. Residents health needs are clearly identified in their care plans. Details of all health appointments are recorded and monitored. Risk assessments are in place for pressure areas, falls, moving and handling and nutrition. We received eleven surveys from residents. Eight residents told us that they always receive the care and support they need and three said they usually do. One resident commented, The care is excellent, the staff are loving and caring. Another resident said, St Wilfrids is very good at help and care. All eleven residents told us that they always receive the medical support they need. We looked at medication policies, procedures, storage and recording. In the Annual Quality Assurance Assessment, (AQAA) completed by the home we were told, Where residents wish to self administer medication, a risk assessment is compiled and agreed with the resident and the residents GP. This is monitored and reviewed monthly with their other care plan documentation. Only senior care staff are allowed to administer medication to residents. They undergo rigorous training including an e learning package and workshops provided by the Pharmacy supplying the homes medication. Competence in this area is monitored by the Home manager, the Locality Manager and the Quality Assurance Team. This was all evidenced during our visit through talking to staff, looking at training and other records, and observing practice. The recording of the receipt, administration and disposal of medication are clearly and accurately recorded. All staff at the home receive induction training that includes treating people with dignity and respect. During the visit we observed staff interacting with residents politely and knocking on peoples doors before entering. Residents told us that staff respect their privacy. Care Homes for Older People Page 13 of 26 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. Residents social and cultural needs are met. They are able to maintain contact with their friends and families and are able to exercise choice and control over their lives. They enjoy the food provided by the home. Evidence: The home provides activities for residents. During February these included Red Nose Day, Music For Health, Valentines Day celebrations, coffee morning, a quiz and a pancake tossing competition. There are also religious services for those who want to attend and weekly visits from a hairdresser. We had a mixed response regarding activities from our surveys. Four residents said that there are usually activities to take part in; four said there sometimes are and three said there always are. A relative commented, Would like to see more staff time available for 1:1 activities although I appreciate residents do not always participate when something has been arranged. Would like there to be the opportunity for trips out in a vehicle designed to take wheelchair bound residents for a country drive, to a garden centre or coffee at local Wildfowl Trust etc. Comments from staff included, More activities could be laid on for the individuals. Care Homes for Older People Page 14 of 26 Evidence: More staff would give more time to the people in our care but there are always the correct amount of staff in accordance to regulations etc but the residents sometimes need more time than we are able to reasonably give. We could stimulate the residents more, we do not have much in the way of entertainment, exercise or activities except for Christmas. I think the residents would benefit from an outing say on a three monthly basis where at the moment they have none. The manager told us that extra care hours now being provided for 1:1 activities such as walks round the cathedral gardens and into town. During the visit we were told by some of the residents that they wouldnt want any more organised activities but they enjoy what does go on in the home. Each resident has their interests are recorded in their care plans. Residents and a visitor said that visitors are always made welcome in the home. The visitors book shows that visitors visit the home regularly and at different times during the day. The home does not manage the finance of residents, this is done by the residents themselves, their families or solicitors. When a new resident moves into the home a form is completed regarding their dietary needs, likes and dislikes and given to the chef. Residents told us that there are always two choices of main meals. Staff go round in the morning and ask everyone individually which they would prefer that day. In response to our survey five residents said they usually like the food and six said they always do. One resident said, Presentation is always very good and appreciated. Always a choice of food. The menu on the day of our visit was roast chicken, stuffing, roast or creamed potatoes and vegetables. For pudding residents could choose between banana custard, fruit and cream, or fresh fruit or yoghurt. Supper was soup with bread and butter or sandwiches, peaches and cream or fresh fruit or cheese and biscuits. We received comments from residents and staff that the cutlery and crockery are not always washed up properly. We discussed this with the manager who said they are in the process of employing new kitchen staff so this should improve. The manager also told us that the new chef who started in December will be taking over the responsibility of supervising kitchen staff. A member of staff told us, Choices are made by service users not staff. Care Homes for Older People Page 15 of 26 Evidence: Care Homes for Older People Page 16 of 26 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. Residents feel that they are listened to and what they say is acted upon. Policies, procedures and staff training are in place to help protect residents from abuse. Evidence: The complaints procedure is displayed in the foyer of the home and is also printed in the Service User Guide and Statement of Purpose that all residents receive. All the residents who returned the survey we sent out said that they know who to speak to if they are not happy and they know how to make a complaint. We saw the homes complaints book. Three complaints had been received since our last inspection. All were clearly recorded and investigated within time limits. Staff and training records confirmed that staff receive training in the Protection of Vulnerable Adults as part of their induction and through an e-learning package. The West Sussex Guidance for Safeguarding Adults is available in the office. There are also written policies and procedures for staff to follow if they suspect any form of abuse. Care Homes for Older People Page 17 of 26 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. The home provides a safe, clean well maintain environment for residents. Evidence: Arundel Priory provides a homely, clean and comfortable environment for residents. Ten out of the eleven residents who responded to the survey said that the home is always fresh and clean, one said it usually is. Furnishings and fittings are of a good quality and in good condition. Residents bedrooms were personalised with their own belongings. Two bedrooms have en suite bathrooms and the home now has planning permission for two more. The home has well tended extensive gardens with tables and chairs so residents can enjoy it in fine weather. There has been a problem with access to the gardens for some of the less mobile residents, however this is now being addressed. A lift is being installed to provide access for everyone. Equipment such as ramps, bath seats and rails are situated throughout home where needed. The laundry facilities are situated away from food preparation areas and are easy to clean. The home has recently refurbished the laundry and kitchen, new chairs and carpets have been provided in the lounge and new furniture in the dining room. The home has a computer with internet access for the use of residents. The keyboard Care Homes for Older People Page 18 of 26 Evidence: has large print letters for people who have sight difficulties. Staff have received training in infection control, and fire safety. Care Homes for Older People Page 19 of 26 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 staff at the home are well trained and able to meet the needs of the residents. The home follows robust recruitment procedures when employing new staff. Evidence: The level of staffing at the home enables the staff to meet the care needs of the residents. However, as reported in a previous section, staff told us that there is not always enough staff to provide one to one time with residents. The manager told us that this is being addressed with more staff hours being provided for activities. The residents who responded to our survey said that staff are always or usually available when they need them. All said that the staff listen to them and act on what they say. Comments from residents include, The staff are very kind and helpful but there is always a lot for them to do. The general atmosphere is very laid back and pleasant. The staff work very hard all the time, to do very basic jobs and dont have time for other jobs. The care is excellent, the staff are loving and caring. A relative told us, The home has a homely caring atmosphere with very dedicated pleasant staff. The home has a thorough induction and staff training programme in place. Staff confirmed that they receive training that is relevant to their role, keeps them up to date with new ways of working and helps them understand and meet the needs of individual residents. The home has over seventy five per cent of staff with a National Vocational Qualification in Care at Level Two or above. Care Homes for Older People Page 20 of 26 Evidence: Comments we received from staff include, All staff get regular training and updates on any changes. The service provides a secure life and friendly environment for all service users and always looks for ways to improve all aspects of their care. We looked at the recruitment records for three members of staff and found them to include all the required documentation including Criminal Records Bureau Checks, two written reference and application forms. Care Homes for Older People Page 21 of 26 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. The manager is fit to undertake the running of the home. There is an adequate quality assurance system in place that seeks the views of residents and other stakeholders. Residents financial interests are safeguarded. The home promotes and protects the health, safety and welfare of residents. Evidence: The registered manager, Jean Houghton, has a National Vocational Qualification in Care Level Four and the Registered Mangers Award, she is also a qualified NVQ Assessor. She has twenty years experience of working in residential care, thirteen of those in management roles. The home has a Quality Assurance system in place that seeks the views of residents and relatives. In the AQAA we were told that the results are treated confidentially, issues arising are prioritised and actioned thus helping the Home to measure its success in meeting its aims and objectives as outlined in our Statement of Purpose Care Homes for Older People Page 22 of 26 Evidence: The home has Health and Safety Policies and Procedures in place. All staff receive mandatory training in Infection Control, COSHH, Fire Safety and Moving and Handling as part of their induction programme. This training is updated annually. Any accidents and incidents are recorded thoroughly. Checks on equipment and services such as hoists, lifts, gas, electricity and fire systems were seen to be up to date. Residents or their representatives manage their own money. We saw the supervision records for staff. They confirmed that staff receive supervision at least six times a year. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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. 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