CARE HOMES FOR OLDER PEOPLE
St Wilfreds- Arundel Priory 2 London Road Arundel West Sussex BN18 9BZ Lead Inspector
Veronica Gay Announced 31 May 2005, 9:15am 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. 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. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 0.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service St Wilfreds-Arundel Priory Address 2 London Road, Arundel, West Sussex, BN18 9BZ 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) 01903 882079 Order of Malta Homes Trust Ms Jean Houghton Care Home (CRH) 20 Category(ies) of Old age, not falling within any other category registration, with number (OP), (20) of places St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 0.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25 February 2005 Brief Description of the Service: 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 via a short flights of steps. This is referred to in the the homes Statement Of Purpose. The home is set in attractive well-maintained gardens, which are only partially accessible to the residents. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 0.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. This was an announced inspection, made at 9-15 am which lasted six hours. A second inspection, which will be unannounced, will be undertaken later in the year. During this inspection the Inspector toured the building, visited every room, and spoke with staff members to gain a sense of what it was like to work in the home. As well as talking to the Manager and six of the staff members, the Inspector spoke at length to 13 of the 20 residents plus a District Nurse. The Inspector examined records about care being provided to residents; as well as records of any accidents, or concerns or complaints, to make sure that the residents are being taken care of. Prior to this inspection “comment cards” were circulated in order that people could make their views known to the Commission for Social Care Inspection. The comments made are incorporated in this report. Standards that were not met at the last inspection were checked for compliance. One requirement in respect of the premises remains outstanding and the inspector was informed that this is being addressed. The Commission requires written confirmation to this effect. During the course of the day the Manager Mrs.Houghton, and her administrator very ably assisted the Inspector and the inspector would like to thank both of them, and everyone else who cooperated with her at this inspection. What the service does well:
This was the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. This was an announced inspection, made at 9-15 am which lasted six hours. A second inspection, which will be unannounced, will be undertaken later in the year. During this inspection the Inspector toured the building, visited every room, and spoke with staff members to gain a sense of what it was like to work in the home. As well as talking to the Manager and six of the staff members, the Inspector spoke at length to 13 of the 20 residents plus a District Nurse. The Inspector examined records about care being provided to residents; as well as records of any accidents, or concerns or complaints, to make sure that the residents are being taken care of. Prior to this inspection “comment cards” were circulated in order that people could make their views known to the Commission for Social Care Inspection. The comments made are incorporated in this report.
St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 0.doc Version 1.20 Page 6 Standards that were not met at the last inspection were checked for compliance. One requirement in respect of the premises remains outstanding and the inspector was informed that this is being addressed. The Commission requires written confirmation to this effect. During the course of the day the Manager Mrs.Houghton, and her administrator very ably assisted the Inspector and the inspector would like to thank both of them, and everyone else who cooperated with her at this inspection. What has improved since the last inspection? What they could do better:
Residents said they didn’t think anything could improve; they were very satisfied with the level of service provided. The manager hopes to delegate appointed tasks to individual staff members e.g. health and safety checks on the home. Some consideration should be given to the change of use of the front door. Since the security system has been installed visitors have to wait for staff to answer the door. This can take time if they are busy with a resident. A relative commented on the frustration it caused her. The manager hopes to use another door, which has cover as the main entrance, to protect relatives/visitors from the elements of the weather whilst they are waiting. A requirement has been made in respect of the laundry, which is soon to be completely upgraded. An assessment of the building should be undertaken to ensure that all areas of the home including the garden are accessible to residents. The gravel driveway could be improved to make it easier for residents and visitors to use. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 Prior to moving into St Wilfred’s people were given sufficient information about what the home offers, to enable them to make a choice as to whether or not they want to live there. People using the service do not move into the home without having their needs assessed first. EVIDENCE: Some of the residents spoken with on the day of inspection confirmed that they had been given information all about St Wilfred’s and that they had been invited to visit the home before they came to stay. Some residents could remember working in the castle and told the inspector about some of the history of the priory. All residents said they thought their needs were being met “ couldn’t fault the care in any way” said one resident. Detailed plans of the resident’s daily needs were kept and this included any GP or nursing input. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 Resident’s health, personal care and social care needs are set out in an individual care plan. Residents make decisions about their lives with assistance being available as needed. Medication is managed safely, and residents who wish to self medicate would be able to do so following a risk assessment. EVIDENCE: Where resident are not able to be involved with the drawing up of their care plans, then the residents relative or advocate is involved. It was acknowledged that some reviews were overdue and the manager confirmed that she was arranging through Social Services that these be done. The dependency levels in the home are considered to be high with two residents receiving a great deal of help and assistance with their personal care needs . The staff members are to be commended on how well they met the needs of these residents on the day of inspection. One resident said “ she had now gained confidence and was able to go out on the community bus to the Holmbush Centre for the day, which she really enjoyed”…”Staff keep a lunch for me on my return”
St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 11 Records of drug administration are maintained, and the correct procedures, relating to medication, were being adhered to. The manager confirmed to the Inspector that staff members administering medication had all received the appropriate training. A visiting District Nurse said she had no concerns about the home “ That’s why I put my Mother here” she said. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15, People living at St Wilfred’s are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate, and residents are encouraged to maintain contact with all their old friends and family wherever possible. The food is of an extremely high standard, and offers a choice of menu, with people able to eat either with other residents or in their own room should they prefer. EVIDENCE: There were a variety of activities on offer at St Wilfred’s, and the majority of residents told the Inspector that they felt they were free to choose, no restrictions were placed upon them. Several residents said they thought that living in Arundel added to their quality of life because of the many attractions and places to visit. One resident said she used to own a tearoom close by. The inspector noted that the meal was served on hot plates and in a way to encourage appetites. One resident told the Inspector that “the cook was really good” and another said that she “could have what she wished as food was not a priority for her ”. From direct observation, the Inspector noted that the mealtime appeared to be unhurried, with residents being afforded sufficient time to eat their meal. The Chef has worked at the home for many years and therefore knew the likes and dislikes of the residents.
St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Residents are listened to and understand how to make a complaint should they wish to. Regular training sessions for staff, plus policies and procedures regarding abuse, ensure that, as far as is possible, the people who live at Wilfred’s are protected from bad practice. EVIDENCE: The Commission has received no complaints since the previous inspection. A relative completed a questionnaire prior to the inspection and stated that a concern he had was dealt with and rectified immediately. The manager confirmed that the majority of residents have regular contact with families or friends. During the inspection the inspector observed the manager contacting a relative about the deterioration in a residents health. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,22,23,25,26 Residents live in a well-maintained comfortable environment. It is recognised that due to the building being listed there are some limitations on use. The historic building has a number of small steps and stairways around the home. There are large attractively maintained gardens, however because these are assessed via steps, residents who are unable to manage stairs are unable to gain access. The registered providers are considering improvements that will address some of these issues. EVIDENCE: The inspector toured the building. All areas of the home used by residents are spotlessly clean and nicely decorated and furnished in a manner that appears “homely”. The inspector met the housekeeper who had been commended on her standard of work within the company. Residents said they appreciated living in such a wonderful building with views of Arundel castle and the Downs. Risk assessments have been undertaken to ensure the safety of residents and to enable them to enjoy a fulfilled life. The manager confirmed that all fire works outstanding have now been done. The radiators are guarded and hot water temperatures monitored to safe guard residents from unnecessary
St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 15 burns. A quote was shown to the inspector confirming that the laundry improvements are soon to start. This work will mean completely upgrading and refurbishing the laundry area and so will improve working conditions for the staff with regards to ventilation and equipment. Lighting in the corridors has been improved as required. An assessment on the building has not been done, however each resident has a full assessment prior to entering the home and the Statement of Purpose ensures prospective users of the service are made away of the layout of the building. Two comments were raised by relatives in relation to the gravel path and driveway leading up to the home, which made it difficult to walk or push a wheelchair on, and this was discussed with the manager at the time by the inspector. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 Adequate staffing is provided to meet the needs of the residents. Staff are trained and competent to do their jobs. EVIDENCE: The inspector saw the staffing rota and asked residents if they thought there were sufficient staff members on duty to help them with their individual needs. Residents comments included “ staff are wonderfully kind even when I am a nuisance they never get cross”.” they answer call bells promptly”.” they always seem to make time even though they are so busy”. Staff members spoken with were able to demonstrate a clear understanding of the resident’s needs. They were committed to their work and were pleased to be included in the daily decision making of the home. Two residents who were very poorly on the day of inspection were seen to be very well cared for and comfortable. A staff member said she hoped they could continue to be cared for in the home. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35,36,38 Mrs Houghton has a number of years experience and appropriate qualifications. Resident’s financial interests are safeguarded. Records needed for the safe running of a care home are kept up to date. Policies and procedures are available for staff members to refer to, to ensure the safety of the people who live and work at St Wilfred’s. EVIDENCE: The manager was registered in March 2005 and since that time improvements were noted with regard to meeting the standards. Residents confirmed that the manager was always available and was approachable and kind. Staff spoken with said that they enjoyed continuing with their training and that they had been taught a lot since the new manger was appointed. They were pleased that the home was run in the best interest for residents. The staff said that they were consulted and that they felt their opinions were valued. Staff said they receive regular supervision, which they found helpful.
St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 18 A health and safety policy is operational in the home to protect the welfare of residents and staff. Comment cards received from residents and relatives prior to the inspection praised the home for the care and attention provided. The residents made not one negative comment during the inspection. St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 3 x 2 3 x 3 1 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 3 x 2 St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 20 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 23 Regulation OP26 Requirement The Registered person shall ensure that laundry facilities are suitable for purpose and of an acceptable standard of provision and repair Timescale for action 30/8/05 2. 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 Good Practice Recommendations St Wilfreds- Arundel Priory H60-H11 S14742 St Wilfreds -Arundel Priory V221423 310505 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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