CARE HOMES FOR OLDER PEOPLE
St Wilfred`s - Arundel Priory 2 London Road Arundel West Sussex BN18 9BZ Lead Inspector
Mrs Veronica Gay Unannounced Inspection 9th January 2006 09:00 X10015.doc Version 1.40 Page 1 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 St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 2 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 Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service St Wilfred`s - Arundel Priory Address 2 London Road Arundel West Sussex BN18 9BZ Telephone number Fax number Email address Provider Web 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 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Up to 20 persons male and/or female service users in the category of old age, not falling within any other category may be accommodated. No service users under 65 years of age may be admitted. Date of last inspection 31st May 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 short flights of steps. This is referred to in the home’s Statement Of Purpose. The home is set in attractive well-maintained gardens, which are only partially accessible to the residents. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. The first inspection, which was announced, was undertaken on 31st May 2005. At this inspection the Inspector looked at standards that were not looked at during the previous inspection, as well as any outstanding issues from the last report. Where there have been no changes the report remains the same. The reader is advised to look at the reports of both inspections for a full picture of the home. During this inspection the Inspector examined records of care being provided to residents, as well as records of any accidents, issues, concerns or complaints, to make sure that the residents St Wilfred’s Arundel Priory were being taken care of. In addition the Inspector toured the building, inspecting several of the rooms that the residents have access to, and joined residents for lunch. From the information available, the positive comments made by the residents and three visitors the inspector gained the impression that the home continues to provide a good standard of care. No requirements were made and all standards assessed on this occasion were met. The Inspector would like to thank everyone who cooperated with her on the day of this inspection. What the service does well:
The majority of residents were spoken to, and all gave a very good account of the home saying it met their varying needs. Residents said that staff were helpful “you’ve only got to ask…caring…and they are friendly”. Resident’s comments included the following; “ visitors are made welcome whenever they visit…food is excellent, good choice with several desserts…we care for each other here” They considered that “It’s a very clean home”. Everyone said that they appreciated being able to lead their own lifestyle with one person saying that she has settled in well”, Visitors said,” It is a really good home, the staff are very kind and the food is very good” St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 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. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 8 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 the following standard(s): 1,3, & 6 Prior to moving into St Wilfred’s people are 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. St Wilfred’s Arundel Priory does not provide intermediate care. EVIDENCE: All service users said that they felt their needs were being met “otherwise I wouldn’t be here” said one lady. A sample of three assessments were seen by the inspector and they all contained information on their health and well-being, social contacts and personal interests. Details of individuals daily needs was also kept and this included any registered nursing input required. Several of the residents said they used to live in Arundel and therefore were well aware of the history of the Priory. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7,8,9, &10 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: Samples of three care plans were seen by the inspector, all of which were up to date. The manager confirmed that these records are reviewed monthly and signed. Residents said that they “see the GP on request”, can see the community nurse when she calls at the home and make direct appointments with the optician and chiropodist. Residents can look after their own medication and this was confirmed by the manager and records kept. Residents described staff as “kind”, “caring”, “helpful”, “reliable” and “supportive”. One person said that although they are always busy they come as soon as they can” and another said, when talking about the help she receives, that they “are always friendly”.
St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 10 The inspector observed staff talking and listening to residents and that they were careful to be invited into their rooms rather than simply walking in. Two residents were receiving full care and they appeared relaxed and comfortable at the time of the inspection. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 11 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 the following 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. The inspector noted that the meal was served on hot plates, with individual vegetable dishes in a way to encourage appetites. The meal was lamb casserole, potatoes, green beans and cauliflower. Followed by a choice of four desserts. One resident told the Inspector “the food was really good always a choice of three fresh vegetables.” From direct observation, the Inspector noted that the mealtime appeared to be unhurried, with residents being afforded sufficient time to eat their meal. The cook consults daily with residents to discuss the menu with them. The cook has worked at the home for many years and therefore knew the likes and dislikes of the residents.
St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 12 St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 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 the following standard(s): 16,17, &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 Arundel Priory are protected from bad practice. EVIDENCE: Residents told the inspector that if they had any concerns they would discuss them with the manager. Visitors spoke highly of the care provided to their friend and said they thought it was a very caring home. Monthly visits to the home are carried out by the Responsible Individual, or delegated member to ensure the standards are being maintained. Reports of these visits are sent as required to the Commission for Social Care Inspection. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 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 the following standard(s): 19,20,21,22,23,24,25,26 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 making 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”. 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 safeguard residents from unnecessary burns. The laundry area has been completely upgraded and staff said how much better this area was to work in.
St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 15 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. Comments raised by residents or relatives are listened to and acted on as far as possible. Future improvements will include a disabled bathroom, fitted with adaptations to assist the residents with their daily needs. Resident said they were very pleased with their bedrooms. One resident said she would like a larger room and the manager said this is being considered as soon as one becomes available. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29 Residents are in safe hands at all times. A robust recruitment procedure is followed to ensure the right type of staff are employed to care for vulnerable people. Staff have the necessary skills and confidence to perform their role in a professional manner. EVIDENCE: The Manager informed the Inspector that all staff members had received induction training together with fire safety, manual handling, first aid, and adult protection. In addition the Inspector was told that all staff members who administer medication, receive up date training. New staff are confirmed in post, following completion of a satisfactory Criminal Records Bureau Disclosure. The inspector spoke with the staff on duty and asked residents if there were sufficient staff for the help and support they needed. They confirmed that staff were always available and one said “ they are available during the night if I need assistance” The manager, administrator, care leader and two care assistants were on duty supported by a cook, kitchen assistant, handy person, housekeeper and cleaner. Records and discussion with residents showed that there was a nucleus of long serving staff who knew the residents needs and wishes very well. Some staff vacancies exist and the manager informed the inspector that she is looking at ways to ensure the home has a full compliment of staff. At present
St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 17 some of the vacant hours are being covered by existing staff or agency care workers. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,37 Ms Houghton has a number of years experience and appropriate qualifications to fulfil the role of a Registered Manager. There are clear guidelines of accountability in the organisation. Records needed for the safe running of a care home are kept up to date. Resident’s financial interests are safeguarded. The home is run in the best interest of the residents. 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 in National Vocational Qualification level 2 and 3. Regular handovers take place at the change of shift to ensure a continuity of care is provided. Staff meetings are arranged and it was noted that the Service manager is to attend. Staff members were seen to work together as a team and to approach the residents in a respectful manner.
St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 19 The manager was reported to be approachable and supportive. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 20 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. 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
HOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 4 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X X X 3 X St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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. 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. St Wilfred`s - Arundel Priory DS0000014742.V274479.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Worthing LO 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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