• Care Home
  • Care home

Archived: Arthur Roberts House

121 Burnthouse Lane, Exeter, Devon, EX2 6NB (01392) 274388

Provided and run by:
Devon County Council

All Inspections

7 November 2013

During a routine inspection

Our inspection was unannounced and lasted approximately eight hours. We were accompanied by an expert by experience. During this visit, we inspected five outcome areas; all five were compliant.

There were 15 people living at the home, and we spoke with 11. We also spent time with people in communal areas of the home so we could make a judgement about how well people were cared for as some people were not able to comment directly on their care. We spoke with six staff members, the registered manager and four relatives. We looked at a selection of care records for three people focussing on how people's health and well-being were supported, including people's dietary and medication needs.

We saw people looking relaxed and at ease with staff and each other. People's health and well-being care needs were assessed, and care was provided in a way that suited people's individual needs. Medication was well managed, as were people's nutritional needs. Individual activities and group events took place, although some people would like more to do on a daily basis. People were offered choices in relation to meals and drinks, and meals were a social event. The manager recognised people's changing health and emotional care needs, and requested additional staffing support where necessary.

7 February 2013

During a routine inspection

On the day of this inspection there were 17 people living at Arthur Roberts House. The home specialises in caring for people with dementia some of whom had varying levels of communication skills at the time of our visit. We looked at the care records four people, including their care plans and records of the care they received, and spoke with each person to find out if the care they received was satisfactory. We also spoke with two relatives, the manager, deputy manager and three members of staff.

People's privacy, dignity and independence were respected. Staff allowed people time to move at their own pace, without rushing them and by explaining how they were going to help them to move. A relative told us 'Nothing is too much trouble ' people are treated with dignity.'

People told us the care and support they received met their needs and protected their rights. Comments included 'Fantastic!' and 'I like it here.' A relative described the care as 'Marvellous!'

People told us they felt safe. They were encouraged and knew how to speak out and raise concerns or complaints. Staff knew how to protect people from the risk of abuse.

People were supported by suitably qualified, skilled and experienced staff. People told us they were entirely satisfied with the staff employed at the home. Comments included 'They are all nice' and 'The staff are all lovely.'

Auditing and monitoring procedures ensured that all aspects of the service were running smoothly

14 July 2011

During an inspection looking at part of the service

We carried out a planned unannounced inspection in January 2011 at Arthur Roberts when we made compliance actions for the home to complete in order to achieve compliance with the Health and Social Care Act 2008.

We carried out this responsive unannounced inspection on 14 July 2011 to check on the compliance actions that we had made after the previous inspection. Devon County Council has kept us up to date with their revised improvement plans, which demonstrated how they have addressed the concerns from our visit in January 2011.

Our visit took place over eight hours. We spoke with seven people living at the home, five staff members and four people visiting the home. During our visit, we completed a SOFI 2 observation, which helped us to make judgements about people's well-being, and how staff interacted with them. We used this because some people were unable to answer specific questions about their care.

We met with people either in their rooms or in communal areas, and we spoke to them individually or in pairs when they were sitting with friends. We spent time in communal areas, which enabled us to observe people's care and hear conversations between staff and people living at the home.

We used pathway tracking to see how three people's care and social needs were met. Where possible, we met with the person. We looked at their care records and spoke to staff about how they met their care needs. We also looked at records relating to staff training and induction, as well as audit and quality assurance records. We spoke to staff about the management of complaints and staffing levels.

When we visited the home on 14 July 2011, 20 people were living at the home. We were told that since our last visit nobody had moved to the home on a permanent basis, which was a decision made by the provider.

We were told by staff that there was one person whose health had declined and was being monitored. We were told that there was nobody living at the home with a pressure sore and no one receiving end of life care.

The home does not currently have a registered manager but an application has been submitted by Devon County Council and a manager is in post. The manager was on annual leave when we visited but we spoke with them on the telephone on 27 July 2011 to confirm information and to receive an update on further work that had taken place.

We were told by staff that several people enjoyed being outside in the garden. We saw that one person appeared to like to be busy and we saw them sorting out the cushions on outside seats and then sitting down to relax in the sun. The second person appeared to enjoy just standing outside and commenting to staff on their surroundings.

Throughout the day, all the staff interactions we saw respected people's dignity and independence. Staff were sensitive to people's needs, for example taking time to make sure that the choice they were offering was meaningful to the person. We saw that staff knew people's like and dislikes with regards to drinks and meals but still checked to make sure they had remembered correctly. Staff were discrete in offering support, including asking about pain relief.

We saw that staff valued people's friendship and recognised the importance of the camaraderie between people living at the home. This was particularly noticeable during the lunchtime meal but also helping people to find a seat next door to each other.

People appeared relaxed with staff members and there was a calm and positive atmosphere. We saw that staff were able to change their approaches according to the individual. For example, some people obviously appreciated a tactile approach, some people responded well to jokes and other people were more formal and anxious to maintain their independence.

We saw that some people were keen to maintain their independence and that staff were sensitive to this. For example, staff were careful to check when people needed assistance with their meals or drinks. Sometimes people did not want to have help but then struggled. We saw staff going back and using a different approach, which was then successful and enabled the person to accept help on their terms.

In the afternoon, a group of people sat with a staff member who encouraged them to reminisce about their childhood, which resulted in laughter and contributions from people living at the home. It was managed well by the member of staff who created an inclusive atmosphere and ensured people were comfortable. Later the staff member used well known catch phrases to instigate discussion, which was also well received by the people in the group. Some people came and went, but were welcomed on their return, and the provision of a hot drink and biscuits added to the friendly atmosphere.

We saw that staff were observant at noticing both physical and mental changes in the people they supported, and this was generally reflected in the care records that we looked at and in our discussions with staff. We saw from records, that concerns were followed up, and that staff were pro-active in ensuring that people received the level of health care support that they required. We told by one relative that 'the care is great and the way people are treated is great' and two other relatives said that in their opinion the care could not be faulted.

We saw that people enjoyed their lunchtime meal from their expressions and their comments such as 'lovely' and 'very nice'. Staff took care to ensure that the portion size reflected people's preferences and we saw that the food was well presented. Throughout the day, we heard people being encouraged to drink and we saw this happening as staff took time to explain it was a hot day and to offer a drink that was acceptable to the person.

Staff were clear that medication administration could not be rushed and that it was vital for people to be given the time to make decisions. They gave the example of pain relief, and we saw staff checking with individuals in a discrete and unhurried manner. When people said 'no', we saw staff checking the person's body language for signs of pain and they reminded people of where the pain may be as a prompt. A member of staff was clear about the significance of pain relief and the impact pain could have on people's well-being.

People that we met during our visit were unable to comment directly on the safety and suitability of the premises. However, during our visit we saw that people were able to move around the communal areas safely and we saw that there were no hazards in these areas.

Most of the people we met during our visit were able to move around independently or with minimal assistance. One person had become frailer since our last visit, and we heard staff confirming with a senior staff member about the way they should be moved. We heard staff checking with people if they needed help to get out of chairs and we heard them listening to people's responses.

We observed that staff responded to people in an appropriate caring and respectful manner. They appeared to know people well. We saw how an agency member of staff diffused a situation in a competent and non-threatening manner, which showed an understanding of people with dementia.

Staff and a visitor told us about the residents' meetings that had taken place and what had been achieved by them. We looked at the minutes for these meetings, which were on display in communal areas, and saw that people were being asked to share their opinions about the service, and we could see examples of how concerns or suggestions had been followed up by staff.

Nobody that we spoke to raised any concerns about their experience of living at Arthur Roberts.

21, 28 January 2011

During a routine inspection

We spent time meeting people living at the home either in their rooms or in communal areas. Some people were not able to comment directly on the service so we spent time in communal areas observing people's care to help us make a judgment about their experience. Generally, people seemed relaxed with staff and in their surroundings. However, we found for many people a lack of stimulation meant that they slept or watched each other and staff, although sometimes this depended on which lounge they sat in. Some people told us they would like more to do.

Some people were able to comment directly on their experience. We asked people to tell us about choices and if they felt involved in their care. We saw that generally people moved around the home as they pleased. However, we also saw that some people were repeatedly told to sit down and to drink their tea in very directive manner by one staff member. Many of the people that we spoke to were unable to answer direct questions about their care and treatment. However, one person told us 'on the whole staff are good', and we heard another person saying that staff were 'so kind'. Some people were able to tell us that they were 'warm' and 'comfortable'.

We saw a mixed approach by staff in the way they involved people and respected their dignity. Many of the staff that we saw working with people showed through their actions, in their conversations and in their discussion with us, empathy for the people they cared for and a respect for their achievements in life. Visitors to the home told us that staff were caring and spoke positively about how staff knew people living at the home well. People living at the home were not asked directly about staff recruitment but some people told us that the staff are 'lovely', 'so kind', 'they are so nice' and 'they look after us well here'.

We saw how some staff explained to people what they were doing when they assisted them to move by using equipment. This meant that people were involved in the process, and were not so startled. However, this approach was not consistent and sometimes we saw staff work in a way which was not respectful.

Many people could not remember what they had eaten or if they had had a choice of what to eat. Some people told us they enjoyed the food they ate, with one person describing it as 'lovely'. They told us they liked the home and their bedrooms. They said it was well kept and 'nice'.

Many people that we met during our visit were unable to comment directly on the staffing levels and staff skills but we observed that some staff were quick to pick up on the care needs of people and tried not to keep people waiting. However, there were times that staff behaviour was not professional and staffing levels were at a minimal level.