Enter and view: Apthorp Care Centre

Healthwatch Barnet carried out an announced Enter and View visit to Apthorp Care Centre on 18 February 2016. Apthorp, operated by the Fremantle Trust, is a large residential care home providing support for older people, including those living with dementia and learning disabilities. At the time of the visit, 80 residents were living in the home. 

The inspection found that the home was well maintained, clean and welcoming. Accommodation was organised into small household-style “flats” of between six and fourteen residents, each with its own lounge, dining room and kitchen area. Healthwatch felt this arrangement helped create a more homely and family-oriented atmosphere. The environment was bright and dementia-friendly, with memory boxes outside many residents’ rooms and attractive décor throughout. 

Care planning followed Fremantle Trust procedures and involved detailed assessments before admission. Residents were assigned a key worker, care plans were updated daily and formally reviewed every month, and relatives and healthcare professionals could access the records when needed. Although some residents were unaware of the formal care planning process, they recognised that staff regularly monitored their wellbeing and involved them in discussions about their care. 

Healthwatch found residents generally appeared happy, well dressed and actively engaged in communal life. The home aimed to maintain continuity by allowing residents who developed dementia to remain in familiar surroundings rather than moving them to different units. Staff interactions with residents were observed to be warm, respectful and person-centred. 

The management of residents’ health and wellbeing was broadly positive. The home worked closely with GPs, district nurses, the Rapid Care Team, opticians, dentists, chiropodists and North London Hospice. The Butterfly Scheme, which promotes personalised dementia care, was also being introduced. Staff highlighted concerns, however, about reduced GP availability following the end of an extended GP service pilot, which sometimes made accessing timely medical care more difficult. 

The report also identified concerns about discharge arrangements from hospitals. Staff described residents returning from hospital late at night without adequate information, medication or equipment, and gave examples where this had negatively affected care. Healthwatch noted that this issue had been raised by several care homes across Barnet. 

Staffing levels were generally viewed as appropriate. The home maintained higher staffing ratios for residents with dementia, and efforts were underway to reduce reliance on agency workers through recruitment of permanent staff. Staff received regular supervision and appraisals and were supported to undertake professional qualifications. 

Training arrangements were comprehensive, covering dementia care, infection control, moving and handling, first aid, safeguarding and medication management. Healthwatch found staff knowledgeable and well supported, with a strong emphasis on ongoing learning and development. 

The activities programme was a particular strength. Residents could participate in a wide variety of activities including interactive film sessions, board games, gardening, religious services and singing. The Apthorp Choir, involving both staff and residents, was especially popular. A dedicated activities coordinator and strong use of communal spaces helped promote engagement and wellbeing.

Food quality was praised throughout the report. Meals were prepared on site by a qualified chef with an emphasis on fresh, home-cooked food. Special diets were catered for, residents spoke positively about meals and the kitchen held a five-star Food Standards Agency rating. Healthwatch was particularly impressed by both the quality and presentation of food. 

The home was reviewing how it engaged residents and relatives. Management had introduced an open-door policy and was moving away from less effective meeting formats towards a residents’ and relatives’ committee. Healthwatch welcomed these developments and encouraged continued efforts to strengthen engagement.

Overall, Healthwatch concluded that Apthorp was a well-run care home providing a high standard of care in a clean, pleasant environment. The report particularly praised the cleanliness, food quality, staff interactions and activities programme. Recommendations included ensuring hand sanitiser was always available at the entrance, continuing to improve engagement with residents and relatives, extending Wi-Fi access across the site, securing adequate medical cover and improving hospital discharge processes. 

Management accepted the findings and reported that the hand sanitiser issue had already been resolved and that the new residents’ and relatives’ committee had been established.