Chelsea’s Margaret Thatcher Infirmary has been rated Outstanding overall by the Care Quality Commission.
It was rated Outstanding for being effective, caring, responsive and well-led. It was rated Good for being safe, following the inspection in June 2019. The provider and staff team had worked hard since the previous inspection in September 2016 and had been able to improve effective from Good to Outstanding at this inspection.
The Margaret Thatcher Infirmary provides accommodation for up to 68 people who require nursing or personal care within the Royal Hospital Chelsea, the home of Chelsea Pensioners. At the time of CQC’s inspection there were 58 people living in the infirmary.
People and their relatives were extremely positive about the caring and compassionate nature of the staff that supported them. One relative said: "The staff are wonderful and go over and above what I would have expected. They have built up a wonderful rapport with all the pensioners."
There was a significant focus on the mental and social welfare of people and linking with people’s families. There were four ‘Captains of Invalids’ whose role was to oversee the welfare of 75 people each and to ensure their general all-round wellbeing. People praised the support they received from their Captains of Invalids and respected and trusted them due to a shared experience of military life. One Captain, who lived on-site said: “We are here to listen to them and they can relate to us because of our military experience. It helps create a great amount of trust.”
People benefitted from an excellent variety of activities, events and trips out that were available to reduce social isolation, give meaning and purpose and enhance their wellbeing. People had an overwhelming sense of pride representing the Chelsea Pensioners.
The provider was externally recognised as providing outstanding care at the end of people's lives. Relatives praised the care and support both they and their family members received at this sensitive and emotional time. People’s lives, and military achievements were honoured after they had passed away and shared with people and the staff team.
People were cared for by dedicated and passionate staff who felt appreciated and privileged to support people who had served their country. Staff spoke positively about the working environment and the support they received to help provide high standards of care. One staff member said: "This is our own village in Chelsea and is a wonderful community. Listening to the stories of the pensioners is the best thing about working here."
People benefitted from having access to an on-site medical centre where they could see the GP on the same day if needed. People and their relatives praised the immediate healthcare support that was available when people’s health deteriorated. Along with this, there was an in-house occupational therapy and physiotherapy team with access to a hydrotherapy pool and gym. There were visiting audiologists, podiatrists, urologists, dentists and psychiatrists. The medical centre also ran diabetic, asthma, stroke awareness and stop smoking clinics.
CQC inspectors observed daily handovers across different wards and saw people's health conditions were discussed and if they were scheduled for any medical appointments. Where any changes were seen overnight, GP referrals had been made for the morning. One relative said: "As their condition deteriorated they have adapted their care at every step and we have been kept updated."
Throughout the inspection inspectors observed staff treating people with kindness and compassion and had developed positive and meaningful relationships with each other. Staff knew how people liked to be addressed and CQC saw many examples of people and staff laughing and joking with one another in a very relaxed environment. One person said: "We have a laugh and a joke with each other. If you can't get a laugh out of life, what's the point?'
People benefitted from an excellent variety of activities and events that were available across the service and made accessible to all. Daily activities included pottery and art classes, Tai Chi sessions and a range of exercise groups, music and reminiscence sessions, film screenings and pet therapy sessions. There were also a wide range of clubs, including bowls and a choir. The provider had introduced music and art therapists to the staff team, where we saw projects had an overwhelmingly positive impact on people and their health and wellbeing. There were over 60 active volunteers who supported people to live the life they wanted to.
The health and wellbeing of people was the priority of the service and the provider's values were imbedded across the organisation. Values of belonging through comradeship, respect, committing to high standards and enabling people to lead happy and fulfilling lives ensured people received excellent care.
People inspectors spoke with praised the service, the ethos and the openness of the staff and management team, which had a positive impact on people's day to day experiences. Comments included: "You see matron every day and she wants to talk with you, she is very easy to talk to. You can see staff aren't worried about her being around" and "Nowhere else is comparable to the standards here. I see news reports and I want to weep. I am so well cared for."
People were also involved in producing a magazine, which included a range of articles and information written by people for everybody at the Royal Hospital Chelsea. People said it kept them updated with events that had happened and upcoming events. It also honoured people's achievements, life stories and the work people had done with other organisations.
Alison Murray, Head of Adult Social Care Inspection in London said: “I am very impressed with the standard of care at Margaret Thatcher Infirmary. People we spoke to were full of praise for the staff and management at the infirmary.
“It is good to see those that have served their country getting such outstanding care. I was particularly impressed to hear that there were many daily activities including pottery and art classes, Tai Chi sessions and a range of exercise groups, music and reminiscence sessions, film screenings and pet therapy sessions.”
You can read the report in full when it is published on CQC’s website at www.cqc.org.uk/location/1-328817696
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