Inspection on 07/12/09 for Bellevue Court

This is the latest available inspection report for this service, carried out on 7th December 2009.

CQC has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bellevue Court 12/08/08

Bellevue Court 25/09/07

Bellevue Court 30/01/07

Bellevue Court 30/10/06

Bellevue Court 10/03/06

Bellevue Court 02/11/05

Bellevue Court 13/12/04

Bellevue Court 09/08/04

Similar services:

The Lodge Nursing Home

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

The Maples

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Bellevue Court Woodcross Street Woodcross Wolverhampton West Midlands WV14 9RT Lead Inspector Rosalind Dennis Key Unannounced Inspection 7th December 2009 09:00 DS0000039462.V378781.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bellevue Court Address Woodcross Street Woodcross Wolverhampton West Midlands WV14 9RT 01902 662166 01902 672230 bellevuecourt@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Ltd 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) Manager post vacant Care Home 68 Category(ies) of Dementia (38), Mental disorder, excluding registration, with number learning disability or dementia (30) of places Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing (Code N) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 38 Mental disorder, excluding learning disability or dementia (MD) 30 The maximum number of service users who can be accommodated is: 68 30th January 2009 2. Date of last inspection Brief Description of the Service: Bellevue Court provides care for persons with a mental illness or dementia. It is a purpose built care home located on the borders of Wolverhampton and Dudley and is a short distance away from local shops and amenities. A bus stop is located nearby. Bellevue Court operates over three floors with lift and stair access between floors. People who have a dementia related illness are accommodated on the ground and top floor (Lark and Nightingale Units) and people with a mental illness reside on the first floor, ‘Kingfisher’ unit. Information on the fees charged by the home is included within the service user guides, where it is documented that the average weekly fees range from £518 to £557, although these fees may vary according to the needs and dependency of the individual. The reader is advised to contact the home to obtain up date information on the fees charged. People can obtain information about this service from the home’s Statement of Purpose and Service User Guide. Inspection reports produced by CQC can be obtained direct from the provider or are available on our website at www.cqc.org.uk. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 5 Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection identifies that there has been a change in rating of the service and people are now receiving 2 star - good quality outcomes. This inspection was carried out over one day by one inspector. The home did not know we were going to visit. The focus of inspections we, the Commission, undertake is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, standards of practice and focuses on aspects of service provision that need further development. Prior to the visit taking place we looked at all the information that we have received, or asked for, since the last key inspection. This included notifications received from the home. These are reports about things that have happened in the home that they have to let us know about by law, and an Annual Quality Assurance Assessment (AQAA). This is a document that provides information about the home and how they think it meets the needs of people living there. Four people living in different areas of the home were case tracked. This involves establishing individual’s experiences of living in the care home by meeting them, observing the care and support they receive, discussing their care with staff, looking at care files, and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. Some of the people living at the home were not able to comment on the care they receive and so we observed the support given by staff and how staff interacted with them. We also looked at feedback given by people living at the home, relatives and two staff when they completed surveys for us. An expert by experience came with us on the inspection, these are people who are or have used services we are inspecting. This experience makes them experts. Their role is to bring a different and independent view to the inspection process by working alongside inspectors observing and gaining the views of people who use the service. The expert by experience spent time meeting and speaking with people who live on Kingfisher Unit. Their comments have been included in the report. We looked around some areas of the home and observed a sample of care, staff and health and safety records. We spoke with staff during the inspection to establish their views of working at the home and if anything needs to be improved. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 7 What the service does well: People have their needs assessed before they move in, which ensures that people are only admitted if the service is confident it can meet their needs. People and their representatives are involved in planning the care and support which is needed to meet their needs. Staff are recruited and selected in ways that ensure safe, skilled individuals are employed People are provided with opportunities to enhance their wellbeing and a choice of meals which meet their needs and preferences. What has improved since the last inspection? What they could do better: We view that people living at Bellevue Court experience good quality outcomes overall, although there are areas for further improvement. We found that People are provided with opportunities to enhance their social well-being, but view that more could be done to build on people’s abilities and enhance their life skills, particularly for people with mental health needs who live on Kingfisher Unit. We were informed by the home in 2008 that they viewed they could do better by offering more rehabilitative and outdoor activities and of their intention to develop a supervised kitchen and laundry facility. We were informed of the same intentions in the AQAA before this inspection and found at the inspection that there had been little development in this area. The home needs to put these plans into place, so that people are offered greater opportunities to enhance their life skills. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.2 Page 8 There has been little improvement with the living accommodation. For example a bath reported as being out of action at the time of the key inspection in January 2008, remains out of action and we identified that a shower is also not in working order, meaning that people are provided with a reduced choice of washing/bathing facilities. Carpets in corridors show signs of wear and tear, which has also been identified at other inspections. During this inspection we looked at documents completed by company representatives during different quality monitoring visits, and saw that these visits identify a need to improve the environment but no apparent action appears to have been taken by the company. The company is required to submit an action plan to tell us when it intends to improve the environment. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 9 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 Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before they move in, which ensures that people are only admitted if the service is confident it can meet their needs. EVIDENCE: We looked at the care records for two people who have moved to the home since the last key inspection. A representative of the home had fully assessed their needs by meeting them in hospital before they were admitted and seeking information about their illness and care needs. This helps to ensure that only people whose needs can be met at are admitted. Both people, because of their illness were unable to tell us their views of the admission process but we saw from looking at the care records that information had been obtained from their representatives about the person’s life before their illness Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 11 and their likes, dislikes and preferences. This helps staff to know more about the person and how to give care based on the person’s needs and wishes. We saw that when a person had gone to hospital from the home staff contacted the hospital to find out if there had been a change in this person’s needs before they returned to Bellevue Court. This is good practice as it enables staff to plan for the person’s return to the home. The AQAA told us that people are able to visit the home and stay for a trial period. A person we spoke with who lives on Kingfisher Unit confirmed this happened before they moved to the home on a permanent basis. Each unit has a specific Service User guide, which contains a good level of information about the home, the services provided and the fees charged. It is documented that the guide can be made available in different formats, such as audio tape, if needed. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their representatives are involved in planning the care and support which is needed to meet their needs. EVIDENCE: We case tracked three people who have dementia and are cared for on Nightingale and Lark Unit. Their care records contained detailed care plans and risk assessments which mean staff have information on how people prefer to have their needs met taking into account any risks to them. We saw that staff identify when people are at risk of harm from behaviours of concern and their care records provide staff with guidance on the most appropriate way to manage the behaviour. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 13 We observed that, for people assessed as being at risk of developing pressure sores they had specific mattresses on their beds and cushions on their chairs, which are designed to reduce the risk of pressure sores occurring and care plans described clearly what staff need to do. We saw that staff followed the plan, assisting people to move at regular intervals or rest on their beds after they had sat in a chair for a short while. People’s care records described the equipment and techniques needed by staff to move them safely. We saw staff using the equipment safely and as described in the care plan. Staff had good approaches with people, providing reassurance and explanation when using the equipment and maintaining people’s dignity. Two people who currently have wounds, had documentation in their file showing the care needed of the wounds to promote healing, including the type of wound dressing and how often it needs to be changed. Their care records showed that staff had been in contact with wound care specialists for guidance to ensure the home is using the most appropriate treatment. We saw that staff are good in their interactions with people with dementia and respond well when people need more support. The staff we spoke with gave good accounts of the varying needs of people and how they meet those needs, which reflected what was written in people’s care plans. In preparation for our inspection we sent surveys to people living at the home and their representatives. We received three surveys from relatives of people who live at the home and they provided positive views of the home, including:My relative “gets all loving care and attention, excellent food and wonderful attention from nurses, doctors and staff, lovely clean and airy room. Thank you.” “all staff try to help residents live a full life, if possible. Care is taken to ensure residents are safe at all times..... Staff are approachable, if I have a problem staff listen and deal with concerns and always in a pleasant and caring way”. “They respond well to differing needs of individuals although a little more stimulation may be added. I am happy with the homeliness and atmosphere. The home smells clean and fresh. Residents are nice and clean. Could do with more chiropodist visits”. We received 16 surveys from people who live on Kingfisher Unit and all apart from one person commented positively about how they are treated by care staff and managers. During the day, one person described how they feel they are “bossed about” by staff but another person we spoke with viewed they are treated well by staff. We looked at the care records for one person which described their mental and healthcare needs and the support they need from staff. We spoke with the person who told us they meet with staff regularly to talk about their care and Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 14 support needs and their care records reflected this. The person described how staff are there when they need additional support, otherwise they like that they are able to do what they want. Another person’s care records showed that a review had taken place recently with the person, their social worker and a representative from the home and the person had commented they were satisfied with the care and support they receive. We spent time on Kingfisher Unit speaking with people and observing how staff interact with them. On one occasion it appeared there was little staff interaction taking place, however on another visit later in the day we saw staff engaging and chatting with people. We looked at the medication records for the people we case tracked and saw these records were up to date and properly completed. We noted that staff working on Nightingale and Lark Units were using different coloured pens to highlight the times when medication is due. We saw that staff were not consistent in the colour of pen they were using and we discussed with the company representative that if the home chooses this approach, then it is good practice to ensure consistency throughout the home, so as to reduce the risk of errors occurring. Medication is stored in locked trolleys and a locked cupboard so that people are not at risk of taking medication they are not prescribed. We saw written records showing that staff monitor the temperature of the medication fridge and the temperature of the room where medication is stored. On the day of inspection we noticed that staff had recorded the fridge temperature as lower than it should be for safe storage of medicines. The acting manager and company representative assured us that action would be taken quickly to rectify that. We saw the service looks at ways to support people’s religious, spiritual and cultural needs, including their wishes should their condition deteriorate. The AQAA tells us that the home is planning to involve all staff and “service users” with the care planning review process and to have health promotion groups for people who live at the home, which will help to ensure people have opportunities to maximise their health. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the service experience good quality outcomes overall in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with opportunities to enhance their social well-being although more could be done to build on people’s abilities and enhance their life skills. People are offered a choice of meals to meet their dietary needs and preferences. EVIDENCE: Most of the people who live on Kingfisher unit and who completed surveys for us told us they are supported to make decisions about what they do each day and can do what they want to do most of the time. One person described how the home organises trips to the cinema, football matches and indoor activities, another person commented they would like to go out more often and another commented they would like to undertake reading classes. We observed people who live on Kingfisher Unit popping in an out of the home throughout the day. A disco had been planned for the following day. One person told us Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 16 they would like to go to a Day Centre and when we looked at their care records saw this was in the process of being organised. Three people told us that the only activities which take place are board games, quizzes, bingo and a “seated exercise” class, however written records we looked at and discussion with staff suggests other activities and events do take place. However what is acknowledged in the AQAA is that the home could do better by offering more rehabilitative and outdoor activities and is also intending to develop a supervised kitchen and laundry facility. At our key inspection in 2008 we had also been informed of these intentions. The home needs to put these plans into place, so that people are offered greater opportunities to enhance their life skills. We saw that people with dementia related conditions have opportunities to enhance their social well-being. Staff showed us where they keep records of activities people take part in, which shows that people are provided with different activities, including visits from people outside of the home, such as singing entertainers. During our inspection we saw that some staff were supporting people to read, others were speaking with people about current and past events, which people appeared to be enjoying. Information on activities and events are advertised on notice boards throughout the home. We looked at a selection of the home’s menus, which shows that people are offered choices and the deputy manager confirmed to us that the home ensures people’s cultural and specific dietary needs are met. People living on Kingfisher Unit told us they like the food, that it is of good quality and they get plenty to eat at set mealtimes, however they also told us that food and hot drinks are not available outside of set times. For example we saw there was no facility for people to make a drink without staff having to bring hot and cold water from the main home kitchen. We saw that meals had been prepared to reflect people’s specific dietary needs, such as swallowing and chewing difficulties and saw that staff had good approaches to support people who needed assistance with their eating and drinking. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure which ensures people and their representatives know how to raise concerns and complaints. Staff know how to safeguard adults from the risk of harm and abuse. EVIDENCE: The complaints procedure is displayed on a notice board in the reception and is also available within the service user guides. The procedure provides people with clear information on the process to follow and who to contact if people want to complain. 17 of the 19 people who completed surveys for us confirmed they know how to make a complaint. The AQAA stated that nine complaints have been received in the last 12 months. We looked at the processes used by the company to respond and act on complaints which shows there is a good process in place, with complaints and the action taken recorded. One person we spoke with was not aware of local advocacy services, another person was aware but did not have the contact details, which shows that staff need to raise awareness of who people can contact if they want. The training records we looked at and the staff we spoke with demonstrates that staff working at the home receive training on safeguarding vulnerable Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 18 adults from the risk of abuse. Staff could describe to us their role in safeguarding adults from the risk of harm and abuse. The previous manager and new acting manager have demonstrated they know when to refer concerns to the local safeguarding adults team for investigation under their procedures. We saw leaflets in different parts of the home on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. The Act governs decision making on behalf of adults, and applies when people lose mental capacity at some point in their lives or where the incapacitating condition has been present since birth. It is important that staff know how to put the Act into every day practice and the procedure to follow should peoples freedom need to be restricted. The acting manager is aware that all staff should have awareness of the Act. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 and 26. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with an environment which is safe but which needs more attention to ensure it is homely and well-maintained so that people are provided with a good standard of living accommodation. EVIDENCE: We looked at the rooms for the people we case tracked, which were clean and decorated to a satisfactory standard. Some people have chosen to personalise their rooms with pictures and photographs. All rooms consist of a bed, wash hand basin, wardrobes and chest of drawers. Toilets are located near to people’s bedrooms. We identified that people are not being provided with their full choice of preferred bathing and showering facilities, due to a specific Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 20 type of bath and “level access shower” being out of action. We reported in our last key inspection report that the bath was not in use as it was broken, so it is disappointing that no apparent action has been taken to repair this facility. Since the last key inspection the communal living areas and corridors on Lark unit have been re-decorated and include murals and objects designed to promote reactions from people. We saw the home has equipment to help move people safely such as hoists and staff working on Nightingale and Lark units told us that there is enough of this equipment to meet people’s varying needs. There is a choice of stairs or passenger lift to the first and second floors. We saw that the home has improved the patio area outside Kingfisher unit and the garden, although small, is well-maintained. People told us how they had enjoyed growing vegetables and other plants earlier in the year. A shelter is provided for people who smoke and people were seen regularly popping outside to this facility. The environment on Kingfisher Unit includes a room with a pool table and board games and at the time of inspection was being prepared for a disco. The lounge was clean and the furniture of good standard, although not particularly homely or reflective of the age group of most of the people who live on this unit. As identified at our other inspections the environment overall still needs attention to improve the appearance, for example carpets in the corridor on Lark Unit are worn in places, a bath and shower out of action and those bathrooms which are in working order could benefit from some updating. The dining area on Nightingale unit included a fridge being used to store some food items and we saw the door had broken and the kitchenette here needed attention. Our findings reflect those of a representative for the local authority who raised concerns about parts of the environment during a visit to the home. During this inspection we looked at documents completed by company representatives during different quality monitoring visits, and saw that these visits identify a need to improve the environment but no apparent action appears to have been taken by the company. We requested at the time of inspection that we be informed of the timescale for improvement. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who have the skills and knowledge to meet their needs and who are suitable to work with vulnerable adults. EVIDENCE: We spoke with staff, observed them working and discussed staffing levels with the acting manager which indicated that sufficient skilled care and nursing staff were on duty to meet the needs of people currently living at home. Staffing rotas and discussions with staff confirms that nurses with qualifications in mental health are available on most shifts to provide input and support for people with mental health needs. Staff we spoke with during our inspection told us that staffing levels are usually sufficient, giving examples of how varying behaviours of people and staff sickness can cause occasional difficulties. The home has an effective process to show when staff are up to date with training and when training is needed. This demonstrates that regular staff training takes place, including training in safe working practice topics such as fire safety, moving and handling, safe use of bed rails as well as more specific Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 22 training such as dementia care, care of people whose behaviour may challenge, pressure area care. The acting manager also informed us of some training sessions which have been held for staff to raise their awareness of mental illness. The AQAA informed us that over 70 of care staff have achieved a recognised qualification in care (National Vocation Qualification) and this should contribute to ensuring the staff team have an effective knowledge of social care. We looked at the process used by the home to recruit three members of staff who have started working at the home since the last key inspection. All parts of the recruitment process were accurately recorded and demonstrated that pre-employment information, such as references and Criminal Record Bureau Disclosures had been sought prior to these staff working at the home. We also saw that new staff are provided with an induction so they know about the home and the care people need. Two staff completed surveys for us before the inspection. One viewed that they receive training relevant to their role but the training does not help them to understand and meet needs. They also told us there is never enough staff on duty, that people could do with more one to one support and when things are reported about clients or staff nothings seems to get done. The other staff member commented in their survey that there is always enough staff and viewed that people are looked after well, but the home could do better by improving the environment. Meetings for staff take place on a regular basis. Minutes are kept of these meetings which show that staff are kept informed of issues relating to topics such as health and safety and care practice Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management arrangements ensure the home is safe and people are provided with opportunities to comment on how the home is run so that their views can be acted upon, however the company is not ensuring people are provided with a good standard of living accommodation. EVIDENCE: Since the last inspection there has been a change in the management arrangements in that the manager at the time of that inspection has recently left and the deputy manager has taken on the role of acting manager with Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 24 support from a company operations manager. The company is aware that an application will need to be made on the appointment of a manager so that we can consider the applicant for registration with us. The acting manager views that the home is providing people with care which is person-centred, but recognises that ongoing development will be beneficial for people. A representative of the company monitors quality at regular intervals with monthly unannounced visits and as mentioned earlier in the report we observed the reports produced as a result of these visits, which shows that the company needs to be proactive in addressing environmental issues promptly. We also looked at how the home provides people with opportunities to comment on different aspects of the home through surveys and saw a sample of surveys completed in October 2009. Information was provided within the AQAA to confirm servicing and maintenance of equipment is undertaken and policies and procedures are reviewed. We looked at a selection of maintenance and servicing records during the inspection, all were up to date and demonstrate that systems are in place to ensure the home and equipment is safe, such as the checking of bed rails and hoist equipment. The AQAA described how there are “safe and secure systems in place to control the personal monies of service users”. This was discussed with the company operations manager who confirmed that people are enabled to have access to any finances the service holds for them as they request, although a person we spoke with viewed that he is ignored when he asks for money for extra cigarettes. Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 25 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 CHOICE 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 26 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. 1 Standard OP19 Regulation 12 Requirement An action plan should be produced and forwarded to the commission, detailing the intentions of the company to redecorate and develop the home. This is to show that people will be provided improved living accommodation Timescale for action 01/02/10 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 OP19 Good Practice Recommendations All parts of the home, including bathrooms, toilets and communal areas must be kept in a good state of repair. This is to ensure that people are provided with a clean, homely and safe place to live. (previous requirement at key inspection in August 2008 and recommendation in January 2009) Bellevue Court DS0000039462.V378781.R01.S.doc Version 5.3 Page 27 Care Quality Commission West Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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