Inspection on 14/02/07 for Belamie Gables

This inspection was carried out on 14th February 2007.

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

Belamie Gables 29/04/08

Belamie Gables 10/10/07

Belamie Gables 02/02/06

Belamie Gables 19/07/05

Belamie Gables 05/01/05

Belamie Gables 25/10/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Belamie Gables 210 Hyde End Road Spencers Wood Reading Berkshire RG7 1DG Lead Inspector Annette Miller Unannounced Inspection 14th February 2007 10.30 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 Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 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. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belamie Gables Address 210 Hyde End Road Spencers Wood Reading Berkshire RG7 1DG 0118 988 3417 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) Mr J Parry Mr D L White Belinda Vickery Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02/02/06 Brief Description of the Service: Belamie Gables is a privately owned care home. The service is registered to provide personal care and accommodation for up to 20 persons who are over the age of 65. It is situated in a quiet residential area to the south of Reading. The property is a large detached house set back from the main road. There are large front and rear gardens with car parking spaces at the front of the property. There is a passenger lift in the building and accommodation is provided on two floors. The registered providers have decided to close two bedrooms because of the limited amount of usable floor space in each room and are considering the possibility of an extension. This has been the situation since the last inspection. The fees for this home range from £417.00 - £438.00 per week. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the 1st April 2006 the Commission for Social Care Inspection (CSCI) has developed the way it undertakes its inspection of care services. This inspection was an unannounced ‘Key Inspection’ to look at the standards CSCI considers are most important. The inspection lasted from 10.30 am to 7.30 pm and was a thorough look at how well the home is doing. It took into account detailed information provided by the manager and any information that CSCI has received about the service since the last inspection. The inspector spoke to one resident individually and to a group of residents in the lounge to find out what life was like in the home. Discussion was held with the manager, deputy manager, a senior carer and the cook. The manager was available during the inspection, except for a period late afternoon when she visited a prospective resident as previously planned. The inspector toured parts of the home, looked at care records and also other documents relevant to the inspection . Three residents, six relatives and three health care professonals returned questionnaires to CSCI to give feedback most comments were good. The inspector looked at how well the home was meeting the standards set by the government and has in this report made judgements about this. What the service does well: What has improved since the last inspection? Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 6 Berkshire Fire Service and Berkshire Environment Health Department have inspected the home since the last inspection and the matters arising were dealt with promptly to ensure the safety of residents. The manager has sent out questionnaires to residents and relatives to obtain feedback to assist in the future development of the service, although only a limited response was received. What they could do better: The inspector found that the temperature of hot water to the first floor bath and some basins in residents’ rooms was too hot and there was a possibility of residents being scalded. The manager was required to inform the inspector in writing by the 23rd February 2006 of the action that was being taken to limit the hot water to a safe temperature. This timescale was complied with and the owners took prompt action to fit thermostatic mixing valves where needed. The owners are not in day-to-day charge of the care home and therefore must arrange for unannounced monthly visits to be made to check that the condition of the home and the care provided is satisfactory. These visits lapsed in March 2005 and must be restarted. A report must be written following every visit and a copy kept in the home for inspection by a CSCI inspector at any time. Care plans should be signed so that queries can be discussed with the appropriate carer and dated to show the period of time the plan relates to. Some important risk assessment had not been done and this potentially put residents at risk. The manager needs to consider implementing risk assessments for falls, nutrition and use of bed rails to ensure prompt action is taken to reduce any identified risk. Residents should be weighed at least monthly to monitor weight loss or gain so that dietary problems are identified promptly. The home provides stand-on scales but the majority of residents are too frail to use them and alternative arrangements are needed. There was no liquid soap in the laundry/sluice room for staff to wash their hands with and the nearest supply of disposable gloves was in reception. Whilst the reception is not far from the laundry/sluice room, it is good practice to keep disposable gloves in rooms where there is increased risk of cross infection. Also, disposable aprons need to be readily available. When the inspector asked where these were kept, two carers eventually found them tucked between clean linen in the linen cupboard opposite the laundry/sluice room. The manager needs to check that the staff team are following appropriate infection control procedures regarding the use of protective clothing to ensure residents are protected from possible sources of infection. Please contact the provider for advice of actions taken in response to this Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 8 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 Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Standard 6 does not apply to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service Users’ Guide are good enabling prospective residents to make an informed decision about admission to the home. Prospective residents are assessed before admission to ensure their care needs can be met. EVIDENCE: The Statement of Purpose and Service Users’ Guide have a good range of information about the services the home provides. The manager said copies are given to every prospective resident, or a family member if this is more appropriate. One resident told the inspector she had received sufficient information before moving into the home and the CSCI questionnaires returned by three residents also confirmed this. New service users are assessed before admission and a record of the assessment is made. The inspector looked at one assessment and saw that it contained relevant information in sufficient detail to help the manager decide Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 10 whether the home could meet the person’s care needs. During the inspection the manager visited a prospective resident to assess the person’s needs as this visit had already been arranged. Two residents said they had visited the home before moving in and this helped them to decide that the home was where they would like to live. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The overall standard of care provided to residents is good but improvements in some aspects of care planning are needed to ensure care needs are adequately met. Also, some important risk assessments are not done and this has the potential to put residents at risk. EVIDENCE: The home’s procedure is to compile a 24-hour care plan for every resident in which the person’s basic care needs are identified and the actions to be taken are stated. This provides carers with the basis for the care to be delivered and the plan continues until changes are needed, when a new care plan is written. This means that care plans accumulate in the care files but as they are not dated it is not clear which is the current plan. The manager should ensure that all care plans are dated when they are written and also signed so that queries can be discussed with the appropriate member of staff. Most of the care plans looked at were not dated or signed. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 12 One resident was recovering from an acute infection but had no plan of care to deal with this. It is in the home’s interests to be able to show what they have done, along with providing the evidence on which to base the monthly review. There was evidence that staff had some awareness of the need to carry out risk assessments to protect residents. In the three files looked at each resident had been assessed for risk of developing pressure sores and where this risk was identified, pressure relieving mattresses and cushions were provided. Handling and moving assessments had been completed showing whether or not hoists were needed and how many carers were required to give assistance. One file showed that precautions to avoid trips and falls had been identified, although a falls risk assessment had not been completed. This needs to be done for every resident with a history of more than one fall in order to reduce risk. Of the three files inspected it was found that a falls assessment was needed for two residents. The care files had information about residents’ dietary likes and dislikes but there was no evidence of a thorough nutritional assessment using a nationally validated nutritional assessment tool (reference: www.bapen.org.uk). Every new resident should have a nutritional assessment to find out if they have any nutritional problems. This is to ensure that prompt action is taken to help residents maintain a healthy diet. Residents need to be weighed at least monthly to monitor weight loss or gain so that dietary problems are identified promptly. The home provides stand-on scales but the majority of residents are too frail to use them and alternative arrangements need to be made. The inspector saw that bed rails were in use for some residents but found no evidence that risk assessments were done before this equipment was put into use. The suitability of the bed rails, bed and bed base in combination for the bed occupant should be determined before bed rails are used as there is a potential risk of entrapment of a resident’s head, neck or limbs between the rails (reference: www.mhra.gov.uk) Medication was safely stored and every resident has his/her own medication record chart. Medication records were generally in good order, although a number of handwritten medication instructions written by carers had not been signed and dated and this needs to be done. Members of staff were seen to act kindly towards residents and to treat them in a respectful way. The six relatives who returned CSCI questionnaires said they were satisfied with the overall care provided. However, one relative raised a concern about the standard of personal hygiene provided. The inspector noted that residents looked clean, but thought that more attention was needed to some aspects of personal care, such as brushing and combing residents’ hair to prevent it becoming matted. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 13 It is good that carers provide a manicure service but when varnish becomes badly chipped it is important that it is removed for those residents who are unable to do this for themselves. The manager was asked to monitor these aspects of residents’ care. Doctors and district nurses visit the home regularly to provide health care. A district nurse said on a CSCI questionnaire that she thought the standard of care at the home was good and that the district nursing team had a good working relationship with the home’s staff. Feedback from a GP also indicated care at the home was good. From the evidence seen by the inspector and comments received the inspector considers this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines and daily life at the home are flexible and although many of the residents were unable to express a view they seemed to be content in their surroundings. EVIDENCE: Most residents sit in the lounge during the day although they could stay in their rooms if they wished. A resident said she liked being in her room and having meals served there, which was never a problem for the staff team. This resident said she was very happy in the home and thought carers were kind and patient. Many residents were unable to express a view due to memory loss and also some deterioration in their mental health. The inspector saw there was normally at least one carer in the lounge chatting to the residents and giving assistance where required. The home does not have an activities organiser and carers provide activities when they have time. The kinds of activities taking place are bingo and reminiscence, as well as occasional visits to a nearby garden centre. The inspector saw a carer sitting with a small group of residents during the afternoon talking to them and looking at photographs. The TV was on in the lounge most of the day, although not many residents were watching it and Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 15 several residents were asleep, indicating it was unnecessary to have it on all of the time. A resident said she could have visitors whenever she wished and the six relatives who returned CSCI questionnaires said they could visit in private. The cook said that menus are changed to provide varied seasonal food and that there is minimal use of frozen food. The cook discusses the day’s menu with residents each morning and individual dishes are prepared when residents ask for an alternative. The inspector saw staff giving unhurried one-to-one assistance to residents during lunch. The three residents who returned CSCI questionnaires said they liked the meals. One said he was “very pleased”. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with some evidence that residents feel that their views are listened to an acted upon. EVIDENCE: The home’s complaints procedure provides information about the stages and timescales for dealing with complaints. This procedure is displayed in reception and also in the Statement of Purpose, which the manager said was given to every new resident or a relative. The last complaint received by the home was in July 2005 and no complainant has contacted CSCI with information concerning a complaint about the home since the last inspection. The three residents who returned CSCI questionnaires said they knew who to speak to if they had a concern. One resident said, “I am rarely not happy and very seldom need to complain, in fact hardly ever”. Four of the six relatives returning CSCI questionnaires said they knew about the complaints procedure. The inspector advised the manager to check the information given in the complaints procedure about referring complaints to an ‘Ombudsman’, as the information about this was not specific enough to help complainants know who this person was and what type of complaints were dealt with. Training on the protection of vulnerable adults is provided and a record of staff attendance is kept. The manager confirmed the home has an adult protection and prevention of abuse policy. This was not examined on this occasion. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment provides a reasonable standard of accommodation but more attention is needed regarding general cleaning and infection control procedures to ensure residents live in a pleasant and safe environment. EVIDENCE: The care home provides a homely environment and on the day of inspection was pleasantly warm. The standard of décor and furnishings is generally good, although the communal rooms and some bedrooms are showing signs of wear and tear. Three empty bedrooms have been redecorated and refurbished recently to a good standard for new residents. Cleanliness could be improved in some areas. Dust had accumulated along skirting boards and in corners and some occasional tables in the lounge were stained with food and felt sticky. The inspector arrived at 10.30 am and the lounge and dining room looked untidy and the carpets needed vacuuming to remove food crumbs and fluff. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 18 The carers are required to clean the home during the day and at night when not providing care to residents. The inspector considers this is acceptable at the present time as the home has low occupancy (14 residents), but this situation will need to be carefully monitored if more residents are admitted. There were no unpleasant smells and this indicates there are good systems in place to keep the environment fresh. The three residents who returned CSCI questionnaires said the home was “always” fresh and clean. There is a rear garden accessible to residents and a small area of lawn at the front with a good amount of parking space. The inspector considered that the gardens would look more attractive if planted with shrubs and flowers and would benefit from the input of a gardener. In December 2005 the Berkshire Fire Service carried out a routine fire safety inspection and identified 24 areas for improvement to ensure the home was safe. The owners arranged for the work to be undertaken promptly and on a follow-up visit in April 2006 the fire officer reported the home had achieved “reasonable standards”. A kitchen inspection by an environmental health officer was done in September 2006 and three requirements were made. The manager confirmed these had been dealt with. The temperature of hot water to the first floor bath and two bedroom basins, selected at random, exceeded the safe temperature limit of 43ºC, meaning residents were potentially exposed to a risk of being scalded. The water at the basins was in the region of 55ºC and the first floor bath water was 48ºC. More regular and robust maintenance checks on water temperature at baths and basins accessible to residents are needed to keep residents safe. (Following the inspection the owners took prompt action to fit thermostatic mixing valves to all basins accessible to residents and to replace the valve to the bath in the first floor bathroom. This work is due to be completed by 28/02/07. The owners also confirmed their intention to set up maintenance service plans to check the valves periodically.) The home has a small laundry consisting of a commercial washing machine capable of washing soiled and infected linen at the correct water temperature, and also a commercial tumble dryer. Situated in the laundry is also a sluice machine in which commode pots are emptied and cleaned mechanically. This is not ideal, although has been a long-standing situation. The manager needs to carefully monitor staff practice to ensure there is no risk of crosscontamination between the body fluids being disposed of and clean laundry. The liquid soap dispenser and paper towel holder in the laundry were empty, although a loose roll of paper towel for hand drying was available. The disposable aprons were found amongst clean linen in the linen cupboard Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 19 opposite the laundry, but were not easily accessible as staff had to search for them. The nearest supply of disposable gloves was in reception and the manager said that carers either picked them up as they passed, or kept a supply in their pockets. The inspector acknowledges that the reception is not far from the laundry/sluice room, but it is good practice to locate a supply of disposable gloves and aprons in more than one location, particularly in high risk areas such as laundry/sluice rooms, to protect people from possible sources of infection. Infection control training had been provided recently when the basic principles of infection control should have been reinforced. The manager needs to check what information was given to staff about basic infection control procedures to ensure they have sufficient knowledge about this. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of carers provided is sufficient to meet the care needs of the residents currently in the home. EVIDENCE: At the time of inspection there were 14 residents living in the home. There were three carers on duty until 12.30 pm and two carers for the remainder of the day and overnight. The manager was on duty and works 7 am – 4 pm five days a week, including weekends. Three days are spent on management duties and two days working as part of the care team. The cook was on duty and works 5 days a week 9 am – 1 pm. Carers prepare and serve suppers, and also lunches when the cook is off duty. Carers involved in preparing and serving food attend the necessary food hygiene training. Two residents said on CSCI questionnaires that they “always” received the care and support they needed; one said “usually” adding, “If staff are busy we cannot demand immediate attention but have to wait just a few minutes. We can be sure they will come immediately they are available”. Five of the six relatives who returned CSCI questionnaires indicated satisfaction with staffing levels; one did not respond to this question. As there has been no recruitment since the last inspection there were no new recruitment files to look at. Instead, the inspector discussed with the manager Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 21 the information and checks that are required and it was clear she was fully aware of what is needed to safeguard residents. 13 out of 15 carers have the NVQ in care. This provides assurance that the staff team has the knowledge and skills needed to provide a good standard of care. This situation also indicates the manager’s commitment to supporting staff through training. The manager has recently attended a seminar on the nationally validated Skills for Care Council’s induction standards so that these can be included in the home’s induction programme. There were no recent induction records to inspect. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides clear leadership throughout the home and this has a positive effect on the care that residents receive. EVIDENCE: The manager has managed the home since 2001 and has a management qualification at level 4 NVQ (The Registered Manager’s Award) and also level 4 NVQ in care. One member of staff said, “The manager does a fantastic job”. A resident complimented the manager on her approachability and willingness to listen to whatever she had to say. This resident said the manager regularly spoke to her to ask if she had everything she needed. It was clear to the inspector that the manager has a good rapport with the residents and regularly finds out what they think of their care. Since the last inspection the manager has attempted to obtain written feedback, but received Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 23 only a small number of responses. She also arranged a residents’ meeting in August 2006 but there was minimal interest. The manager accepts small amounts of money from residents for safekeeping, which residents use for day-to-day expenses. The accounts of two residents were checked to be sure money was properly looked after. One account was correct but the other had a small deficit. The manager recalled the resident had asked for money, which she had forgotten to record. The inspector checked a third account and found it was correct. The inspector discussed with the manager the importance of keeping a record of all transactions as they occurred. The manager gave detailed written information to CSCI prior to the inspection showing that safety checks on the home’s electrical equipment are regularly carried out and that maintenance agreements are in place where needed. The manager had training records showing that staff attended mandatory training with regular updates, including fire safety training. It is the home’s policy to allow residents to have their pets living with them in the home. The inspector observed that a resident’s dog with a trailing lead was at times walking around the lounge. A risk assessment needs to be done to ensure residents are not put at risk of trips and falls as a result of this situation. The registered providers are not in day-to-day charge of the care home and therefore must arrange for unannounced monthly visits to be made to check that the condition of the home and the care provided is satisfactory. These visits lapsed in March 2005 and must be restarted. A report must be written following every visit and a copy kept in the home for inspection by a CSCI inspector at any time. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 24 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X 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 X X X X 1 2 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 3 X 3 X 3 X X 2 Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 25 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 OP25 Regulation 13(4)(a) Requirement The manager must inform the inspector in writing of the action taken to reduce the temperature of hot water to a level that does not expose residents to a risk of being scalded at baths and basins. (This short time scale was complied with and action to reduce the temperature of water is due for completion by 28/02/07). The registered providers must appoint a representative to undertake monthly unannounced visits to the home. A report of each visit must be written and a copy kept in the home for inspection by a CSCI inspector at any time. Timescale for action 23/02/07 2 OP38 26 & Schedule 4 (5) 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 26 No. 1 Refer to Standard OP7 Good Practice Recommendations It is the manager’s responsibility to ensure: ●care plans are signed so that queries can be discussed with the appropriate carer. ●care plans are dated to show the period of time care plans relate to ●all care needs are identified in a plan of care to ensure residents receive the care they need. It is the manager’s responsibility to ensure risk assessment are carried out and kept under review to safeguard residents, for example: ●nutrition ●falls ●use of bed rails The manager should ensure that residents are weighed on admission and at monthly intervals to ensure they maintain a healthy weight. It is the manager’s responsibility to ensure: ●information that is written by carers on medication charts is signed so that queries can be discussed with the appropriate carer ●information copied onto a medication chart by a carer from an original prescription is checked for accuracy by a second carer who countersigns the chart confirming this. The manager should ensure the laundry is adequately equipped at all times with the necessary hand wash materials, as well as disposable aprons and gloves, to protect residents and staff from risk of cross infection. The manager should arrange for a risk assessment to be carried out to identify if residents’ pets that are free to roam the home place the residents at increased risk of trips and falls. If risk is identified action must be taken to reduce risk. 2 OP8 3 4 OP8 OP9 5 OP26 6 OP38 Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Belamie Gables DS0000011398.V327724.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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