Inspection on 14/02/06 for Bell Lodge

This inspection was carried out on 14th February 2006.

CSCI 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 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

Bell Lodge 21/11/07

Bell Lodge 22/06/06

Bell Lodge 28/06/05

Bell Lodge 16/03/05

Bell Lodge 21/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Bell Lodge 25 Bell Lane Byfield Daventry Northants NN11 6US Lead Inspector Mrs Pat Harte Unannounced Inspection 14th February 2006 11:25 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 Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 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. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bell Lodge Address 25 Bell Lane Byfield Daventry Northants NN11 6US 01327 262483 01327 262483 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 Graham Henry Edwin Holden Ms Jane Piengjai Thongsook Ms Jane Piengjai Thongsook Care Home 15 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (15) of places Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include within the total of 15, a maximum of 5 service users in need of personal care by reason of Dementia over the age of 65 years. Date of last inspection Brief Description of the Service: Bell Lodge is a residential care home situated in the village of Byfield within Northamptonshire. The Home is owned by Mr. Graham Holden and Ms Jane Thongsook. Ms Thongsook is the registered Manager. The Home provides care for Elderly People over the age of 65 years and has up to 5 places for People with Dementia. The Home is situated in a quiet road on the perimeter of the village being close to the local school. It is a five or ten-minute walk from the village centre and its local amenities. The premises are over three floors. The top floor is devoted to the Owners accommodation with the ground and first floors providing accommodation for Residents. A stair lift is provided. There are 11 single and two double bedrooms. En suite facilities are not provided. Communal space on the ground floor includes a lounge and dining room. Residents have access to a large well-maintained walled garden. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took one hour and consisted of a review of the last Inspection report and the Home’s service history including notifications and events. The primary method of inspection used was ‘case tracking’ which involved selecting two Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition two staff and five Residents were spoken with to obtain their views. A partial tour of the premises took place, a selection of records was inspected and observations made on care practices. Discussions were held with the Manager and Provider. The Inspection took place during the morning and afternoon over a period of three hours and was carried out on an unannounced basis What the service does well: The pre-admission process ensures that the Manager visits all Residents prior to admission. The assessment process was thorough and ensures that Residents needs are identified. Residents spoke very positively about the staff group saying that they were committed to their well-being and were sensitive and caring. They felt that the staff group provided them with good care and support and knew their needs well. Relationships with the staff group and Providers were said to be very good. Residents stated that staff were prompt in responding to their needs but allowed them to do things for themselves enabling them to retain as much independence as possible. They stated that staff protected their privacy and dignity by ensuring that personal care tasks were carried out in private. Routines were relaxed and flexible. Residents felt they were enabled to follow their preferred lifestyle routines and had choice in rising and going to bed times and were free to choose where and how they wished to spend their time. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 6 Residents stated that meals are varied and they are able to choose what they wish to eat. They stated that alternatives were available to “tempt the appetite”. They felt that their likes and dislikes were taken into account and special diets are respected. Residents felt that staff responded quickly to any health care needs and made arrangements for them to see their General Practitioners and other Health Care Professionals quickly. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 7 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 Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Prospective Residents are provided with information on the Home’s facilities and services in order that they can make an informed choice on their placement. The Home’s assessment process is effective in ensuring the needs of Residents admitted to the Home can be met. EVIDENCE: Written information is provided to prospective Residents and their relatives on the Home’s services, facilities to enable them to make an informed decision on their placement. Records show that the Manager carries through an assessment of all prospective Residents prior to admission in order to ensure their needs can be met. The assessment process viewed for one Resident showed that her wishes in relation to preferred routines, lifestyles and likes and dislikes were noted and Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 9 respected. Background information had been gathered from relevant sources, such as the Residents themselves, Medical Professionals and Relatives, on general and health care needs, life history, personal contacts, hobbies and interests. Recognised risk assessment tools are used to identify any risk areas such as Nutritional intake and Skin Care. Prospective Residents, where possible, and their relatives are encouraged to visit the Home, view the accommodation and meet with staff and other Residents prior to admission. Written contracts on terms and conditions of Residency are provided to Residents following their admission. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Care plans provided staff with guidance and instruction on personal care needs however plans relating to Dementia care needs should be developed further to guide staff on how to respond to Residents’ confusion and how to deal with their behaviours. EVIDENCE: Two Residents care plans were inspected. The plans showed that Residents had been consulted in the planning process and that account had been taken of their wishes with regard to their preferred lifestyles and daily routines. They also documented the things that Residents could do for themselves and showed that they were encouraged to maintain as much independence as possible. Physical care needs were generally well documented and instructions for staff detailed how the tasks were to be carried through. For example the plans showed the timings agreed with Residents for the bathing routines, the equipment to be used and detailed instructions for the way in which Residents were to be bathed, recognising the things they could do for themselves and the level of supervision or prompting needed. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 11 One care plan was viewed for a new Resident with Dementia care needs. The plan identified a specific behaviour and acknowledged that this behaviour led to a risk of soreness and skin damage. Verbal instructions had been given to staff to monitor and supervise the Resident but no written strategy for the management of the behaviour was in place. In the same instance the plan did not show written guidance for staff on how they were to deal with her memory loss and respond to her frustrations and questions. Staff evidenced through discussions that they had received verbal instructions and were responding appropriately. The Manager agreed to ensure the on going development of written dementia care plans. It was clear from discussions with staff that they knew their Residents needs and routines well. Residents commented that staff were on hand to provide prompt and sensitive assistance and support. Resident’s comments showed that staff responded quickly to health care needs and promptly called in the relevant Medical Professionals such as General Practitioners and Community Nurses including the Community Psychiatric Nurse. Records showed that routine checks for Dental, Optical, Auditory and foot care needs were carried through on a regular basis. The Home’s medication system was found to be in good order. The required records for incoming, administration and disposal were well maintained. Observations and Residents comments confirmed that staff carry through personal care tasks in private protecting their Residents’ privacy and dignity. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 &15 Routines are relaxed and flexible taking account of the individual’s personal lifestyle preferences. The food provision takes account of Residents’ dietary needs and likes and dislikes and Residents are provided with a range of choice and alternatives. EVIDENCE: Residents stated that routines were relaxed and flexible and took account of their personal preferences including rising and going to bed times. They felt they were enabled and supported to maintain control over their lives, make choices in where and how they wished to spend their time and were free to choose whether they wished to socialise and join in activities. Residents stated that are enabled and supported to pursue their individual hobbies and interests. A programme of activities is provided and includes quizzes, craftwork, exercises, discussions and reminiscence, games and videos. They also confirmed that external entertainers also visit the Home approximately fortnightly to provide musical entertainment. The home offers Residents the opportunity to exercise their religious and cultural beliefs and arrangements are made for visits from the Clergy. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 13 The Home has an open visiting policy and Residents confirmed that they are able to receive their visitors in private if they wish. Residents stated that staff made their visitors welcome and extended hospitality to them. Residents were positive in their comments on the food provision and confirmed that their dietary needs and likes and dislikes were respected and they were afforded choice and alternatives. Nutritional risk assessments are carried through and Residents’ weight is monitored. The serving of the midday meal was observed. The meal offered choice, was nicely presented and efficiently served. Residents are encouraged to take meals in the main dining rooms to promote social interaction but they may eat in their rooms or the Lounge if they prefer. Discussions were held with the Providers on replacing the existing cooker, which was missing a door to the grill. The Providers agreed that this would be undertaken. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The Home has a complaints procedure ensuring that any complaints are listened to, investigated and acted upon. Staff are provided with training in the Protection of Vulnerable Adults procedures ensuring that Residents are protected from abuse. EVIDENCE: Residents confirmed that they had received copies of the Home’s complaints procedure. All Residents spoken with felt that they had the confidence to raise any issues or concerns with the staff or the Providers. A record of complaints is maintained. There have been no complaints recorded by the Home or referred to the Commission since the last Inspection. Discussions with staff confirmed that they had received training in the Protection of Vulnerable Adult procedures, that they recognised areas that constitute abuse and were clear in their duty to report any allegations or suspicions to the Manager. The Manager has overall responsibility for reporting to the relevant Authorities. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25 & 26 The Home was warm, safe and comfortable and standards of domestic and hygiene maintenance were satisfactory. EVIDENCE: Selected areas of the premises including bathing and toileting facilities were inspected. Standards of domestic and hygiene maintenance were satisfactory. Residents are enabled to personalise their rooms as they wish and have their furniture and belongings around them. The grill door from the kitchen cooker was missing. The Provider stated that the door had been repaired following the March 2005 Inspection but that it was problematic and kept falling out. The Provider agreed that the cooker should now be replaced. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 28 Sufficient numbers of staff are on duty to meet the needs of the current Residents. EVIDENCE: Residents spoken with said that the staff were very kind, committed and caring. Relationships between staff and Residents were good. Two carers are deployed on all daytime shifts and one waking and one sleeping in carers provide night care. The Manager and Provider are also on duty or available as back up. In addition the Home employs domestic staff. Residents’ comments and observations confirmed that care staff responded quickly to their needs. Discussions with staff and observations made confirmed that staff monitor their Residents and in quieter periods have time to sit and talk with them or provide activities. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 & 38 The Home is appropriately managed and the health and safety of Residents and staff is promoted and protected. EVIDENCE: The Manager is currently looking to undertake the management element National Vocational Qualification level 4 to fulfil the minimum qualification for Registered Managers. Staff spoken with felt that the Manager was easily accessible to them and confirmed that she worked alongside them on the floor. They stated that she was willing to discuss any issues and guide them in practice. Within the overall management of the business the registered Provider tends to take greater responsibility for financial matters and some other aspects of the running of the whole business. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 18 Residents felt that the Manager and Provider were readily available to them and sought their views and opinions of the service. They felt that their opinions were listened to, valued and acted upon and that they had trust and confidence in the staff group as a whole. The system for safekeeping of Residents moneys was inspected. The records were in good order and receipts were maintained for any items or services purchased on behalf of Residents by staff. Attention was paid to safe working practices. The records relating to the testing of the fire alarm and equipment were in good order. Tests were carried through at the intervals recommended by the Fire Officer. A fire drill was carried out during the Inspection and staff on duty demonstrated their knowledge and understanding of the evacuation procedures. Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 19 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 X X X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X 3 X X 3 Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 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 Bell Lodge DS0000012704.V274035.R01.S.doc Version 5.1 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!