Inspection on 21/11/07 for Bell Lodge

This inspection was carried out on 21st November 2007.

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 22/06/06

Bell Lodge 14/02/06

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 Debbie Williams Unannounced Inspection 21st November 2007 10:00 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.V342093.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. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 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.V342093.R01.S.doc Version 5.2 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. 22nd June 2006 Date of last inspection Brief Description of the Service: Bell Lodge is situated in the village of Byfield within Northamptonshire and is registered to provide personal care, without nursing, for older people. Bell Lodge is situated in a quiet residential street within Byfield, close to the village centre and its local amenities. The ground and first floors of Bell Lodge provide the private and communal accommodation for the residents. A stair lift is provided. There are eleven single and two double bedrooms. En-suite facilities are not provided. Communal space on the ground floor includes lounge areas and the dining room. Residents have access to a large well-maintained walled garden to the rear of the property. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for residents and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. During this inspection we were able to speak with two residents, three relatives and two staff member as well as the Registered Provider and Registered Manager. Evidence from the providers Annual Quality Assurance assessment was also used. This was a positive inspection with good outcomes for residents being achieved in all areas. This inspection was unannounced, the providers and staff on duty facilitated this inspection in a friendly and professional manner. Residents and relatives spoken with praised the service provided. Comments made included -: ‘You wouldn’t find anywhere better’ ‘Staff are always kind and respectful’. What the service does well: The home has a ‘family’ atmosphere; accommodation is homely, comfortable and well maintained. Residents and their visitors appeared relaxed and comfortable. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 6 Routines of daily living are made flexible and every effort is made to meet the individual lifestyle needs and preferences of residents. A staff training and development programme was in place ensuring that staff are competent to do their jobs. Assessment and care planning was good so ensuring that residents needs are identified and communicated to staff members, residents are encouraged to be involved in the care planning process. Communication between management, staff and residents was good. The service was well managed and the providers were enthusiastic and motivated to ensure their knowledge and practice was based on the most recent, up to date training and guidance. 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. The summary of this inspection report can Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Bell Lodge DS0000012704.V342093.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 Bell Lodge DS0000012704.V342093.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): Standards 1, 3 and 5. (Standard 6 is not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are able to make an informed decision prior to moving into the home and can be assured that their needs will be met. EVIDENCE: All residents have their needs assessed prior to admission and a four-week trial period is offered. Assessment records were seen; all relevant needs assessment and risk assessment details were included. The provider said that a new nutritional risk assessment was to be introduced. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 10 Residents and relatives spoken with confirmed that information was provided about the home prior to them moving in and that a needs assessment was also undertaken. Bell Lodge DS0000012704.V342093.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): Standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their health and social care needs met in a sensitive and appropriate manner. EVIDENCE: One staff member spoken with said that GP’s are contacted and visits requested as required by residents. At the time of this inspection there were two GP surgeries providing a service to the home. Evidence was seen in care records of consultation with appropriate healthcare professionals. Residents and relatives spoken with confirmed that GP’s and community nurses were consulted as required. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 12 Four of the care staff employed were trained to administer medication to residents. Staff are assessed by the manager before they administer medication unsupervised. Records of ‘safe handling of medication’ training were seen. A monitored dosage system of medication administration was being used. Storage areas and administration records were seen, these appeared in good order and accurate. Advice/information sheets were seen with the administration records for staff to refer to. There were no controlled medications being prescribed at the time of this inspection. None of the residents living at the home were managing their own medication but the providers said that residents could be supported to do this if they wished. Medication policies and procedures were in place for staff to follow. Care plans seen were very detailed, individual needs and preferences were stated and included social histories, social interests and hobbies. Risk assessments were incorporated within care plans. Care plans were reviewed on at least a monthly basis. Residents and or their relatives were given the opportunity to be involved in their care planning. Residents and relatives spoken with said that staff were kind and respectful. Interactions observed between staff and residents appeared positive. The providers stated within their annual quality assurance assessment that they do not discriminate against people on the grounds of age, sexual orientation, race, gender identity or religion. Staff are instructed during their induction training to respect residents privacy and dignity at all times and their performance with regard to this is monitored. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 13 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): Standards 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. Residents experience the lifestyle that meets their expectations, preferences and needs. EVIDENCE: There were a range of activities available, these included musicians, arts and crafts and reminiscing. Staff facilitate recreational activities for residents between 2 and 3 each afternoon. Care plans seen were very detailed, individual needs and preferences were stated, including social interests and hobbies. The providers stated within their annual quality assurance assessment that they do not discriminate against people on the grounds of age, sexual orientation, race, gender identity or religion. Information provided within the quality assurance assessment also stated that daily living patterns are adjusted according to residents changing needs and Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 14 preferences. Residents choose when to get up, when to go to bed, where they take their meals and refreshments and how they spend their time. Residents, relatives and staff spoken with confirmed this. One resident spoken with said they received Holy Communion at the home. Residents and visitors said that they could visit at anytime and were made to feel welcome. The provider said that a new nutritional risk assessment was being introduced. Residents are referred to a dietician as required. One resident and three relatives spoken with said that the food was nice and that staff seemed to bringing the residents something to eat or drink throughout the day. The lunchtime meal was observed during this inspection. The meal provided appeared wholesome and nutritious and was well presented. The provider said that the lunchtime meal was the main cooked meal of the day and that an alternative to the selection of meat and two vegetables was always available. A selection of fruit, cereal and toast was available at breakfast time and a light supper in the evening. Diabetic and soft diets were also being provided at the time of this inspection. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by robust policies, procedures and staff training. EVIDENCE: One staff member spoken with confirmed they had received training regarding the protection of vulnerable adults and was able to describe the correct procedures to follow in the event of suspected abuse. A copy of the home’s prevention of abuse policy was seen, this was comprehensive and gave clear instruction to staff regarding procedures to follow. The providers had a copy of national guidance regarding safeguarding adults and were aware of the correct policies and procedures to follow. A record of all complaints received was maintained along with action taken by the providers. Residents and relatives spoken with said they would feel comfortable speaking with staff regarding a concern or complaint and felt that appropriate action would be taken. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 16 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): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a pleasant, comfortable and safe environment. EVIDENCE: An ongoing programme of redecoration and refurbishment was underway. The provider said that the exterior paintwork on the building had recently been redecorated. Some floor coverings and carpets were due to be replaced and some new armchairs purchased in the next twelve months. All areas of the home seen appeared clean, homely and comfortable. Resident’s private rooms were personalised. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 17 Fire alarms were tested weekly and fire drills regularly held. Risk assessments were carried out annually. The kitchen area was seen and the cook was spoken with. The kitchen area appeared clean and tidy, the flooring was in need of replacement but this had already been planned in by the provider. There was one area on the wall where plaster was peeling off, the cook said this was caused by the new hot water heater and this was being addressed. An Environmental health officer visited the home last year, a recommendation was made that staff should implement the guidance ‘safer food, better business’ and this has been done. Staff had received infection control training, their were policies in place for this and staff were aware of these. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 18 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): Standards 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. Residents are cared for by competent staff and are protected by recruitment procedures. EVIDENCE: One staff member spoken with said that staff numbers were sufficient to meet resident’s needs and that the training required to do their job was provided. Training received by this staff member included induction training, moving and handling, dementia awareness, protection of vulnerable adults and fire safety training. All staff were undertaking basic food hygiene training, workbooks for this were seen. The registered provider/owner holds a National Vocation Qualification in staff training. Three care staff held qualifications, which were equivalent to the National Vocational Qualification in care and one care staff member was working towards this qualification. Staffing levels during day and night times were discussed; four care staff are on duty in the morning, two in the afternoon and evening and one during the Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 19 night. The manager was supernumerary and there were two staff on call at night (on the premises). Staff records were seen for two staff members, these contained all relevant documents, Criminal Records Bureau disclosures, references and records of training received. Induction training was provided in line with national training organisation standards (skills for care). Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 20 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): Standards 31,32,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed and run in the best interests of residents. EVIDENCE: One staff member spoken with described the owner and manager as supportive, approachable and always available. Staff meetings are held weekly. The providers stated within their annual quality assurance assessment that residents meetings were occasionally held but because of the variance in communication abilities experienced by residents then individual communication and feedback is more effective and that in practice this takes Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 21 place at least three times a week for each resident and on most visits by the residents representative. Relatives spoken with did feel that communication with staff and management was very good. Resident/relative satisfaction questionnaires are sent out annually, the information is then audited and incorporated into the following years development plan. Residents are encouraged to manage their own financial affairs. Where the provider does manage resident’s money, records are maintained of all transactions. The Registered Manager is a qualified nurse and has been in post for 17 years. The Registered provider also works full time at the home and with the Registered Manager provides the management and administrative support. Staff supervision records were seen; care staff receive formal supervision every two months. Accident records are maintained. The provider’s annual quality assurance assessment confirmed that all required routine maintenance and testing had been carried out. The home’s electrical circuits were tested three weeks prior to this inspection and found to meet required standards. The appropriate health and safety training had been provided to staff and policies and procedures were in place. Fire alarms were tested weekly and fire drills regularly held. Risk assessments were carried out annually. Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 22 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 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 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 3 3 3 x 3 3 x 3 Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? 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.V342093.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Bell Lodge DS0000012704.V342093.R01.S.doc Version 5.2 Page 25 - 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!