Inspection on 19/09/05 for Bella Care Home

This inspection was carried out on 19th September 2005.

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

Bella Care Home 04/05/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Bella Care Home 12 Carmarthen Road St Judes Plymouth PL4 9EW Lead Inspector Antonia Reynolds Announced 19 September 2005 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bella Care Home Address 12 Carmarthen Road, St Judes, Plymouth, Devon, PL4 9EW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 246145 Mrs Jayne Page Mrs Jayne Page Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Three service users with a Learning Disability (LD) Age 18-65 The Registered Provider to complete NVQ4 and the Registered Manager`s Award by December 2006 Date of last inspection N/A Brief Description of the Service: Bella is a care home providing personal care and accommodation for three people, aged 18 – 65, with learning disabilities. It is privately owned by Mrs Jayne Page. The home was opened in May 2005 and is a two-storey mid-terraced house, located in the residential area of St Judes. It is close to Plymouth city centre and all local amenities. All the home’s bedrooms are single and on the 1st floor. They all contain wash hand basins and one of them has an en suite shower and toilet. Also on the 1st floor there is a bathroom with a bath and a toilet as well as a separate toilet. On the ground floor there is a through lounge/dining room, and a kitchen/diner, as well as sleeping accommodation for the staff with an en suite shower and toilet, which the service users may use if they wish to. At the front of the home is a small paved area and there is a much larger paved/concrete area at the back of the house. All areas are accessible to the service users. There is no dedicated parking for the home, although on street parking is available nearby. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this home and took place between 10am and 2.45pm. The Registered Provider, Jayne Page, was present throughout. A tour of the premises took place and some of the care, staff and home’s records were inspected. A pre-inspection questionnaire had been completed by the Registered Provider, which contained information relevant to the inspection. Comments cards had been completed by the three service users, with assistance from staff, and comments cards were also received from two relatives, all of which were complimentary about the service provided. Two of the three service users were spoken to during the day and interaction with staff members was observed. What the service does well: What has improved since the last inspection? What they could do better: Considering that this was the first inspection of a care home that has only been opened for four months, there were very few issues raised during the inspection and no requirements or recommendations made. Advice was given to: Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 6 - obtain thermometers to monitor the temperature of refrigerators and freezers, as well as cooked meats, to further reduce any risk of food poisoning - obtain a copy of the more detailed adult protection Alerter’s Guidance from the local authority, so that service users are better protected by staff being more knowledgeable about adult protection issues - document the key workers role, so that staff are clear about their responsibilities to service users. 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. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 The home’s Statement of Purpose and Service User Guide provide service users and prospective service users with details of the services the home provides, enabling an informed decision about admission. EVIDENCE: There is a Statement of Purpose and Service User Guide available in the home and the pre-admission processes ensured that the service users were compatible before they moved in. Before the home opened, careful consideration was given to identifying the three service users and enabling them to meet each other, as well as relatives/representatives and staff. Discussion with the Registered Provider confirmed that the service users had been actively involved and consulted throughout the process. Individual records were kept for each of the service users and these contained assessments, care plans and risk assessments and behavioural guidelines, all of which had been recently reviewed. Ongoing evaluation is recorded daily. Each service user had a contract with the local authority, which contained a statement of terms and conditions of residency. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 The service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Each service user had a care plan and risk assessments devised by the home that were regularly reviewed. Care plans had been discussed and agreed with service users and, where possible, service users had signed them. The Registered Provider confirmed that she was in the process of introducing person centred planning into the home. There were also copies of assessments from other professionals involved in the service users’ care such as psychiatric services. The staff were fully aware of the needs of each service user. Any restrictions on choice or freedom were documented and had been agreed with the service user and other people involved in the person’s care. The attitude and approach of the staff team promoted independence by encouraging and enabling service users to do as much as possible for themselves. Records relating to service users’ money were up to date and accurate. From these it was evident that different systems were in place for each service user, dependent on circumstances. The Registered Provider was still trying to open a bank account for one of the service users and resolve a change of address Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 10 issue on a savings account for another service user. Service users were expected to pay for personal items and public transport. The Registered Provider confirmed that staff cars, that were appropriately insured, were also used to transport service users but no financial charge was levied for this service. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Service users can learn life skills, attend day services and participate in community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Information in care plans, as well as talking with service users and the Registered Provider, showed that service users were enabled to live as full a life as they wished to and had opportunities for personal development. Service users were encouraged to participate in all the domestic activities in the home and to take part in leisure activities of their choice. The Registered Provider confirmed that a holiday was being arranged for next year but the details had not been finalised. At the time of inspection the home had only been open for four months therefore service users’ wants, needs and aspirations concerning employment or educational opportunities were still being assessed in relation to their abilities and skill levels. Service users were being supported to attend day services and participate in various activities at local community-based facilities. Where appropriate, service users had weekly activity plans devised using Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 12 makaton symbols to enhance communication. The Registered Provider confirmed that service users would be enrolled on the electoral register and supported to vote if they wished to. Where possible, service users were encouraged and supported to use public transport but staff cars were also used when required. It was evident, through observation during the inspection, that service users felt very ‘at home’ and were empowered to make decisions. Discussion with service users and the Registered Provider, confirmed that service users chose the menu, did the shopping and were assisted with making their own meals, drinks and snacks. Records were kept of meals provided. The Registered Provider said that service users sometimes went out for meals and drinks and these were paid for by the home. Contact with relatives and friends was encouraged by telephone and post, with assistance from staff where necessary. There were no limitations in place regarding visitors to the home, who could stay for meals if the service users agreed. The Registered Provider confirmed that service users were supported to visit relatives and friends away from the home, if that is what the service users wished to do. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 and 21 Service users can be confident that personal support is provided in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Service user plans provided information about personal, emotional and health care needs. Since moving into the home all the service users had seen a dentist, optician and chiropodist and were registered with a local doctor. All incidents were documented and monitored by the Registered Provider. Information contained in service users’ files, as well as discussion with the Registered Provider, confirmed that external professional advice and guidance was sought when necessary from local health care professionals or social services. Through observation it was clear that timings were flexible and the choice of the service user. Each service user had a designated key worker and the Registered Provider was clear about the expectations of the staff in this role, but the responsibilities had not been documented. None of the service users were self-medicating and home used a monitored dosage system. Medication was locked away safely and regular medication reviews took place. Records pertaining to the administration of medication were up to date. The Registered Provider has been in close consultation with a local pharmacist regarding the administration of medication. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 14 The Registered Provider confirmed that service users can remain in the home as long as the staff and primary health care teams could meet their needs. Where possible, service users’ wishes concerning what should happen in the event of death, had been obtained and documented. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that the Registered Provider always deals with complaints seriously and any concerns from service users are listened to and acted upon immediately. EVIDENCE: The home has a complaints procedure and service users were clear about who they would talk to if they had a problem. Regular informal meetings between individual service users and the Registered Provider were held where any issues could be raised and dealt with immediately, although it was also clear from discussion that service users could raise any issue at any time. The Commission for Social Care Inspection had received an anonymous complaint regarding the home, which was investigated thoroughly by the Registered Provider and was not substantiated. All staff had undertaken, or were going to undertake, training in adult protection. Discussion with the Registered Provider confirmed that she was well aware of adult protection issues and procedures were available. Advice was given to obtain a copy of the more detailed Alerter’s Guidance from the local authority. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 and 30 The standard of the environment and décor within this home is very good, providing service users with an attractive and homely place to live. EVIDENCE: The home was spacious, comfortable, safe and clean with a very good standard of décor and furnishings. Before the home opened in May 2005 it was completed redecorated and refurbished to a high standard. The Registered Provider confirmed that the care staff carry out all domestic tasks and encourage service users to participate as much as possible. Each service user had a single bedroom on the 1st floor, all of which had wash hand basins and one had an en suite toilet and shower. The Registered Provider was still waiting for a Building Control officer from the local authority to inspect and certificate this en-suite facility. Bedrooms were individually furnished, contained many personal possessions and inventories were kept. Each service user had a lockable safe in their bedrooms, that were fastened to prevent removal, where they could store money if required. After consultation with the service users it was agreed that the keys were kept by the Registered Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 17 Provider and this was documented. Bedroom doors were fitted with appropriate locks that could be opened by staff from the outside in an emergency. The home had a portable telephone that service users may use in private and they were not expected to pay for this. The home had a bathroom on the 1st floor consisting of a bath with an over bath shower, wash hand basin and a toilet and there was a separate toilet beside it. On the ground floor was an office, which was also the staff sleeping in room, which had an en suite shower, toilet and wash hand basin. Service users were able to use this if they wished to. There were shared rooms on the ground floor consisting of a kitchen/diner, and a through lounge/dining room although the furniture had been arranged in such a way that separated the lounge and dining areas. A washing machine and tumble dryer were located in a cupboard under the stairs to ensure that soiled laundry was not carried through any areas where food was cooked, prepared or eaten. The home did not have any specific aids or adaptations because these were not required for the service users. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users’ needs are met by high staffing levels. Service users benefit from well supported and supervised staff. EVIDENCE: Staff files inspected showed that the organisation had a robust recruitment procedure and all the required information was available including two written references and Criminal Record Bureau checks. All staff were provided with contracts of employment and job descriptions. The Registered Provider confirmed that regular staff meetings and individual supervision sessions took place and these were documented in personnel files. The Registered Provider was in the process of arranging ongoing training for the staff team, including courses specifically related to working with people with learning disabilities and behaviours that challenge services, as well as National Vocational Qualifications. Staffing rotas were available in the home and the Registered Provider confirmed that the staffing was on a 1:1 basis with service users during the day and early evening. This reduced to two staff after 7pm and there was one waking and one sleeping member of staff at night. Sleeping accommodation for staff was on the ground floor in the office. The high staffing ratio enabled service users to go out on individual outings and pursue their own interests, Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 19 although there were occasions when group trips were arranged, for example, picnics or attending local events, such as the Moscow State Circus. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42 and 43 The management approach is open, inclusive and positive, providing clear leadership and guidance. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Registered Provider had several years experience of management in residential settings for adults with learning disabilities. She has agreed to complete a level 4 National Vocational Qualification and the Registered Manager’s Award by December 2006 and this is a condition of her registration with the Commission for Social Care Inspection. Observation of the interaction between the staff and the Registered Provider indicated that the management approach is positive and staff are consulted and included in any decisions regarding the running of the home. All documentation relating to service users was up to date and accurate. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 21 Records and documents relating to health and safety issues, such as risk assessments, fire safety, employers liability insurance certificate and gas safety checks were available. The home had an accident book but no accidents had occurred since the home opened in May 2005. Tests and checks of fire safety equipment had been carried out as required and the Registered Provider was aware of fire safety procedures. There was a fireguard secured in front of the fire in the lounge room. The pre-inspection documentation confirmed that a fire drill was carried out in June 2005. Hazardous substances were locked away and risk assessments and data sheets were available. The home had a combination boiler, therefore no hot water was stored, and the hot water temperature had been regulated to approximately 43°C. Radiators were not guarded as this was not considered necessary for the safety of service users. The Registered Provider was in the process of arranging staff training in health and safety, emergency first aid, manual handling, food hygiene and fire safety for those staff who had not completed them. Infection control practices described by the Registered Provider were satisfactory and disposable gloves and aprons were available for the staff. Advice was given to obtain thermometers to monitor the temperature of refrigerators and freezers, as well as cooked meats. The pre-inspection documentation showed that gas servicing had been carried out, and a five-year electrical wiring certificate issued, in May 2005. A business and financial plan had been provided to the Commission for Social Care Inspection as part of the registration application. The Registered Provider had produced a detailed development plan for the home to use as part of the quality assurance system and continuous improvement agenda. Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bella Care Home Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 23 N/A 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. 1. 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. 1. Refer to Standard Good Practice Recommendations Bella Care Home D52-D04 S63047 Bella Care Home V239997 190905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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