Inspection on 17/05/05 for Belle House

This inspection was carried out on 17th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Belle House 19/08/08

Belle House 21/09/07

Belle House 19/05/06

Belle House 18/10/05

Belle House 25/10/04

Belle House 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Belle House Belle Hill Old Town Bexhill-On-Sea TN40 2AP Lead Inspector Andy Denness Announced 17 May 2005 10:00 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 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. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Belle House Address Belle Hill Old Town Bexhill-On-Sea East Sussex TN40 2AP 01424 221624 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) Britannia Care Homes Ltd Mrs Gillian Parsons Care Home 16 Category(ies) of Dementia (DE) 16 registration, with number of places Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is sixteen. 2. The people accommodated will be aged sixty five years or over on admission. 3. The people accommodated will have senile dementia type illness. Date of last inspection 25 October 2004 Brief Description of the Service: Belle House is an old converted property situated in the old town area of Bexhill on Sea, close to the local church and amenities. The town centre with its shops and access to bus and rail routes is approximately half a mile away. Accommodation is provided on two floors and a stair lift is fitted to assist access to first floor accommodation; however some first floor rooms can still only accessed by two or three stairs. The home is registered to accommodate 16 older people with a dementia type illness. The registered provider is Brittania Care Homes Ltd. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced Inspection took place over a morning and afternoon in May and lasted 6 hours. To help gather evidence on how the home is performing meetings took place with staff, the manager and the owner, a range of records and written information was examined and an inspection of the premises took place. Discussions took place with seven service users and written comments were received from the relatives of six service users. What the service does well: 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. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1, 3, 4 & 5. Current pre-admission procedures are satisfactory and help ensure that service users are appropriately placed in a service that is suitable to meet their needs. EVIDENCE: Records examined confirmed that a statement of purpose and a service user’s guide have been produced for the home, these documents provide guidance for prospective service users about Belle House and the service provided. Records examined confirmed that to make sure that Belle House can meet service users needs, an assessment of their needs is undertaken prior to their admission to the home; the quality of the written assessments was satisfactory. Service users were not able to say if they visited the home prior to moving in, although staff did say that this is usually done on their behalf by relatives. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7, 8 & 9. Current arrangements regarding the provision of identifying and meeting service users’ personal care needs are not satisfactory and could result in needs not being met. Procedures and practice regarding medication were generally satisfactory. EVIDENCE: An examination of individual plans of care indicated that current arrangements are not satisfactory. The information and guidance for staff was very scant and in some instances provided little or no information regarding service users preferences regarding how they would like to be supported with their personal care tasks such as bathing. Also records of care delivered were poor and it was not possible to ascertain if the care identified in plans had been provided. Because of service users mental health needs and in most cases poor memory, it is imperative that these matters are addressed. Records examined confirmed service users health needs are met with the support of a range of health care professionals. On the day of the inspection a GP and a Chiropodist were observed visiting service users. Because of the potential dangers staff manage all service user’s medication for them. Storage and records were examined, these were in order, however it was observed that staff left the medication trolley open and unattended in the dining room, whilst dispensing medication, because of service users mental health needs and the potential Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 9 dangers this presents to them, immediate action has been required to halt this practice. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12, 13 & 15. Although, because of their mental health needs, it was difficult to obtain views from all service users regarding daily life, social activities and meals, satisfactory standards were noted in this area. EVIDENCE: Records examined confirmed that activities in the home last month included, music and movement, a sing a long, a visiting musician and TV and video. On the afternoon of the inspection most service users were watching a musical on the television. Written comments from relatives confirmed that they are always made to feel welcome when visiting. The Inspector sat and ate a meal with service users; it was well prepared and obviously enjoyed by them. The cook said that he provides special diets for those who require them, records examined confirmed this. Some service users required help with eating this was provided in a caring way by staff. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16 & 18. Procedures and practices regarding complaints and adult protection were satisfactory. EVIDENCE: Written procedures were seen regarding both complaints and adult protection matters. The complaints record confirmed that service users and their relatives feel able to complain and that the manager takes appropriate action to address their concerns. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19, 20, 21, 23, 24, 25, & 26. Belle House is an old property and is difficult to maintain. Furnishings and the standard of decoration in some areas were poor; action has been required to ensure that service users live in a well-maintained and comfortable environment. Standards of cleanliness and hygiene were good. EVIDENCE: An inspection of the premises took place. Furnishings and fittings in bedrooms were minimal and in several instances of a poor quality and in poor condition with broken hinges and mismatched handles. Some rooms had no ornaments or pictures. The communal areas, which consist of a large lounge, a lounge/dining room and a dining room, were decorated and furnished to a satisfactory standard. Not all radiators are covered, and in some instances the guards that have been fitted are unvarnished and because of this are now looking dirty and stained. Thermostatic mixer valves are fitted to all hot water outlets to ensure service users safety; some of these were tested and found to working. Sufficient numbers of bathrooms and WCs are available to meet. service users needs. Standards of cleanliness and hygiene were found to be good and the laundry was suitably equipped. The home has a large pleasant Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 13 rear garden laid mainly to lawn, which some service users said that they enjoyed using in the better weather. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30. Staffing levels were generally satisfactory however considerable work is required to ensure that they are trained to the required level. EVIDENCE: Staffing levels on the day of the inspection were satisfactory. At the last inspection of the home it was required that catering and cleaning staff numbers be increased, this is partly happened although there are some days in the week when there is still a shortage. It has been required that the manager continues to advertise to fill these vacancies. An examination of records indicated a considerable shortfall in the number of staff trained to NVQ level and some staff not trained in basic health and safety training courses, such as moving and handling and first aid. Recently because of poor practice regarding recruitment procedures a formal legal notice was served against the home requiring them to take immediate action to address problems in this area. A separate inspection of records just before this inspection confirms that standards in this area are now good. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 & 38. The manager’s experience and knowledge of service users’ needs helps support staff in their day-to-day work. EVIDENCE: The manager is experienced and demonstrated an obvious knowledgeable of the needs of older people with dementia, however she has not yet started her required management training and is unsure whether she will start this as she is close to retirement. She was respected by her staff and had a good rapport with service users. New questionnaires for relatives and service users have recently been introduced, these have not yet been distributed it has been required that this now happens. The manager has no involvement in service users’ finances. Staff confirmed that they have annual appraisals and receive one to one supervision from the manager. The manager clearly understands the importance of ensuring a safe environment for her staff and service users. A selection of health and safety records including fire records and the testing of hot water temperatures were examined, these were in order. All policies and Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 16 procedures required were in place. A selection of other records required by regulation was examined, these were in order and stored securely. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 1 x x STAFFING Standard No Score 27 1 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 1 x 1 x 1 3 3 3 Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 18 Yes 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 7 Regulation 15(1) Requirement That care plans are expanded to indicate in detail the support required by service users to meet their needs and that daily records are made to confirm when needs have been met. That the medication trolley is not left open and unattended at any time and that training is provided for staff in medication matters. That a plan is forwarded to the Commission for Social Care Inspection detailing how the proprietors intend to address the problem of poor quality bedroom accommodation and that all radiators are guarded. That additonal cleaners and catering staff are employed to ensure sufficient cover over seven days. (outstanding from previous inspection) That training is provided for untrained staff in food hygiene, fire prevention, moving and handling, infection control and first aid. That the manager undertakes management training to NVQ level 4.(outstanding from Timescale for action 17/8/05 2. 9 13(2) 17/5/05 3. 24 16(2) 17/6/05 4. 27 18(1)(a) 17/8/05 5. 30 18(1)(a) 17/8/05 6. 31 18(1)(a) 31/12/05 Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 19 previous inspection) 7. 33 24(1) That the new questionairres 17/8/05 introduced as part of the homes quality assurance system are distributed to interested parties. 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 28 Good Practice Recommendations That 50 of staff are trained to NVQ level 2. Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Belle House H59-H10 S21048 Belle House V218226 170505 Stage 4.doc Version 1.30 Page 21 - 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. 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