Inspection on 18/10/05 for Belle House

This inspection was carried out on 18th October 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 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 17/05/05

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 East Sussex TN40 2AP Lead Inspector Andy Denness Unannounced Inspection 18th October 2005 02:00 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 Belle House DS0000021048.V254248.R01.S.doc Version 5.0 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. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 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 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) Britannia Care Homes Limited Mrs Gillian Parsons Care Home 16 Category(ies) of Dementia (16) registration, with number of places Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of residents to be accommodated is sixteen The people accommodated will be aged sixty five years or over on admission The people accommodated will have senile dementia type illness Date of last inspection 17th May 2005 Brief Description of the Service: Belle House is an old converted property situated in the old town area of Bexhill on Sea, close to local amenities. The main town centre with its access to bus and rail routes is approximately half a mile away. Accommodation is provided on two floors and a shaft lift is fitted to assist access to first floor accommodation. The home is registered to accommodate up to sixteen older people with a dementia type illness. The registered providers are Brittania Care Homes Ltd. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over an afternoon and evening in October. To help gather evidence on how the home is performing the Inspector met with staff and a representative of the owners of the home and examined a range of records and written information; an inspection of the premises took place. The Inspector sat and ate an evening meal with service users and discussions took place with six of them and a relative who was visiting at the time of the inspection. 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 DS0000021048.V254248.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Belle House DS0000021048.V254248.R01.S.doc Version 5.0 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 the following standard(s): 1,3 & 6 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. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 & 10. Current arrangements regarding the provision of identifying and meeting service users’ personal care needs are generally satisfactory although some improvements have been required so that needs are not overlooked. Procedures and practice regarding medication were generally satisfactory. EVIDENCE: Individual plans of care are in place for service users, these describe their needs and what support they require from staff. An examination of several plans confirmed that improvements have been made to the system since the last inspection. However it was concerning to note that a plan of care was not in place for a service user who was staying in the home for only a short period. Improvements were also noted to the system that identifies area of risk to service users. Records examined confirmed that service users health needs are met with the support of a range of health care professionals. Because of the potential dangers staff manage all service user’s medication for them. Storage and records were examined, these were generally in order although it has been required that alternative storage is provided for one particular medication. Staff were observed to interact with service users in such a way as to ensure them respect and dignity. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 9 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): 15 Generally service users are provided with a varied and wholesome menu, the exception to this is breakfast. EVIDENCE: The Inspector sat and ate the evening meal with service users; the meal was well prepared and enjoyed by them, several service users said that the meals were good. Some service users required help with eating; staff provided this discretely and sensitively. Records examined confirmed that at teatime and lunch times a varied menu is provided, at every breakfast all service users have Weetabix and milk; it has been required that arrangements are now made to give service users more choice and variety at this meal time. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 10 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): Procedures and practices regarding complaints and adult protection were satisfactory. EVIDENCE: Written procedures are in place 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. The Inspector was told that training regarding Adult Protection was planned for soon after the Inspection. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 11 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): 19,20,21,22,23,24,25 & 26. Improvements have been made to the environment since the last inspection however work is still required to ensure that service users live in a well maintained and well furnished environment. EVIDENCE: An inspection of most areas of the premises took place. At the last inspection it was required that improvements were made to decoration and furnishing in bedrooms, improvements have taken place, it has been required that this work continues. 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 work is underway to address these matters. 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 Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 12 was suitably equipped. The home has a large rear garden laid mainly to lawn. Considerable work is required to make the roof safe and weatherproof, the proprietors have confirmed that this work will start on the 20th October 2005. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 13 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, 29 & 30. Staffing arrangements were satisfactory with sufficient numbers of staff on duty to meet service user needs. EVIDENCE: Staffing levels on the day of the inspection were satisfactory to meet the needs of service users. Records examined confirmed levels have increased since the last inspection and are satisfactory at most other times, the Inspector was told that the manager is still attempting to employ a weekend cleaner. Staff were observed to work in a caring and respectful way with service users. Records examined confirmed that the majority of staff are trained in required safe working practices. 50 of staff are not yet trained to NVQ level 2. Records examined confirmed that satisfactory recruitment procedures are followed when new staff are employed. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 14 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, 33, 35, 37 & 38. Management and administrative systems were generally good. EVIDENCE: The registered manager was not present during the inspection, she is an experienced manager and is registered with the Commission for Social Care Inspection, however she has not yet started her required management training course, which should be completed by the end of this year. A senior member of staff and a representative of the owners were both present during the inspection. Throughout the inspection they both demonstrated a clear understanding of the needs of older people with a dementia type illness. The Inspector was told that as part of the home’s quality assurance process questionnaires have been sent to relatives of relatives and others to gauge their views of the service provided at Belle House and that few people have responded. It has been required that efforts continue to gain relatives views of Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 15 the service. A selection of the records required by regulation were examined, these were in order and stored securely. Risk assessments and fire precaution records were examined and found to be in order. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 3 3 Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? Yes 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 2 3 4 Standard OP7 OP9 OP15 OP19 Regulation 15 13 16(i) 23(1)(b) Requirement That care plans are in place for all service users including those receiving respite care. That alternative recommended storage be provided for the medication discussed. That more choices are made available at service users at breakfast. That the work to repaint/ revarnish radiator guards continues and that the work is extended to the safety gates. That the work to redecorate and refurnish bedrooms continues. That the efforts continue to introduce an effective quality assurance system. Timescale for action 18/10/05 18/11/05 18/10/05 18/01/06 5 6 OP24 OP33 16(c) 24(1) 18/04/06 18/01/06 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 Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 18 1 2 OP31 OP28 That the manager is trained to NVQ level 4 in management and care by the end of 2005. That 50 of staff are trained to NVQ level by the end of 2005. Belle House DS0000021048.V254248.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection East Sussex Area Office 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. 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