Inspection on 07/11/06 for Belle Vue Country House

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Vue Country House 12/02/08

Belle Vue Country House 15/02/06

Belle Vue Country House 15/06/05

Belle Vue Country House 13/01/05

Belle Vue Country House 27/08/04

Belle Vue Country House 30/07/02

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

The Laurels

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

CARE HOMES FOR OLDER PEOPLE Belle Vue Country House Warninglid Lane Warninglid West Sussex RH17 5TQ Lead Inspector Mrs A Peace Unannounced Inspection 7th November 2006 09:45 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 Vue Country House DS0000024117.V318275.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. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belle Vue Country House Address Warninglid Lane Warninglid West Sussex RH17 5TQ 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) 01444 461207 01444 461077 Newcare Homes Limited Mrs Irma Lew Kum Hoi Care Home 41 Category(ies) of Dementia - over 65 years of age (41), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (41) Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That up to 3 persons under the age of 65 may be accommodated in the home. 15th February 2006 Date of last inspection Brief Description of the Service: Belle Vue Country House is a Care Home registered to provide 41 places in the category of Elderly Mental Disorder and Dementia (including 3 places for 50 ). Belle Vue is an adapted and extended two-storey house, standing its own extensive grounds near the village of Warninglid. The home is situated within a rural location in reach of the A23 and there is a bus service that stops near the home. Accommodation is provided on two floors with a lift connecting the two floors. The home currently has 29 single rooms and 6-shared rooms. The home has an extensive garden around the home and an enclosed patio area. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Ann Peace Regulatory Inspector carried out this unannounced fieldwork inspection on 7th November 2006. This is the first inspection for the year 20062007. It is called a key inspection and will determine the frequency of visits/inspections hereafter. Prior to the inspection, records held on file and information received from the home since the last inspection were reviewed and comments from relatives and other professionals taken into account. During this inspection the Inspector toured the building, visited the majority of rooms, and joined the residents in the lounge areas. The Inspector talked to the Manager, members of staff, residents and visitors. The Inspector examined records about care being provided to residents; as well as records of any accidents, or concerns or complaints, to make sure that the residents at Belle Vue Country House are being taken care of. Due to the mental frailty of the majority of the residents it was not possible to engage in meaningful conversation. However from their demeanour and interactions with the staff team, the inspector concluded that they were relaxed and content in their environment. The Inspector was able to speak to relatives who were visiting the home and take into account comments from relatives that are recorded in the home’s quality assurance survey report. Some comments were: “Staff are approachable and friendly and they look after my husband very well”. “My husband is always clean, well dressed and comfortable”. “Staff are welcoming, friendly and caring”. “ Very approachable”. “Nursing staff attend without delay and show extreme care and thoughtfulness”. During this visit, the Registered Manager and staff assisted the inspector. The inspector would like to thank them all. One requirement made at the two previous inspections has not been complied with and this is carried over. This requirement is in respect of Regulation twenty-six reports of visits that should be made by the Responsible Individual. Since the previous inspection the Commission had received no complaints for Social Care Inspection. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the home is right for them. The personalised needs assessment mean that people’s diverse needs are identified and planned for to enable staff to give them the care they need. Trial visits are encouraged. Intermediate care is not provided at Belle Vue. EVIDENCE: Mrs Lew Kum Hoi the Registered Manager told the inspector that the Statement of purpose/service users guide was presently being updated and would be available soon. The previous copy is still being given out to prospective residents, Mrs Lew Kum Hoi said generally it is still relevant. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 9 The statement of purpose sets out the aims and objectives for the home and includes a resident’s guide, which provides basic information about the service. The records seen showed that residents are provided with a statement of the terms and conditions with what fees are to be paid and what is and what is not included in the fees. From records and by talking to relatives the Inspector could confirm that admissions to the home are not made unless a full needs assessment has been undertaken by qualified staff to ensure the home will be able to met identified needs. Where resident’s placements are contracted by other agencies, management assessments and care plans were available. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are reflected in the assessments and care plans. The medication procedure is safe and qualified nurses administer medication. Residents are where possible encouraged with assistance to make choices about their lives and the staff protect their privacy and dignity. EVIDENCE: A key worker system is operated in the home to ensure staff are aware of residents needs and for continuity of care. A named member of staff is responsible for a group of residents. Daily care sheets are kept of the care provided and notes any changes in the resident’s health and well-being. Resident’s health care is monitored and appropriate action taken. Individual care plans are well written and contain all the information necessary for staff to look after the residents. Risk assessments are in place and had been updated. Monthly updates are carried out on basic observations. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 11 The inspector tracked care records to care given and equipment provided and was able to speak to some of the residents and relatives, she could confirm that the staff care for the residents to a good standard. Staff who were spoken to were knowledgeable about the residents and their care and were noted to be attentive and patient with residents who were wandering. One man was helped outside to smoke his pipe. Some residents had been given soft neck pillows for comfort while they sit in the lounges. Residents with an identified risk of pressure area damage had pressurerelieving equipment in place. Mrs Lew Kum Hoi was reminded to ensure that airflow mattresses were set for the correct weight for the resident. Five visitors were spoken to and all were complimentary about the home and the staff. Some comments were: “Staff are approachable and friendly and they look after my husband very well”. “My husband is always clean, well dressed and comfortable”. The home has recently undertaken a QA survey and some of the comments recorded by relatives were “Staff are welcoming, friendly and caring”. “ Very approachable”. “Nursing staff attend without delay and show extreme care and thoughtfulness”. “The home is excellent, could not be happier with care provided. “My husband has thrived since admission to the home”. There were some slightly negative comments that relatives had made that identified that the home should do some things differently, the home have recognised this and made action points on the survey. On care issues these were that the key worker or allocated worker are to make an extra effort to speak to the relatives on their visit and give them an update. Relatives told the inspector that this had happened. Also allocated worker to ensure that residents are wearing their glasses and hearing aid if appropriate. General practitioners, opticians, dentists and other professionals also visit the home when requested and records are kept of all such visits. Medication is stored safely and records are well kept in regard to the administering and disposing of them. Qualified nurses always administer medication. A number of these were checked and were in order. Staff were observed to treat the residents sensitively showing them respect. Privacy and dignity issues are covered in the induction training for new staff. Screens are provided in shared rooms. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 12 By observing staff and through speaking with residents and relatives the inspector could confirm that staff do respect the privacy and dignity of residents at all times. Belle Vue Country House DS0000024117.V318275.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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable activities are arranged. Residents are encouraged to make decisions when they are able to and are able to keep in contact with their family and friends. A variety of good home cooked food is provided. EVIDENCE: The routines are flexible within care needs and relatives and friends feel welcome and know they can visit at anytime. Residents are encouraged to make decisions with help, although many are heavily dependent and do not have the mental capacity to make choices so have to rely on staff. Residents can bring personal possessions into the home to make their rooms homely and personalised. Most residents were in the lounges although some in their rooms through choice. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 14 Where there was music playing it was old time music which residents seemed to enjoy. Staff were in attendance in all lounges with the residents and were seen to talk to them and offer them drinks, some residents were watching television others talking to relatives. One lady was playing the organ with the help of a carer and another carer was playing skittles with a group of residents. Relatives who visit the home regularly said that this was the norm and was not just because the inspector was there. The residents are mentally frail and a number immobile. Activities such as word games, quizzes, sing-along, musical bingo and arts and crafts are provided to meet the varying needs of the residents. A social activities co-ordinator visits the home to broaden the scope of activities available to the residents. There were photos on the board of a BBQ held at the home in the summer; they included resident’s relatives and staff. One relative told the inspector that when she visits she often shuts the bedroom door but it is not very long before a member of staff knocks to see if everything ok, she said they did not interfere with privacy and she was grateful that they do check to see if her husband is ok. Trained chefs cook meals at the home and the chef on duty during the visit knew what the residents liked or disliked. The Quality Assurance survey undertaken at the home was complimentary about the food although one said that more fresh fruit should be provided. There was evidence of this in the lounges on the day of the visit. The main meal on the day of the visit was roast lamb, roast potatoes, Yorkshire pudding, mixed vegetable florets and minted gravy. This was followed by baked rice pudding. There was a vegetarian option available. The evening meal was corned beef, cheese, tomato savoury bake with baked beans followed by fruit jelly and cream. Alternatives were available. The inspector sampled the main meal and found it tasty and well balanced. Residents were seen to be eating well and staff sensitive to the needs of residents who needed help with feeding. They sat with them and helped in an unhurried manner. The mealtime was relaxed and residents were seen to enjoy their meal. Birthdays and celebratory occasions are made special for residents. One lady told the inspector that she could have a meal with her husband if she wants. Visitors said they are always given tea on a tray when they visit. Residents can have their meals in their rooms if they wish and a number were doing this on the day of the visit. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 15 Tables in the dining rooms were set nicely with linen tablecloths and up to date menus were on the tables. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 16 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are handled in accordance with the home’s procedure and relatives stated that their views are listened to and acted on. Staff are trained in the protection of vulnerable adults procedures. EVIDENCE: One complaint was recorded, this was dealt with in house and a letter sent to relatives who were satisfied. The home has a clear complaint procedure which is on show in the home. Four new staff files seen and all evidenced training in the protection of vulnerable adults. Three staff were asked about procedure and did know what to do if abuse was witnessed or suspected. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 17 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): 19,20,21,22,23,24,25,26. 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 safe, homely, clean and comfortable environment and there are sufficient facilities and equipment to meet their needs. EVIDENCE: The home is situated in a rural area, large well kept gardens surround the home and there is a patio area which is safe for residents to walk around. There is a large car park to the front of the home The home has a well maintained environment which provides aids and equipment to meet the care needs of the residents. It is a pleasant and safe Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 18 place to live. Rooms have been personalised with resident’s belongings to make them more homely. Some rooms are shared and screens are provided to protect privacy. The home is well lit, comfortable, homely, well furnished and smells fresh. Communal lounges are pleasant, furnished in a homely fashion with high back comfortable chairs available. Safety checks on equipment and regular training for staff ensure residents are protected as far as possible. Standards of hygiene and cleanliness throughout the home were of a high standard. No odours were present. The QA survey indicated that generally people were happy. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient staff employed over the 24-hour period to ensure that resident’s needs are met. The home’s recruitment policy is robust and does protect residents. Staff training is provided and staff are competent to do their jobs, all staff have instruction in adult protection procedures. EVIDENCE: Duty rotas showed that a good number and skill mix of staff is employed over a 24-hour period to meet the needs of the residents. Records of staff recruited since the last inspection were examined and all were in order and contained information according to legislation. The home has a good recruitment procedure that clearly follows the requirements of the legislation and protects residents. Comments in surveys from residents suggested that residents are getting the support they needed from the staff. All residents who could offer an opinion were very complimentary about staff. The Inspector noted that many residents who are unable to communicate were at ease with staff. Staff observed going about their work and they seemed Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 20 happy and were caring and patient towards residents. Those spoken to said they enjoyed working at the home. Staff said they were well supported and that they were able to look after residents how they would wish. They confirmed they had training to be able to look after residents with dementia and all knew the adult protection procedure. Staff said they are encouraged to undertake other training for instance NVQ and Mrs Lew Kum Hoi said over 50 of staff have completed NVQ 2. The home ensures the staff have specific training to meet needs of the residents accommodated and these training records were seen. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 21 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): 31,32,33,34,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Belle Vue Country House provides an open environment for residents to live in. Mrs Lew Kum Hoi is the Registered Manager and under her leadership the home runs well and the staff are supported to carry out their work. It is apparent that the home is run in the best interests of residents. Record of monthly visits carried out by the Responsible Individual in respect of Regulation 26 reports were not available. Therefore a requirement to this effect has been made. EVIDENCE: Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 22 Mrs Lew Kum Hoi the Registered Manager was on duty during the visit and was very helpful, Mrs Lew Kum Hoi is in the process of completing the Registered Managers Award. Residents spoken to knew the management structure at the home and one relative said that “Belle Vue is an excellent home and under Mrs Lew Kum Hoi’s leadership it provides excellent care and good support for relatives”. Mrs Lew Kum Hoi said she has an open door policy and staff and relatives confirmed this. Relatives said that Mrs Lew Kum Hoi has a high profile in the home which they like. Staff said they were supervised regularly and sessions are recorded. A quality assurance survey was recently undertaken and the results published with any action that was needed. Overall the feedback was positive and any action needed is being carried out. Five visitors were spoken with and from the QA surveys it is indicated that all are happy with the reception from the staff they get Appropriate policies and procedures are available and Insurance cover is available in the home and was displayed on the wall in the hall. Residents are encouraged to manage their own affairs with the help of relatives or advocates if necessary. From reviewing records, speaking to resident’s relatives and staff the inspector concluded that service users rights and best interests were safeguarded by the home’s record keeping. Staff training records are available to indicate that staff have received training in appropriate health and safety procedures and that further regular training is been planned throughout the year. Induction training records were seen for new staff. At the last two inspections a requirement was made that Regulation 26 visits be carried out and a report written on the conduct of the care home, however this has not happened and the requirement remains outstanding. Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 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 3 3 3 3 3 3 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 1 3 3 3 3 3 3 Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 24 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 Standard OP32 Regulation 26 Requirement The responsible individual shall visit the care home in accordance with this regulation and write a monthly report of findings. This report should be available in the home for inspection purposes. Timescale for action 31/12/06 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 Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Belle Vue Country House DS0000024117.V318275.R01.S.doc Version 5.2 Page 26 - 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. 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