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Inspection on 12/09/05 for Belle Vue House

Also see our care home review for Belle Vue House for more information

This inspection was carried out on 12th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Mr and Mrs Lake have been providing care and support in their own home for approximately twelve years. They work well together as a team. This was observed during the inspection. The care provided was delivered in an untimely, respectful way. Both Mr and Mrs Lake show a deep empathy to service users and clearly enjoy sharing their home and their lives with them. Mrs Lake spoke fondly of all the service users remembering service users that are no longer with her, but with whom contact is still maintained with family members. The home provides a high standard of accommodation, which exceeds the national minimum standards and is appropriate to the needs of the service users.

What has improved since the last inspection?

All the standards were met at the last inspection. This is still the case other than one requirement made. Mr and Mrs Lake are continuously striving to ensure the highest standards of care are maintained. They do so with the support of the primary health and social care services and local day care provision. Families also provide a vital element of support to the whole service.

What the care home could do better:

No areas for improvements were identified.

CARE HOMES FOR OLDER PEOPLE Belle Vue House Little Heath Gamlingay Bedfordshire SG19 3LL Lead Inspector Shirley Christopher Unannounced 12 September @ 11:20 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 Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Belle Vue House Address Little Heath Gamlingay Bedfordshire SG19 3LL 01767 650226 01767 650226 N/A Mrs Christine Lake 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) Mrs Christine Lake Care Home 3 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (3) of places Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 4 February 2005 Brief Description of the Service: Bellevue House is a large family residence that stands in an acre of attractive gardens. The property is situated in the village of Gamlingay on a single dirt track off the main road. The home is a small care home that has been established for over 12 years. It is registered to take three service users over the age of 65 years who may be people with age-related mental health needs. The registered provider Mrs Lake and her husband live in the property. The home is comfortably furnished. One member of staff is employed for one day each week and the proprietor has an arrangement with a suitably qualified person who can manage the home when holidays are arranged or under exceptional circumstances. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 12 September from 11.30 am until 1.30 pm. During this inspection all three service users were met and spoken to briefly. Some areas of the home were viewed and interaction between Mr and Mrs Lake and the service users was observed. Some records were inspected including staff files, training certificates, one care plan, financial records, medication records, evidence of quality assurance and service user reviews. Mrs Lake was spoken to at length. What the service does well: What has improved since the last inspection? All the standards were met at the last inspection. This is still the case other than one requirement made. Mr and Mrs Lake are continuously striving to ensure the highest standards of care are maintained. They do so with the support of the primary health and social care services and local day care provision. Families also provide a vital element of support to the whole service. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 6 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 Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5 Service users’ needs are assessed to ensure that the registered providers feel that they are able to meet their identified needs. Service users are given written information about the service and are encouraged to visit the home before admission. EVIDENCE: One service user file was inspected for the person most recently admitted to the home. This provided evidence that a pre admission assessment is sought from other agencies before admission. Mrs Lake provides service users with a comprehensive service user guide and there is also a statement of purpose available. Admission to the home is provided on a trial period and followed by a review after four to six weeks to ensure that the service is appropriate to needs. Evidence of annual review was also provided. Visits to the home prior to admission are always advisable. Contracts were not requested on this occasion. Mrs Lake is supported by her husband and two other members of paid staff, one who provides temporary cover for holidays/ illness and one member of Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 9 staff who works one day a week, to give Mr and Mrs Lake a day off. Mr and Mrs Lake have provided and completed relevant training and all have considerable experience. Mrs Lake attends multidisciplinary workshops at Addenbrooks hosptital every month, where a guest speaker gives a presentation on a particular illness or health condition. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Service users can be assured that they will receive the highest quality of care at the home. EVIDENCE: One care plan was inspected and provided adequate information about meeting service users’ needs. Mrs Lake has a clear and in-depth knowledge of service users in her care and involves all relevant agencies to ensure that the care provided meets the physical, social, psychological and spiritual needs of service users. A diary is kept for each service user to record any significant event or participation in social activities, and includes a list of visitors. Separate records are kept of record service user finance, dietary intake, record of weights and health care appointments are recorded in the diary and on a separate attachment in the care plan. Care plans are kept in service user bedrooms and are openly discussed with them and are continuously reviewed. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 11 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) 12,13,14,15 Bellevue House provides spacious accommodation in substantial grounds. Social activities are provided around individuals expressed wishes and choices. Ordinary patterns of family life are the norm. Service users share Mr and Mrs Lakes home, as part of an extended family. EVIDENCE: Regular contact is maintained with family members, who are free to visit when they like, according to the wishes of the service users. Mr and Mrs Lake also provide transport to escort service users to various day centre, lunch clubs, visits to family members, drives out and trips to local events/festivities and services. Mrs Lake stated that it is not possible to go out as much as they would like. One gentleman requires support from both Mr and Mrs Lake and is unable to travel easily by car, given the nature of his disability. However every attempt is made to ensure that service users have structured activities to attend and forward planning makes it possible for continuing provision of activities for service users. Service users needs are fully understood and Mr and Mrs Lake have a good insight into the social history of each service user. They demonstrate a good deal of patience in dealing with symptoms of illness and disability in a courteous, respectful way. Service users are free to exercise choice in all Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 12 aspects of the daily life and emphasis is placed on their abilities rather than disabilities. The home provides a relaxed, comfortable environment which is conducive to service users needs. Regular meals are provided and food is of a high standard and an important part of the day. One gentleman was having his breakfast at the time of inspection and the support he received was highly appropriate. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 13 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 The home has adequate measures in place for the protection of vulnerable adults, through policies, procedures and the uptake of regular training. EVIDENCE: The home has a complaints policy and procedure, which is available to service users and their representatives. No complaints have been made. Mrs Lake confirmed that she has the latest guidance for the protection of vulnerable adults and has recently attended training to update existing training. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 14 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) 19,20,22,23,25,26 Service users live in a safe well maintained home, which is situated in a private, quiet location, overlooking beautifully manicured gardens of approximately one acre. EVIDENCE: The home provides spacious, comfortable accommodation. Only the communal areas were seen as part of this inspection and included the main lounge, dining room and conservatory. Mrs Lake confirmed that appropriate equipment is provided as required including an electric hoist and bed. Equipment to assist with lifting is identified as part of the manual handling assessment. Mr Lake who is now officially retired was a electrical engineer. He ensures that all the safety and maintenance records are up to date and tested as required. Mrs Lake confirmed that the fire records, alarms/ lighting are tested weekly and the fire officer visited recently at the request of Mrs Lake and made no requirements or recommendations. The heating system has recently been replaced and Mr Lake does the annual portable appliance testing. Weekly water temperatures are recorded. No maintenance records were inspected. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 15 Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 16 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 Mr and Mrs Lake have considerable personal experience and have employed people known in the community to assist them in providing the highest quality of care. Relevant training is provided and Mr and Mrs Lake support each other and staff employed by them. EVIDENCE: Mr and Mrs Lake provide care and practical support to service users around the clock when required. They employ two paid carers. One who works once a week to give Mr and Mrs Lake a break and a second member of staff who provides temporary cover for longer periods such as holidays or in exceptional circumstances. Evidence was provided of staff training and relevant experience for the post. Mrs Lake takes up suitable references and CRB/Pova 1st checks. Applications forms and staff photographs were also seen but no personal identification was seen on file and Mrs Lake was asked to provide this. Mr and Mrs Lake have both been doing NVQ 2 in care and provided evidence that they had completed all the relevant statutory training, as have staff employed by them. Service users also had the opportunity to contribute to training. Mrs Lake confirmed that she supports staff and ensures that information is handed over correctly. There are written protocols in place in terms of the daily running of the home. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 17 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) 31,32,33,35,37,38 Appropriate measures are put in place to ensure that the well being and safety of service users are met. EVIDENCE: Mr and Mrs Lake have been running a service for more than twelve years and have considerable personal and professional experience. They have both nearly completed an NVQ 2 qualification, which covers all the relevant, mandatory training. Mrs Lake discussed the possibility of going on to do NVQ 3, which would be off no financial cost to her. However the practical implications of further study on her time were discussed and it was felt on balance to be impractical. Her only opportunity for study time would be late in the evening after the service users were settled. Evidence was seen that Mrs Lake is able to meet the defined needs of service users in a highly professional and competent manner. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 18 A limited number of records were inspected and included, financial records for service user personal spending, medication records, service user care plans and pre-admission assessments. Evidence of quality assurance was seen. Staff records provided evidence of pre employment checks and relevant training undertaken since employment. No maintenance records were seen as part of this inspection, but Mrs Lake confirmed that they were all up to date and no immediate hazards were identified during the course of the inspection. Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 19 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 4 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION 4 4 x 3 3 x 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x 3 x 3 3 Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 20 No 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 29 Regulation 19 Requirement The registered provider must ensure that a form of identification is held as part of the staff record as identifed in Schedule 2 Timescale for action 30 October 2005 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 Belle Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 21 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Vue House I03 I53 s15226 BELLE VUE HOUSE v238123 120905 STAGE 4.doc Version 1.40 Page 22 - 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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