CARE HOMES FOR OLDER PEOPLE
Belle Vue House Little Heath Gamlingay Bedfordshire SG19 3LL Lead Inspector
Don Traylen Unannounced Inspection 19th January 2006 16:30 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 House DS0000015226.V273206.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 Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Belle Vue House Address Little Heath Gamlingay Bedfordshire SG19 3LL 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) 01767 650226 01767 650226 Mrs Christine Lake 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 DS0000015226.V273206.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 12th September 2005 Brief Description of the Service: Bellevue House is a large family residence that stands in an acre of attractive gardens in a quiet, rural setting. The property is situated in the village of Gamlingay, accessible by a single dirt track off the main road. The home has been established for over 12 years and 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 Christine Lake and her husband, live in the property. The home is furnished to a high standard. 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 when other circumstances prevail. Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The home has been inspected previously in this inspection year and twice in the previous inspection year. It is recommended ton read this report in conjunction with the report for the last inspection on the 12/09/2005. The registered provider, Mrs Lake, is also the registered manager. At the time of inspection two service users were living in the home. This inspection visit was brief, and the inspector judged that the inspection should focus on the philosophy of care behind the service and the observed interaction between the provider and two service users. In the previous inspection on the 12/11/2005, all the key standards were assessed and have been met. What the service does well:
Bellvue House can be described as a ‘home from home’. The home offers a comforting and secure environment where care is person-centred and is based on respect and a professional approach. The differing needs of service users are known by the proprietor and her husband and are responded to in ways that are considerate of each service user’s character, ability and needs. Mrs Lake and her husband work well together and are usually both present to manage personal care tasks. A relief care worker is employed when Mrs and Mr Lake take holidays or breaks. The arrangement is long standing and has worked well to ensure that the registered provider and her husband enjoy necessary breaks from providing 24-hour care. The attention to individual needs was observed in the intricacies of skilful personal verbal and non-verbal interactions shown by both Mr and Mrs Lake when they were talking to service users. The environment is spacious, very well maintained, clean and is comfortably furnished to a high standard. The atmosphere that has been created is based on respect and is a calm and friendly environment that is ideally suited to the needs of the two service users. Support for service users’ health needs is sought through community health professionals including Community Psychiatric Nurses, District Nurse and a GP. No requirements or recommendations have been made in this report.
Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 6 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 Vue House DS0000015226.V273206.R01.S.doc Version 5.0 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 House DS0000015226.V273206.R01.S.doc Version 5.0 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 the following standard(s): None assessed EVIDENCE: No service users have moved into the home since the last inspection, or since the inspection prior to that. Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 9 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): 8,10,11, Service users are treated with respect and their dignity is promoted. EVIDENCE: The recent death of one service user had been sensitively managed and a card from the family confirmed their appreciation of the understanding and care provided by the home. The manager discussed the circumstances and effects of the loss of this service user. Respect was evident in this discussion and in the observations made of the personal interaction the manager and her husband conducted with service users. The health care arrangements for one service user are managed in close consultation with health services. The recent hoist and a ‘hospital’ bed with a pressure mattress have been made available for one service user who has also been provided with a wheelchair. A hospital based consultant and a specialist nurse are available to contact should there be a concern about the service users immediate health needs. Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14, Service users’ family links are facilitated and maintained. EVIDENCE: One service user visits his relatives who live locally. The relatives of one other service user visit him at the home. Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 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 the following standard(s): None assessed EVIDENCE: Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,23,24,25,26, The environment is ideal for the home’s two service users. EVIDENCE: All the Standards in this section were met at the last inspection and have again been met at this inspection. Since the last inspection, a hoist and a pressurerelieving mattress have been acquired by the home to meet the changing needs of one service user. The emotional atmosphere and the safe, clean and comfortable conditions of the home are suitable for the service users’ needs and expectations. Belle Vue House DS0000015226.V273206.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): 30, Service users benefit from the familiar and the regularity, of key people who provide their care. EVIDENCE: All Standards were assessed and met at the previous inspection. At the time of inspection Mr Lake was waiting to attend an ‘Adult Protection’ training course. Belle Vue House DS0000015226.V273206.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): None assessed EVIDENCE: Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 15 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 4 3 3 3 3 4 4 4 STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X x X x Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Belle Vue House DS0000015226.V273206.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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