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Inspection on 03/11/05 for Belle Vue Nursing Home

Also see our care home review for Belle Vue Nursing Home for more information

This inspection was carried out on 3rd November 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 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

Belle Vue Nursing Home is well maintained providing residents with a welldecorated, modern, spacious and attractive environment. Residents spoken to during the inspection said that they were well cared for. One resident said, "The staff are very good and always cheerful", another said, "I feel safe here, very much so", another said, "The activities are good there is always something to do"

What has improved since the last inspection?

Requirements highlighted at the last inspection have been addressed. The Manager and staff at the home have worked hard to develop the home`s system for recording of complaints and all staff files have been updated to include a photograph of the staff member, many improvements were noted.

What the care home could do better:

The home`s induction training requires further development to include all of the required elements. Staffing levels must be reviewed to determine if there is sufficient staff on duty Water temperatures in resident`s bedrooms must be taken and recorded on a regular basis. The Manager must ensure that the residents/relatives survey results are published and made available

CARE HOMES FOR OLDER PEOPLE Belle Vue Nursing Home 26a Belle Vue Grove Middlesbrough TS4 2PX Lead Inspector Katherine Acheson Unannounced Inspection 3rd November 2005 09:20 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 Nursing Home DS0000000146.V264384.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 Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Belle Vue Nursing Home Address 26a Belle Vue Grove Middlesbrough TS4 2PX 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) 01642 852324 Belle Vue Healthcare Limited Dr Dilip Basant Acquilla, Mrs Sushma Acquilla Mrs Dorothy Matthews Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To allow a maximum of 6 named service users, who are under the age category to reside in the home. To allow a maximum of 10 service users, with a physicial disability who are 50 to reside in the home. The Manager (Mrs Dorothy Matthews) should attain a relevant Management qualification by 2005. 7th June 2005 Date of last inspection Brief Description of the Service: Belle Vue Nursing Home is registered to provide personal and nursing care to sixty service users. The home is situated on Belle Vue Grove in Middlesbrough, and is close to all Local amenities and shops. The home is a two storey, modern, purpose built facility providing accommodation in the form of fifty-six single bedrooms and two double bedrooms. All bedrooms have ensuite facilities, which comprise of a toilet and hash washbasin, all bedrooms meet the required amount of space. The home offers a large dining area and a number of lounges. Belle vue is set in grounds, which are accessible to residents, and provides car-parking facilities for visitors. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 9:20am and lasted for just over four hours. Four residents, one relative and the Manager were spoken to during the inspection. Staff were spoken to informally. Numerous records including medication, policies/procedures, menus, and staff recruitment and training records were examined. A tour of the home was carried out. Requirements highlighted at the last inspection in June 2005 were re-visited What the service does well: What has improved since the last inspection? Requirements highlighted at the last inspection have been addressed. The Manager and staff at the home have worked hard to develop the home’s system for recording of complaints and all staff files have been updated to include a photograph of the staff member, many improvements were noted. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 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 Nursing Home DS0000000146.V264384.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 Nursing Home DS0000000146.V264384.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): EVIDENCE: The above standards were not inspected. Belle Vue Nursing Home DS0000000146.V264384.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): 9 The home’s medication policy/procedure ensures that there are safe practices in place for dealing with medication. EVIDENCE: The home’s system for storing, administering and recording medication was seen to be effective, storage is safe and complies with the relevant regulations and records of medication received at the home and given to residents were seen to be accurate. An appropriate system for disposal of medication is in operation. A record of controlled drugs is maintained. The Manager said that those residents who are able are encouraged to self medicate, a risk assessment is carried out on the resident to determine ability and safety, and lockable storage for medication is provided. Standards 7 was not inspected in full, however, a requirement highlighted at the last inspection in June 2005 in respect of ensuring that care plans were updated on a monthly basis or more often if required was re-visited. Two plans of care examined at random during this inspection had been updated on a monthly basis. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 10 Four residents and one relative were spoken to during the inspection. One resident said, “All the staff are nice, they try hard to keep you comfortable”, another said, “The best thing about the home is the atmosphere” another said, “The home is kept lovely and clean”. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 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 the following standard(s): 15 EVIDENCE: The home offers a menu with an alternative choice available at each mealtime. Menus examined were wholesome and showed variety. Records were available to confirm that appropriate temperature checks are carried out on fridge, freezers and food. Records of food provided were available for inspection. One resident spoken to during the inspection said, “The choice of food is good, you always get two choices”, another said, “The food varies, dinners are good, however teas are poor, a lot of repetition with bread, but the cakes are nice”. One relative spoken to during the inspection said, “The food is pretty good, I get a bit of dinner whilst I’m visiting” Mealtime was observed to be pleasant and relaxed. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: The above standards were not inspected in full, however a requirement highlighted at the last inspection in June 2005 in respect of developing a system to ensure that all complaints were recorded individually had been addressed. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 13 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 standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. EVIDENCE: A tour of the premises found the home to be well maintained internally and externally. The home is modern, spacious and welcoming. Suitable communal space is provided for residents and these areas are decorated in a homely and comfortable manner, as are the home’s toilet and bathroom areas, which provide any aids needed by residents. The Manager said that a number of areas in the home environment are to benefit from redecoration and replacement carpets within the next couple of weeks and that new furniture has been purchased for the dining room. This plan of refurbishment was available for inspection. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 14 Resident’s bedrooms are homely and personalised with personal possessions being evident. Residents bedrooms visited were well decorated and furnished. The Manager said that all baths, showers and sinks in the home environment are temperature regulated. Records were available to confirm that the water temperature in communal bathroom and shower areas were taken and recorded on a regular basis. Water temperatures in resident’s bedrooms were taken and recorded, however not on a regular basis. It was highlighted at the last inspection that some bath temperatures in resident areas were too cool, this had been addressed. At the time of this unannounced visit the home was commendably clean and hygienic with good facilities and procedures for handling laundry and preventing odours or the spread of infection. The home has two hoists, many pressure relieving mattresses and other specialist equipment to assist residents and maximise their independence. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 15 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, 28, 30 The residents needs are met by a well trained team, however the home’s induction training requires further development and the Manager must ensure that appropriate numbers of staff are trained to NVQ level 2 in care. EVIDENCE: Duty rotas examined during the inspection confirmed that the home is working with the appropriate number of staff on duty. The Manager said that staffing levels fluctuate depending on dependency and resident numbers. Four residents were spoken to during the inspection, two residents felt that there was sufficient staff on duty two did not, however, thought that this was possibly due to staff sickness and holidays. The Manager said that 17 of care staff are trained to NVQ level 2 in care or equivalent with a number of other care staff working towards their NVQ level 2 in care. Records were examined to confirm that mandatory and other training relevant to the job that staff do is provided. Training for staff has also been planned for 2006. The home carries out an induction with all staff and records were evidenced to confirm that this is the case, however the home’s induction was observed to be more of a checklist and as such does not include all of the required elements. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 16 A discussion took place with the Manager regarding the required induction standards. Standard 29 was not inspected in full, however requirements highlighted at the last inspection were re-visited and observed to have been addressed. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 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 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, The Manager is working extremely hard to ensure the effective and efficient running of the home. The home seeks the views of residents and their families to ensure that it is managed with their best interest. EVIDENCE: The Manager, Dorothy Matthews, is a first level Registered Nurse who has worked in the nursing and social care environment for many years. The Manager is currently working towards achieving her NVQ level 4 in Management. Residents and the one relative spoken to during the inspection spoke highly of the Manager, staff team and care that is provided. One resident said, “The Matron’s a nice person”, another said, “The Matron, Sister’s and staff are all nice” Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 18 The Manager has a quality assurance system in place. A survey/questionnaire is sent out to residents and relatives six weeks after admission and then annually asking if they are happy with the care that is being received and other areas relevant to the resident and home. Records were available to confirm that the home have commenced this process. A discussion took place with the Manager regarding publishing the results of the survey. Records were examined to confirm that staff at the home are receiving formal supervision on a regular basis. Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 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 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 3 X X Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 20 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 2 Standard OP21 OP27 Regulation 13 13, 18 Requirement Water temperatures in residents bedrooms must be taken and recorded on a regular basis The Manager must review dependency of residents and current staffing levels to determine if there are sufficient staff on duty The home’s induction training requires further development to include all of the required elements The results of the residents/relatives survey must be published and made available Timescale for action 03/11/05 03/11/05 3 OP30 19 30/12/05 4 OP33 24 30/12/05 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. 2 Refer to Standard OP31 OP28 Good Practice Recommendations The Manager should continue to work towards achieving her NVQ Level 4 in Management The Manager should continue to work towards achieving DS0000000146.V264384.R01.S.doc Version 5.0 Page 21 Belle Vue Nursing Home 50 of care staff trained to NVQ level 2 in care or equivalent by 2005 Belle Vue Nursing Home DS0000000146.V264384.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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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