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Inspection on 06/11/06 for Bellerose Residential Home

Also see our care home review for Bellerose Residential Home for more information

This inspection was carried out on 6th November 2006.

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

The home has achieved a high level of person centred care, effectively backed up in the good standard of its policies, procedures and records; care plans for example are drawn up in conjunction with individual service users and provide clear goals and are regularly reviewed. Service users express a high degree of satisfaction with the service and members of the staff team are well supported with the training they require to carry out their roles.

What has improved since the last inspection?

The central heating and hot water system of the home has been replaced. No requirements or recommendations were made in the report of the inspection carried out in January 2006, any requirements made before then have always been fully complied with.

What the care home could do better:

This service has sustained a high standard of care for its service users for some time now and with the exception of some minor adjustments in practice identified in this report, needs only to ensure that this high standard is maintained in the future.

CARE HOME ADULTS 18-65 Bellerose Residential Home 14-16 Westland Road Watford Hertfordshire WD17 1QS Lead Inspector Jeffrey Orange Key Unannounced Inspection 6th November 2006 09:00 Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 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 Bellerose Residential Home DS0000019284.V319158.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 Adults 18-65. 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. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bellerose Residential Home Address 14-16 Westland Road Watford Hertfordshire WD17 1QS 01923 466630 01923 466630 FP 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) Mastercare Residential Home Association Stephen John Holt Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 10th January 2006 Brief Description of the Service: Bellerose is a three-storey house, located in a quiet street in a residential neighbourhood in Watford. The home is one of two operated by Mastercare Residential Homes Association, and provides accommodation and care for adults of both sexes who have mental health problems. The building has no lift therefore service users must be physically able to manage stairs. There are seven spacious bedrooms on the ground and first floors, a comfortable lounge and domestic style kitchen on the ground floor and adequate bathing and toilet facilities. Some bedrooms have en-suite showers. The second floor has been converted to provide a semi-independent flat with separate kitchen, lounge and bathroom for two service users planning eventually to move on to fully independent living. Outside to the rear of the building is a small, enclosed paved garden with a small pre-fabricated out building for smokers to use. The home is within easy walking distance of Watford town centre with its shops and amenities, including bus terminals, two mainline railway stations and an underground station. The home has a statement of purpose and service user’s guide, which include contact details for the Commission for Social Care Inspection (CSCI). A copy of the latest inspection report is also available in the home for service users and visitors. Weekly charges, which cover basic care and accommodation, are subject to individual assessment and range from approximately £600 to £1048. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place in the morning and provided an opportunity to meet service users and staff, to discuss the way the home operates and the experience of living and working there. Some key records were examined, including those for staff recruitment and service user medication and a brief inspection of the premises was made. This report takes account of the assessment made following the inspections of September 2005 and January 2006, together with any additional information received by the CSCI since then. What the service does well: What has improved since the last inspection? What they could do better: This service has sustained a high standard of care for its service users for some time now and with the exception of some minor adjustments in practice identified in this report, needs only to ensure that this high standard is maintained in the future. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 6 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. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have access to clearly presented information about the home and the care service it provides and are able to make a well informed and supported decision about whether it can meet their needs satisfactorily. Prospective users needs are assessed very fully before admission and the home has demonstrated a robust determination only to admit those whose needs it is confident they can meet without adversely affecting existing service users. EVIDENCE: A sample number of written contracts were seen which clearly set out the roles and responsibilities of the home and service users. The home has a statement of purpose and a service user’s guide in an appropriate format, which clearly sets out details of the services provided, so that any service user can know what to expect. Care plans seen demonstrate a person centred focus, with individual preferences and goals established and clear action plans set out and reviewed in order to achieve them. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 9 Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a high standard of person centred care planning. Service users are fully involved in decisions about their care and how it is to be provided in a way that recognises their rights as well as identifying and addressing any risk involved. EVIDENCE: Service user meeting records were seen, as were details of service user survey forms completed by service users and covering all aspects of their lives and the care they receive. Care plans and associated documents include a robust and thorough series of risk assessments, which are discussed and agreed with service users. Service users were seen to be given choices and asked for their preferences throughout this inspection and it has previously been well established that service users are fully involved in the running of the home and their views are obtained and taken into account in the decision making process. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 11 Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and assisted to be active in the local community, to access courses, social and leisure activities that promote their personal development and to follow lifestyles that suit them. Policies and practices in the home generally promote and respect service user’s rights and encourage them to take personal responsibility for housekeeping and their own personal hygiene, with guidance and support being provided as necessary. One minor adjustment to current practice is recommended. EVIDENCE: Services users have indicated that they participate in a wide range of activities in the local community and maintain various family and social relationships. Care plans seen include details of day care, visits and leisure breaks and family and other social contacts. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 13 A holiday break for those service users who wanted to go was arranged to Great Yarmouth earlier in the year. One service user has recently married and will be moving on from the home once suitable accommodation can be arranged. Service users wanting to have a bath were seen to have to ask for the bathplug, following problems with baths over-flowing. This practice should be reviewed on an individual risk basis to promote personal responsibility. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The individual preferences and needs of service users are reflected in the way that their care is provided. Policies and procedures in the home support service users in making choices about their lives. The medication policies and procedures in place mean that service users can retain control of their medication where it is assessed as safe for them to do so. Where risk assessment shows that it is not safe for them to do so, medication is administered for them in a safe way. EVIDENCE: Details about service user preferences, choices and wishes regarding personal care are recorded in care plans. Staff were seen to offer choices to service users and also to be providing prompts and guidance in respect of, for example personal hygiene. Service users expressed a high degree of satisfaction with the way that their care is provided by the home’s staff team. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 15 Service users are encouraged to self medicate either fully or to the extent that is assessed as being safe for them to do. Medication records were checked and found to be satisfactory. Care plans seen include details of the involvement of a range of health and social care professionals with service users. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their views are listened to and that the home is managed and run in a way that attempts to reflect those views. Staff are aware of how they and others should behave towards service users and what to do if they see or suspect abuse is taking place either in or outside of the home. EVIDENCE: Service users were aware of the complaints policy and procedure and how they can use it. They were very positive about how staff respond to them and felt confident in the members of staff and the management of the home. Staff have received training in the protection of vulnerable adults and have previously been found to understand the whistle-blowing policy. The views of service users are actively sought and recorded. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises provide a homely and comfortable environment that is safe, clean and well maintained for those who live and work there. EVIDENCE: Those rooms seen, with the permission of service users were personalised to reflect their interests and personalities. All areas inspected were again clean, tidy and free from any unpleasant smells. There has been an improved heating system installed and routine maintenance work continues. The exterior paintwork at the front will need attention in the medium term. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate numbers of staff, with the appropriate skills are provided in order to meet the needs of service users at all times. The home has a robust recruitment process in place for the protection of service users. EVIDENCE: Staff receive regular group and individual supervision, those staff spoken with confirmed that they felt well supported by the manager. Recruitment records for the most recently recruited members of the staff team were seen and included the necessary checks and details to provide reassurance to service users and those responsible for them. Details of induction and other training were seen and provided confirmation that the staff team are encouraged to develop their personal skills and expertise, which can only benefit service users. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is excellent.This judgement has been made using available evidence including a visit to this service. This is a well managed home with policies in place and a consistently high standard of care practice that ensures that the welfare of service users is promoted and that staff and residents interests are safeguarded. EVIDENCE: The registered manager achieved his Registered Managers Award in May 2006. Staff and service users were very positive about the management of the home. There are regular staff and service user meetings, records of these are available and there is also a process of service user surveys in place as part of the home’s quality assurance process. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 20 There is a monthly system of risk assessment review and those records seen relating to health and safety were well completed and up to date. Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 22 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. 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. 1 Refer to Standard YA16 Good Practice Recommendations Any restrictions on free use of the home’s bath should be based on individual risk assessment and only apply to an individual if they are deemed to present a risk. These assessments should be recorded and discussed with the service users concerned. As part of the home’s quality assurance process, monthly reports by the proprietor, in line with reg. 26 of the Care Homes Regulations 2001 should be completed and kept in the home. 2 YA39 Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Bellerose Residential Home DS0000019284.V319158.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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