CARE HOMES FOR OLDER PEOPLE
Belma 120 Torquay Road Newton Abbot Devon TQ12 4AH Lead Inspector
Mark Sharman Announced 10 and 11/05/05 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. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Belma Address 120 Torquay Road, Newton Abbot, Devon, TQ12 4AH 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) 01626 356465 01626 356465 Mr Gerald Reginald SymondsMrs Jennifer Mary Symonds Care Home Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 26/11/04 Brief Description of the Service: Belma is a large house situated on a main road about half a mile from the centre of Newton Abbot, and on a bus route. The home has been operated by the resident owners for nearly seventeen years and can accommodate up to twelve people aged 65 and over, although not people suffering from mental health problems. There are two lounges and a dining room, and most of the bedrooms are single rooms. Disability equipment available includes stair lifts, bath hoists and a portable hoist. At night there are sleeping-in staff but no staff awake (although there is a call system). There are gardens at the front and rear, and a car parking area at the front. The rear garden includes a sheltered patio area with garden furniture. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection lasting a little less than six hours. A completed pre-inspection questionnaire was received before the inspection. Six residents and six staff were interviewed, and some staff records and residents’ records were inspected. A tour of most of the building was carried out. What the service does well: What has improved since the last inspection?
A requirement was made at the last inspection that self-closing fire doors must not be wedged open, and this has been dealt with. Some electronic devices have been bought and fitted to certain bedroom doors, so that they can now be held open safely. On operation of the fire alarm they will close automatically, thus ensuring that residents remain safe in the event of a fire. A requirement was also made for the covering of radiators which are accessible to residents to eliminate the risk of burns, and this work has been partially done. Those radiators assessed to pose the highest risk have been covered, leaving others still to be done. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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) 3. Standard 6 is inapplicable. The needs of prospective new residents are carefully assessed before their admission in order to ensure that the home can meet their needs. EVIDENCE: Only one new resident has been admitted to the home since the last inspection. She said that she had visited the home on numerous occasions before coming to live there, and so knew what the home is like and what services are provided. The home owner/manager was fully aware of her needs before she moved in. In the case of previous residents there are written assessments of their needs in their files, carried out by local authority care managers prior to their admission. The owner discussed a recent example of declining an admission because she felt the person’s needs could not be adequately met at Belma. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 standard(s) 7, 8 and 9. There is a clear care planning system in place to provide staff with the information needed to meet the residents’ needs. Their medication is well managed and their health care needs are being fully met. EVIDENCE: The sample of care plans inspected were clear and concise, and specified actions to be taken to ensure that the residents’ health care and social care needs are addressed. Each resident’s file included a risk assessment, and the care plans were reviewed monthly. All visits by general practitioners, district nurses, chiropodist etc. are recorded, and a weight chart is kept for each resident. The residents spoken to all said that they are cared for very well and that professional medical help is obtained for them whenever necessary. Special equipment for the prevention of pressure sores is being used for certain residents. At present three residents are looking after their medication themselves. The medication cupboard and medication records were inspected. The staff said that they are all to have professional medication training in the next few weeks. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 standard(s) 12, 13 and 14. Although the organised activities on offer are quite limited, this provision suits the residents’ preferences and particular interests. They are fully able to make decisions for themselves and to follow their own routines. EVIDENCE: The residents said that in the main they like to pursue their own interests and that the activities which are organised by the home for them are sufficient. These include a regular activities afternoon with a quiz, reminiscence and indoor games, and there are regular exercise sessions. Three residents said that they go out frequently on their own, and some have regular external commitments. One said that she goes to church each week and to a weekly meeting. Another said that there are no restrictions in the home, and that “you can do what you like within reason”. Several confirmed that they get up/go to bed when it suits them. A few said that they manage their personal money themselves. There is a notice in the hall welcoming visitors at any time, and several residents said that they have regular visitors. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 standard(s) 16 and 18. There is a satisfactory complaints system, and staff have a good understanding of adult protection issues which protects residents from abuse. EVIDENCE: The home has a clear complaints procedure, which is displayed on a notice board. All of the residents were entirely confident that if they expressed a complaint it would be dealt with satisfactorily, although none had any complaint. The staff were aware of the home’s policies on abuse issues, including whistleblowing, and where to access the policies. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 standard(s) 19, 25 and 26. The home provides comfortable, attractive accommodation which is noninstitutional in appearance. It was warm, clean, hygienic and tidy. EVIDENCE: Most parts of the home were inspected, and everywhere was very clean and tidy. The residents said that it is always kept like this and that their bedrooms are cleaned every day. Liquid soap dispensers and paper towels are now provided in most of the bedrooms, contributing to maintenance of hygiene. The communal rooms were comfortable and well furnished. Some more radiators have now been covered, and the owners have carried out a written risk assessment in respect of these. This work needs to be completed on this risk assessment basis. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 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, 29 and 30. The staffing arrangements are satisfactory and meet the residents’ needs, and the staff are well trained. The recruitment procedures ensure that suitable staff are employed and that residents are thus protected, although appropriate checks must be extended to the youngest staff member. EVIDENCE: The residents said that in their experience there are always enough staff on duty for their needs, and the staff spoken to said this too. All of the residents were very complimentary about the caring and helpful attitude of the staff. The staff seen were cheerful in their work and staff morale is high. Only the cleaner has left since the last inspection (retired). Staff said that they receive good training, and about half of them have NVQ level 2 (and two have level 3). They said that they all had professional moving and handling training and fire training recently, and will have emergency first aid training soon. Health and safety training is to follow. A training/competence record is kept for all staff, and a sample was seen (and annual appraisals). Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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 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) 35 and 38. The residents’ financial interests are safeguarded and they control their own personal money. The owners take a responsible approach to health and safety issues, and one outstanding matter is now being dealt with. EVIDENCE: Some residents said that they control their personal money themselves, and in all other cases this is done by relatives. Regular training for all staff includes manual handling, fire safety, food hygiene, health and safety and emergency first aid, which was confirmed by the staff present. The fire log was inspected, and the home’s fire alarm system was professionally serviced on the first morning of this inspection. Electronic devices are now used to hold open self-closing fire doors, as previously required. Several radiators have now been covered, although this work has not been completed. Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 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 x x x x 3 x x 3 Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 Page 16 Yes. 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 25 Regulation 13 Requirement All pipework and radiators accessible to service users must be guarded or have low temperature surfaces. (Some radiators have now been covered). A standard Criminal Records Bureau disclosure must be obtained in respect of the junior helper employed. Timescale for action 30/11/05 2. 29 19 30/6/05 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. Refer to Standard Good Practice Recommendations Belma D54-D07 S3649 Belma V213647 100505 Stage 4.doc Version 1.20 Page 17 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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