Inspection on 05/06/06 for Belmont

This inspection was carried out on 5th June 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.

Other inspections for this house

Belmont 08/11/07

Belmont 02/12/05

Belmont 05/09/05

Belmont 22/02/05

Belmont 19/04/04

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Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Belmont Stone Street Stanford North Ashford Kent TN25 6DF Lead Inspector Paul Stibbons Unannounced Inspection 5th June 2006 10:45 Belmont DS0000023333.V297645.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 Belmont DS0000023333.V297645.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. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belmont Address Stone Street Stanford North Ashford Kent TN25 6DF 01303 813084 01303 813084 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) Counticare Limited Mrs Dawn Annette Smith Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd December 2005 Brief Description of the Service: Belmont is situated in the village of Stanford North, between Folkestone and Ashford. It is a large country house providing accommodation and personal care for six residents with a learning disability. The home is owned by Counticare, a registered provider of approximately 15 homes in the East Kent area. Communal areas comprise a lounge, music/quiet room, dining kitchen area, conservatory and laundry room. Within the grounds of Belmont is a large outbuilding, which provides a recreational area for music, relaxation and arts and crafts, and the managers office. The home has extensive gardens with a large swing and greenhouse. The home has use of a minibus and a car to access the wider community, as the village has no amenities other than a local pub. There is no regular public transport links to the home. The current scale of charges as at 19/05/06 range between £1084.36 and £1353.77 per week for service users’. There are additional charges for Chiropody, hairdressing, horse riding and bowling. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulatory inspector Paul Stibbons conducted this unannounced site visit from 10:45 until 13:15 on the 5th June 2006. The Registered manager was on annual leave and the deputy manager and two team leaders assisted with the process. I was unable to interview service users as five were out at various activities and one at home declined to give input. The pre-inspection questionnaire was received by the CSCI prior to the visit and one service user survey was received on the day. A tour of the building was carried out and various documents were examined. The three staff on duty were spoken with. Judgements throughout the report have been made from observations and evidence gathered both during and before the visit to this service. What the service does well: What has improved since the last inspection? The dining room table and chairs have been replaced and are more comfortable for service users. Medication policies and procedures have been reviewed and updated for the protection of service users. Staff training has been ongoing making a safer environment for service users. The home is currently recruiting staff to raise staffing levels at weekends, which will enable more individual opportunities for service users. Regulation 26 visits from the provider now seek the views of service users and staff for self-monitoring purposes. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 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. Belmont DS0000023333.V297645.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 Belmont DS0000023333.V297645.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A documented full assessment of needs ensures service users receive the support they require. Service users each have a written contract of terms and conditions of the home and the service they can expect. EVIDENCE: Care plans viewed have full assessments of individual needs and life plans are in place that are continually reviewed. Daily routines are recorded with service user support requirements as guidance for staff. Contracts of terms and conditions and fees payable are clear and signed by all parties or their representatives. Any services that are not covered by the fees are clearly documented. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. 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. Service users are supported in making choices and participate in the life of the home. Their assessed and changing needs and personal goals are reflected in their care plans. EVIDENCE: Life plans viewed contain information on service user lifestyles and routines and each is allocated a “Keyworker” who assists the service user in choosing personal goals. The service users have decided to have two pet rabbits and agreements were seen to contribute to the cost of feeding them. A number of risk assessments are in place to support an independent lifestyle for service users. The deputy manager states that residents toiletries are no longer kept in the staff sleep-in room and have been moved to a more appropriate location. There has been consultation between resident, parent and Epilepsy nurse regards monitor in service users bedroom. Various other aids have been tried to alert staff to seizures without success, and service user is in agreement to have the monitor, they are able to turn the monitor off at any time. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 10 Evidence from service user meetings shows their involvement in the choice of meals in the home and other aspects of life in the home. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. 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. Daily life meets the service users lifestyle preferences and expectations. They have regular contact with their families and receive a balanced diet according to their choices. EVIDENCE: Care plans and daily records showed that service users lead an active lifestyle accessing the company’s day centre at various times during the week. The home has spacious safe, well-maintained grounds where service users can enjoy outdoor games and activities. Various games and puzzles are available for indoor use and some service users have been to horse riding and golf. There is a large outbuilding in the grounds that is used for art and craft and music. Shopping trips take place for the home in small groups and personal shopping with individual keyworkers. Weekend activities include trips to the local public house, boot-fairs, swimming and walks. The deputy manager Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 12 states that efforts are made to involve the local community in events at the home and that the home is in the process of recruiting additional staff for weekends to enable more opportunities. Staff state that one service user goes home alternate weekends and others are supported in maintaining family contact, there are family photographs in service user bedrooms. The menu’s viewed were varied, balanced and nutritious with input from service users evidenced through resident meetings. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in the way they prefer and require and are referred to other relevant Healthcare professionals when necessary. T They are protected by the homes policies and procedures and staff training for medication. EVIDENCE: Support plans viewed give clear guidance to staff in delivering personal support to individuals in the way they prefer and require. There was clear evidence of referrals to relevant healthcare professionals where required documented within service user care plans. Medication policies and procedures have recently been reviewed and updated and the majority of staff have completed a course leading to a certificate of safe handling of medication. Medication administration record sheets were completed accurately and medication was securely stored in an appropriate cabinet. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. 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. Care workers have a good understanding of adult protection issues and reporting procedures and service users can be confident their views are listened to and acted upon. EVIDENCE: All staff except one have now received adult protection training. Members of staff spoken with were clear about procedures for reporting allegations of abuse and the “Whistle blowing policy”. One service user complained they were cold in the lounge and the heating was turned on at their request. Disputes between housekeeper and seniors about roles and responsibilities are resolved at management level. Resident meetings each tuesday give service users the opportunity to raise any concerns. Internal questionnaires ensure service users know how and to whom to raise concerns. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living, in a homely, comfortable and safe environment with adequate personal and communal space. EVIDENCE: The home is currently undergoing re-decoration and the deputy manager says service users had input into colour schemes. Bedrooms are spacious and reflect the individual interests and lifestyles of residents and suit their needs. The deputy manager states that an audit has been done on the furniture requirements for individual bedrooms and clients have chosen their requirements. One service user has a two-seater leather sofa. There are spacious communal areas in the home that complement and supplement individual bedrooms. The dining room table and chairs have been replaced and are more suitable for use. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 16 There are adequate bathrooms, toilets and shower room to meet the needs of service users. Large well-maintained grounds that are level enable service users to safely access outside areas when the weather is appropriate. The home is homely and comfortable and kept in a clean and hygienic condition. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. 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. Service users are supported by competent and committed staff who are well trained and supervised. Service users are protected by robust recruitment procedures. EVIDENCE: The staff training matrix viewed evidenced that training opportunities are ongoing and the majority of staff have been updated on current best practice. The home has recently facilitated courses for infection control, moving and handling and food hygiene. 70 of the staff team have achieved the NVQ level 2 in care or above. A supervision chart indicates that staff receive in excess of six supervisions per year. Staff personnel records were not available to view due to the home’s manager being on annual leave and being the only person with authorised access. The deputy manager assured that all staff undergo a rigorous recruitment check Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 18 and induction process. The home is currently recruiting additional staff to address weekend levels. Belmont DS0000023333.V297645.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home, that is managed competently. Their views are sought and underpin all self-monitoring. The health and safety of service users is promoted and protected. EVIDENCE: It was not possible to discuss quality assurance with the home manager due to annual leave. The deputy manager states that residents surveys are now being conducted and comments analysed. N In addition regulation 26 visits now include interviews with service users. Staff spoken with state that weekly resident meetings and individual keyworker meetings are used to gain feedback from them. Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 20 Staff and service users appear to benefit from the leadership and management of the home. When asked about training opportunities two seniors stated “I have always been given any training requested”. There are no obvious health and safety hazards and records viewed are kept to a good standard. Belmont DS0000023333.V297645.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 x 2 3 3 x 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 3 26 3 27 3 28 3 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 Belmont DS0000023333.V297645.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. Refer to Standard Good Practice Recommendations Belmont DS0000023333.V297645.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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