Inspection on 08/11/07 for Belmont

This inspection was carried out on 8th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 05/06/06

Belmont 02/12/05

Belmont 05/09/05

Belmont 22/02/05

Belmont 19/04/04

Similar services:

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 Key Unannounced Inspection 8th November 2007 13:00 Belmont DS0000023333.V352594.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.V352594.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.V352594.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 Ltd Mrs Dawn Annette Smith Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th June 2006 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 home’s 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.V352594.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over a period of 3.5 hours and the manager was present. A completed Annual Quality Assurance Assessment (AQAA) had been returned to the Commission prior to this visit. A tour of the premises was carried out and a variety of documents and records were examined. Only one resident was at home during the visit but the inspector was able to speak with members of staff on duty. Relatives and Care managers were contacted by telephone following the visit to seek their views as to the quality of care provided by the service. What the service does well: What has improved since the last inspection? Since the last inspection the home has put a lot of work into developing methods of communication that are showing positive results with less frustration for residents. The home has introduced 1-1 talk time for residents and developed a communication profile for each individual to show staff the best and most effective way to communicate with each individual taking into account comprehension abilities and degree of learning disability. Belmont DS0000023333.V352594.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. The summary of this inspection report can be made available in other formats on request. Belmont DS0000023333.V352594.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.V352594.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): 1,2,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into the home are provided with sufficient information on which to make an informed decision. Prior to admission to the home individuals have a comprehensive assessment of their needs to ensure the home is suitable for their requirements. People benefit from a trial stay in the home prior to committing to a permanent placement. People living in the home benefit from the security of an individual written contract detailing the terms and conditions with the home. EVIDENCE: The Statement of Purpose and Service user guide is clear about the aims and objectives of the home. The home has recently introduced pictures into the statement of purpose to help with understanding for people who use the Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 9 service. The home’s manager states that it is planned to create an abbreviated version of the Statement of purpose and a picture/photo brochure about the home for people to keep in their rooms. There have been no new admissions to the home for three years but preadmission assessments viewed in three care plans were comprehensive in detailing relevant information and support requirements of individuals. The home’s manager confirmed that any new admissions would have the opportunity to visit the home and meet residents and staff including an overnight stay prior to deciding on a permanent placement. People living in the home have an individual written contract detailing the terms and conditions with the home. Belmont DS0000023333.V352594.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): 6,7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from having their assessed and changing needs and personal goals reflected in an individual plan of care. People are supported in making decisions about their lives and taking responsible risks as part of an independent lifestyle. People living in the home have their right to confidentiality of information upheld. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three care plans were viewed and each included a comprehensive person centred support plan. The support plans included all aspects of personal care, social support and healthcare needs along with the likes and dislikes of people relating to activities, food, the home, clothing etc. Various communication aids were seen and observed in use that included objects of reference, communication boards, photos and pictures, catalogues and photographic roster board to enable people to make decisions. Risk assessments were seen in care plans that support people to take responsible risks as part of leading an independent lifestyle. People living in the home are shown photographs of places to dine so they can choose where they want to go. The home is to be commended on their development of communication aids that empower people living in the home to make decisions about their lives. Information of a confidential nature is securely stored in the manager’s office. Belmont DS0000023333.V352594.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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home are offered a range of activities that address their social, leisure and personal development. People living in the home are supported in maintaining appropriate personal and family relationships. A varied and healthy diet is enjoyed by people living in the home and is of their own choice. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 13 EVIDENCE: A number of daily records were viewed that evidenced a variety of activities are participated in by people living at the home. At the time of the visit all of the residents bar one were out at the day centre. It was observed that the resident remaining in the home was enjoying one to one time with staff and was noted assisting with meal preparation. The home monitors the interest shown by people for any given activity in a record called “Keeping tracks”. Activities participated in included college courses, bowling, swimming at Mote Park, discos and clubs at the Martello centre and personal shopping. The home also has a greenhouse where produce grown is used by the home and residents are involved where an interest is shown. A relative spoken with confirms that her daughter participates in the aforementioned activities and comments, “I doubt if she could fit anymore into her days”. The AQAA states some residents have made friends at these venues and often meet with them for dinner or drinks. People living in the home enjoy time at the local public house where they are welcomed by the locals and are very much part of the community. There is a large outbuilding in the grounds of the home that is used for arts and crafts and music sessions. The home is very proactive in using communication aids such as photos, pictures and symbols and the AQAA states that these methods have a positive impact on peoples involvement in choices and making decisions in everyday lifestyle and also to explore new experiences and opportunities. A care manager made the comment at a recent care review that “other home’s could learn from methods employed here”. This comment was later confirmed when speaking with the resident’s relative. Staff members spoken with were enthusiastic about the continuing personal development of people living in the home. People living in the home are encouraged and supported in maintaining family relationships by visits, telephone and letter. One relative confirms that their relative is able to telephone them and vice versa at any time. The home held Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 14 a summer fete in September with barbeque and games hosted by the residents. Family and friends were invited, and was enjoyed by all who attended. Relatives spoken with made comments such as “excellent day”, “a good get together with other families and local villagers”. Photographs of family, friends and events were seen displayed in resident’s’ private rooms. The AQAA states that all of the people living in the home are registered to vote and would be supported in doing so if it was their wish. The week’s menu was viewed and indicated a varied and healthy diet. Records of 1-1 talk times and resident meetings viewed confirm that residents choose the menu. Residents are enabled to make choices through pictures of meals where necessary and the home is currently further developing this area of communication. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 15 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. People living in the home benefit from access to a multi-disciplinary team that meets their physical and emotional needs and they receive personal support in the manner they prefer. People living in the home are protected by the home’s policies and procedures for dealing with medication. EVIDENCE: Three individual support plans were examined and each plan was clear about the support requirements of the individual. Records within the plans included support requirements and the preferred manner of that support, evidence of resident involvement and staff understanding of the plan through signatures, frequent reviews of the plan, likes and dislikes and positive interaction Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 16 feedback sheets. There is evidence through records of referral to other health care professionals when required and support in attending routine appointments. Each resident has their own communication profile in their support plan that directs staff in the best and most effective way to communicate with the individual. The manager states that since the introduction of new methods of communication and the re-education of the staff team, there has been a significant reduction in negative behaviour displays. Staff members spoken with confirm this improvement with a figure of 74 reductions in negative behaviour incidents for one resident within a ten-month period. The home has a GP communication pack that has symbols and pictures of routine health procedures that enables interaction between the GP and the resident. Medication is securely stored in a drugs cabinet in the manager’s office. Administering charts were examined and seen to be legible and complete. Medication seen was clearly labelled for individuals with concise guidelines for administering for staff members guidance. Two training records viewed evidenced that staff have received training in the safe handling of medication and the manager confirmed that all staff responsible for dealing with medication have received training. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 17 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. People living in the home have access to complaints procedures where their views are listened to and acted on. People living in the home are protected from abuse and neglect. EVIDENCE: The home has a complaints procedure that is in both written and widget format. People living in the home have opportunities through 1-1 talk times to express concerns and for those with communication difficulties pictures such as smiley or downcast faces can be used. One resident has an advocate who will raise concerns on their behalf and others have frequent contact with family. One relative spoken with had raised a concern about the height of grass in the back garden and says this was quickly addressed and the reasons explained. There have been no complaints about the home sent to the Commission and two complaints received by the home have been dealt with appropriately. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 18 Three training files viewed confirm training around safeguarding vulnerable adults and the AQAA confirms all staff had received training. The home has a copy of the local Kent Safeguarding Procedures in place. There is a stable and established staff team in this home and those spoken with felt that they are able to recognise when a resident is not happy and resolve any issues. All staff spoken with confirmed they had a CRB/POVA check as a pre-condition of employment. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 19 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): 24,25,27,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home enjoy a homely, comfortable and safe environment with adequate personal and communal space to meet their needs. People living in the home have access to toilets and bathrooms that provide sufficient privacy and meet their individual needs. EVIDENCE: The home has two large lounges that give a choice for people living in the home of quieter areas if that is their wish. The home is generally well decorated and maintained with comfortable furniture of reasonable standard and ample seating areas for residents to enjoy. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 20 There is a large kitchen and dining area that is adequately equipped and accessible to residents. The residents have requested a new kitchen table and selected one from an Argos catalogue that the home is hoping to purchase. There is a conservatory at the rear of the home that also has seating and creates another area for residents to enjoy. There is a laundry room at the back of the house with adequate equipment to meet the needs of people living in the home. The home has spacious grounds and as previously mentioned in this report within the grounds is a large outbuilding used for arts and crafts and music and at the lower end of the gardens a greenhouse and vegetable patch which the residents can access if they so wish. One resident chose to show me their bedroom and personal possessions on display and appeared proud and happy with his room. All of the bedrooms are single rooms and had personal possessions that reflected each individual’s interests and lifestyles. One relative states that on occasions when their loved one goes for home visits they ask, “when am I going back to my home”. There are adequate bathrooms, toilets and shower room to meet the needs of people living in the home and provide sufficient privacy. On the day of the visit the home was clean and tidy and free of any offensive odours. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 21 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. People living in the home are supported by sufficient numbers of qualified staff to meet their individual and joint needs. People living in the home are protected by the home’s robust recruitment policies and procedures. EVIDENCE: The training planner viewed indicates that staff training is currently up to date. Three training records viewed included training for health and safety, food hygiene, manual handling, First Aid and fire awareness. The manager states that 50 of staff had achieved an NVQ qualification in Care and the remaining 50 are working towards the award. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 22 One member of staff spoken with confirmed that the staff had an induction period that lasted 6 months, that they had completed all of the required mandatory training and was currently working towards an NVQ qualification. In addition a further induction was being undertaken with a view to a team leader position. Staffing rotas viewed are designed around the requirements of individual service user needs, one relative commented, “ there always seem to be plenty of staff to take them out”. Staff members spoken with felt that adequate levels of staff were in place to meet the needs of residents. Staff meetings are held monthly to discuss issues and ensure consistency within the team, comments from staff spoken with included the manager is supportive, open, approachable and they were comfortable in discussing new ways of working and improving the service. A new pro-forma has been agreed for staff records held in the home in line with the CSCI guidelines and the manager confirms that HR dept have conducted all required checks prior to employment. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 23 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): 37,38,39,41,42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well run home that is managed by a competent manager and where their health, safety and welfare is promoted and protected. The views of people living in the home, underpins all self-monitoring, review and development by the home and people’s rights and best interests, are safeguarded by the home’s record keeping policies and procedures. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 24 EVIDENCE: A qualified, and registered manager, with over 11 years experience working with this service user group is in charge of day-to-day running of this home. The registered manager is assisted with running the home by an experienced and competent deputy manager. As previously mentioned throughout this report people living in the home are consulted about the running of the home through 1-1 talk time, residents meetings and care reviews using communication aids where necessary. The manager states that the home will always support residents with the decisions that they wish to make with regard to the home and lifestyles. This is evidenced recently by the requisition for a new kitchen table of the residents’ choosing. Monthly provider visits are conducted to assess the quality of care being provided by the home. One such visit was being conducted during this inspection. The home conducts monthly health and safety audits and there is a dedicated maintenance team to attend to issues requiring attention. Relatives spoken with have described the home as “excellent”, “brilliant”, staff enthusiastic. Staff members spoken with have described the management support as helpful, supportive, open, approachable, and inclusive. All records viewed during the inspection were legible and maintained to a good standard. Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 25 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 X 4 3 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 X 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 4 4 4 3 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 4 4 X 3 3 X Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 26 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 Home’s 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.V352594.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Belmont DS0000023333.V352594.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!