Inspection on 25/04/05 for Belmont Castle

This inspection was carried out on 25th April 2005.

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 Castle 09/02/09

Belmont Castle 21/05/08

Belmont Castle 08/05/07

Belmont Castle 05/02/06

Belmont Castle 08/11/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Belmont Castle Portsdown Hill Road Bedhampton Hampshire PO9 3JW Lead Inspector Martin Bayne Unannounced 25.04.05 9:00am 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. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Belmont Castle Address Portsdown Hill Road, Bedhampton, Hampshire, PO9 3JW 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) 023 9247 5624 023 9247 50910 London Residential Healthcare Ltd N/A CRH 40 Category(ies) of OP - 40, DE - 40, DE(E) - 40, PD - 6 & PD(E) - 6 registration, with number of places Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 55 years of age. 2. A total of six service users may be accommodated in the PD and PD(E) category. Date of last inspection 08.11.04 Brief Description of the Service: Belmont Castle is a residential care home that can accommodate up to forty people. The home is set in three acres of well-maintained gardens. The original part of the building was built by Lord Palmerston in the 19th century. The home is situated in a quiet residential area with commanding views of Portsmouth and the Solent. Belmont Castle has thirty-six bedrooms, of which about three quarters have ensuite bathrooms. The home has five shared rooms the others are for single occuapancy. There are two dining areas, two sitting rooms, a TV lounge and a small library area. The home has a shaft lift that services the three floors. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Residents generally spoke very highly of the home, the attitude of the staff and the care that they received. The home is sited prominently with wellmaintained gardens and views. The home has recently been taken over under new management and a new manager is to be appointed. Proposed changes to the medication administration system and the recording format are supported by the inspector, as being beneficial to the staff and residents. Residents reported that their care needs were being met, activities being arranged and good food being provided. The home has a core of long-standing staff who attend to the needs of residents. One requirement was made in respect of the locking arrangement of the front door, so that this does not compromise the fire safety standards. What the service does well: What has improved since the last inspection? Since the last inspection the home has appointed a manager who is due to start work at the home on May 9th and an activities co-coordinator who is also due to start work at the home on that date. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 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 Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 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 Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 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) 1, 3, 4 The assessment process and the information available to prospective residents have ensured that residents needs are met at the home. EVIDENCE: At the last inspection it was agreed that the Service User Guide would be amended to be particular to Belmont Castle and not generalised to all the homes within the group. This had been attended to and all the residents had a copy of the guide in their room. A resident admitted to the home since the last inspection was found to have had a thorough assessment of their needs undertaken by the Matron before a place was offered at the home. A four-week trial is offered for new admissions to the home. The inspector spoke with nine residents during the inspection and generally people said that their needs were met. Issues raised by two residents who expressed some dissatisfaction were discussed with the Matron and the Responsible Individual, Mr Dixson, who will follow up on the issues. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 9 Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 10 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, 9 & 10 Health and care needs of residents are met through a longstanding staff team, however the medication administration system has inherent weaknesses that could potentially pose a risk to the residents. The new proposed recording system will benefit the staff and residents through its concise and user-friendly format. EVIDENCE: The care plan for one of the residents spoken with was looked at and this reflected the care needs discussed with that person. The plan was written together with the resident and the plan was being reviewed each month. The inspector was told that the home is to change the recording format to a standardised package that brings together all care plans, assessments and risk assessments into one format. Residents said that their health needs were being met and on the day a doctor was visiting one resident. Another reported that the district nurse had been visiting to dress a pressure area. The home had supplied this resident with a specialist mattress as part of their treatment. There was also evidence that the home works with the mental health services to meet the needs of the residents. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 11 The medication administration system was not inspected in depth however the procedures adopted were discussed and it was agreed that the system would be changed. The matron informed that all of the staff were receiving distance learning on medication administration. One resident told the inspector that his wish to administer his own medication was respected, a risk assessment being undertaken first. Residents said that their privacy and dignity were respected and in general spoke highly of the staff team. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 12 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 & 15 The good standard of food provided at the home is recognised by residents, however the home may wish to liaise with the residents on how to shorten the time taken to serve the food in order to meet their full approval. EVIDENCE: The residents said that they could entertain guests at any time and that visitors were made welcome at the home. Entries in the visitor’s book at reception confirmed that the home had many visitors. Residents also informed that activities were arranged in the home. An activities co-ordinator is to start work in May. The inspector was told that a new cook had started work at the home and was meeting the high standards set by the previous cook. The home has two dining areas, one catering to the needs of residents who require assistance at mealtimes. One dining are is served 15 minutes before the other, however three residents said that they found the wait before being served too long. This was discussed with Mr Dixson and the matron and it was suggested that a solution to this issue be found through liaison with the residents. The meal served on the day of inspection was found to be of good standard and of ample portion. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 13 Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 14 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 & 18 Residents are protected through a well advertised complaints procedure and training to staff on abuse and protection of vulnerable adults. EVIDENCE: The home maintains a complaints log. The complaints procedure is accessible to residents as this is detailed in the Service User Guide, a copy available in each bedroom. The home provides training to all the staff on abuse and the protection of vulnerable adults. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 15 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, 20, 23 24 & 26 Residents benefit from an attractive well maintained environment, however the current arrangements for the locking of the front door could potentially be a risk to residents in the event of a fire. EVIDENCE: The home is well maintained and offers comfortable and genteel communal areas. The bedrooms are all well lit with plenty of windows, the majority of the rooms having ensuite toilet facilities. The home offers 31 single rooms and 5 shared rooms. The building is imposing and set in three acres of attractive gardens with views looking over Portsmouth and the Solent. All of the furnishings and fittings were in good repair and the home was well decorated throughout. A shaft lift ensures that residents can safely access all floors of the home. With respect to the building, the only issue of concern was the locking arrangements for the front door, which is an escape exit in case of fire. On the inspection day the door had had to be locked in the safety interests of one Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 16 resident. The key to the door was either being kept adjacent to the door or in the staff office. The home is required to liaise with the fire safety officer on an arrangement that will provide both security and maintain fire safety arrangements. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 17 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 The residents should benefit through the appointment of an activities coordinator and manager. EVIDENCE: Residents, in general, reported that the staff were both friendly and attentive to respecting their dignity and independence. Two residents were concerned that the staffing levels at times were not adequate at some times through the day. It was found that there are six members of care staff on duty between 8am to 2pm, three care staff between 2pm to 6pm and then four between 6pm to 10pm. The matron works additional to these levels during the weekdays. During the night time period there are 3 awake members of staff. The matron and the Mr Dixson felt that these levels met the physical needs of the current residents and that with the appointment of the activities co-ordinator and a manager, this additional staffing should satisfy the concerns of those residents. Ancillary staff of two domestics, a laundry assistant, two cooks, a handyman and an administrator also support the residents. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 18 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) Standards under this section will be inspected on the next visit to the home. EVIDENCE: These standards were not assessed on this visit to the home. Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x 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 x x x x Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 20 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 13 Requirement You are required to liaise with the fire officer in respect of the locking arrangement of the front door and adhere to the advice given. Timescale for action 9-5-05 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 9 Good Practice Recommendations It is recommended that the medication administration system is changed to one which conforms to best practice Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 21 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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. Extracts may not be used or reproduced without the express permission of CSCI Belmont Castle H54 S62222 Belmont Castle V223953 250405.doc Version 1.30 Page 22 - 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!