Inspection on 22/03/06 for Belmont Court

This inspection was carried out on 22nd March 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Belmont Court 23/01/07

Belmont Court 24/08/05

Belmont Court 20/01/05

Belmont Court 30/06/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Belmont Court Basil Street Heaton Norris Stockport Cheshire SK4 1QL Lead Inspector Kathleen Mcall Announced Inspection 22nd March 2006 10:00 X10015.doc Version 1.40 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 Court DS0000008540.V283770.R01.S.doc Version 5.1 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 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 Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Belmont Court Address Basil Street Heaton Norris Stockport Cheshire SK4 1QL 0161-477 1282 0161 480 6887 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) Borough Care Limited Mrs Jean Hall Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4) Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 34 service users to include: *up to 34 service users in the category of DE(E) (Dementia over 65 years of age). *up to 4 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 24th August 2005 2. Date of last inspection Brief Description of the Service: Belmont Court is a residential care home that is registered to provide specialist care for up to 34 service users who have dementia, including four service users with a diagnosed mental illness. Belmont Court provides permanent residential care, respite care and day care facilities for up to eight service users, available Monday to Friday. Day care facilities are located on the first floor with two members of staff being specifically employed for the day care unit. Mrs Jean Hall is the manager and has been in post since the 16th May 2005. Belmont Court is of 12 care homes owned by Borough Care Limited. Accommodation comprises of thirty single rooms, seven of which are located on the first floor, and two double bedrooms located on the ground floor. There are four lounge areas and one large dining room. The home is suitable for wheelchair users. A visitors kitchen is situated on the ground floor. A full passenger lift is in place. There are pleasant enclosed garden areas. The home is situated in Heaton Norris, close to Stockport town centre and motorway network. Public transport is easily accessible. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over the course of a day. The registered manager accompanied the inspector throughout the inspection process. Care plans, assessment documentation, medicines and their storage were examined. The inspector spoke with several residents, and two relatives who were in the home at the time of the inspection and spoke with members of staff. The majority of residents were unable to comment in detail on the quality of care they received due to their levels of dementia. A sample of service user questionnaires was sent to the home and the registered manager passed these on to relatives to complete with service users, however none were returned. The inspector spent time with a number of residents and observed that residents appeared to be well cared for, that care staffs approach towards residents was sensitive and caring and that the daily routine of the home was flexible and fitted around the residents care needs. Five relatives comment cards were returned; all five indicated that they were satisfied with the overall care provided. All five cards indicated that they were made welcome at the home at any time and that they were kept informed of important matters concerning their relatives. Five cards indicated that relatives were aware of the home’s complaints procedure and none had made a complaint. All five cards said that there was always a sufficient number of staff on duty. Comments from relatives included, ‘I feel this is an excellent home, well managed and with very caring and competent staff. I cannot think of anything which could be done better.’ Another relative said ‘Management and staff are always ready and willing to help in any way they can.’ And ‘I have nothing but praise for Belmont Court. The staff are always caring, helpful and friendly and I always made to feel most welcome. I visit my wife every day and am very happy with the care she receives’. A comment card from a GP who visits the home was also received who indicated that he was satisfied with the overall care provided to service users within the home and said, ‘Good quality of care staff communicate well’. What the service does well: Belmont Court is a fairly large home that offers comfortable accommodation; it has a relaxed and friendly atmosphere. The home has a structured programme of activities on offer and residents have the choice of joining in or Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 6 choosing to spend their time as they please which may include using one of several lounges situated around the home or spending time in their bedrooms. The home is clean and well maintained. Assessment and care planning arrangements at the home were good and all residents are fully assessed before an admission is arranged so as to ensure that the home will be able to meet their needs. Residents appeared to be well cared for and supported by a trained and competent workforce. What has improved since the last inspection? What they could do better: At the previous inspection it had been a requirement that all comfortable seating provided in the home must be cleaned or replaced to minimise the risk of cross infection. Since the last inspection a small number of chairs had been replaced, however the majority of chairs still require cleaning or being replaced. The registered manager must ensure that handwritten recordings on medication administration records are checked and signed by a second member of staff to verify their content and accuracy. At a previous inspection it was observed that daily records kept in respect of residents were poor in that the information recorded by care staff did not give a full picture of how residents care needs were being met and did not Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 7 demonstrate what care staff were doing for residents on a daily basis. The registered manager was asked to review the way in which staff record information. At the time of this inspection there had been no improvement in the standards of recordings on daily records. This issue remains unresolved and requires a satisfactory solution. A number of issues concerning fire safety in the home remain unresolved and require a satisfactory conclusion. 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 Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 2, 3 and 5. Service users care needs were fully assessed before admission. EVIDENCE: Service users admitted to the home had a written contract which detailed the terms and conditions of their stay. Several new service users had been admitted to the home since the last inspection. As part of the inspection a selection of service user files were examined. These contained a sufficient amount of assessment information in respect of each service user. It was the practice of the home that service users were assessed prior to their admission. Assessments were obtained from social workers and health professionals if they had been involved in the admission and no service users were admitted to the home without their care needs having been assessed. Borough Care had its own assessment documentation called the “key-working together document”; which was completed in respect of all new service users admitted to the home. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 10 The majority of service users admitted had previously had contact with Belmont Court; either by attending day care or using respite care facilities. For those with no previous contact, arrangements were in place for service users to have a trial visit the home prior to their admission, this may include a day visit or a shorter visit to stay for lunch. In the first instance assessment documentation was completed with or obtained from the service user, relatives and professionals involved and then a visit to the home was organised. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 7, 8, 9 and 10 Service users health and personal care needs were identified through care planning and met by care staff. EVIDENCE: All service users had a care plan the overall standard and quality of care plans was good. Care plans seen were individualised to each service users care needs with information held in one accessible document. This information included risk assessments, moving and handling assessments, weight charts, oral hygiene programme, daily records and a review sheet. Service users care plans were stored in their bedrooms. Care plans were reviewed on a monthly basis and any changes needed were included. Care plans were usually drawn up with a service users relative or a professional who may have been involved in their admission to the home. At a previous inspection it was observed that daily records held in respect of service users were of a poor quality. The amount and detail of information recorded on daily record sheets was poor and did not give a full picture of how serivce users care needs were being met. At the time of this inspection it was Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 12 observed that there had been no improvement in the standard of recordings on service users care plans. Daily records contained little or no information on how a service user had spent their day or how staff had assisted them. Risk assessments were in place to address the risk of falls, the use of bed rails and service users moving and handling issues. Risk assessments were reviewed monthly or sooner if required. Belmont Court had specialist equipment in place to meet the needs of service users. GP’s, district nurses and community dieticians were regular visitors to the home. Two relatives told the inspector that they were very satisfied with the care provided, that their relatives health needs were always addressed and that the home kept them informed at all times. Medication was provided in a monitored dosage system, this was stored appropriately. Medication records were in the main accurately maintained with the exception of handwritten medications, which must be verified by a second member of staff. The home had a dedicated refrigerator for the storage of medication. Senior staff responsible for the administration of medication had undertaken training in the ‘Safe Handling of Medicines’. A large number of service users were unable to comment on the quality of care provided due to levels of dementia and short term memory loss, consequently the inspector spent time observing the practices of staff and the daily routine of the home and observed that staffs approach towards service users was sensitive and caring. In addition the inspector observed that the service users looked physically well cared for. Relatives told the inspector that they were very satisfied with the way in which care staff treated their relatives and one relative said that he had ‘complete admiration and appreciation for all the staff at the home’. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 12, 13, 14 and 15. The day-to-day routine of the home including mealtime arrangements was relaxed and informal and met service users needs. EVIDENCE: Belmont Court offered a flexible routine to service users. Staff encouraged service users to make choices as to how they spent their time, whether they wished to join in activities or not, what they ate and what clothes they chose to wear. Some service users preferred to spend time in their rooms and others preferred to use one of the four lounge areas. Since the last inspection the registered manager had reviewed the lounge and dining room facilities at the home. Previously there had been two small dining room areas, two small lounge areas and one large lounge, which was used for activities. The registered manager and staff at the home felt that this arrangement was not working in the best interests of service users and facilities were reorganised to provide four smaller lounge areas, one without a TV and one large dining room area. Although the dining room area was a large facility seating the majority of service users, as it was situated directly next to the kitchen which made it easier for meals to be served by the cook and kitchen assistants thus freeing care staffs time to assist those service users who required assistance at mealtimes. The inspector spoke with the cook who said he found it helpful as he could now observe service users and assess their Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 14 responses to food provided. Meals were served at regular intervals, a hot meal option was offered at both lunchtime and teatime meals with the exception of Sunday teatime when a cold buffet tea was offered. On previous inspections it had been observed that the main corridor of the home was a focal point of activity, used by staff, service users and visitors to the home. The provision of extra lounge areas and one dining room area has meant that service users now had a greater choice of were to sit and that meal times appeared to be better organised. Changes in the layout of the home and changes in daily routines had impacted upon the atmosphere, which was generally calmer with service users appearing less agitated. One relative told the inspector that initially he had reservations about the changes but felt that they had worked very well. All lounge areas were well used by service users. At the time of the inspection an entertainer was visiting the home and the majority of service users had joined in the activity. Visitors were made welcome at the home and service users kept in touch with family and friends. Relatives told the inspector that they were always made to feel welcome and part of the home. Another relative said he appreciated staff keeping him informed of how his wife was doing. The majority of service users had a relative or a representative who acted on their behalf, however there were service users at Belmont Court who did not have capacity to make decisions on a daily basis and who did not have a relative or a representative to represent them at reviews. These service users would benefit from independent advocacy representation. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 16 and 18. Relatives felt confident that their complaints would be taken seriously and acted upon. Staff had undertaken appropriate training in adult protection, which ensured the protection of service users. EVIDENCE: The home had a detailed complaints policy and procedure; there had been no complaints since the last inspection. Relatives with whom the inspector spoke said that they knew who to complain to if they had a problem and all felt confident that the problem would be resolved in a satisfactory manner. The home had a procedure for responding to allegations of abuse. The majority of staff had completed training in adult protection, either as part of their induction, NVQ training or by attending and in house training course. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 19, 24 and 26. Service users lived in a clean and comfortable environment however fire safety standards were compromised. EVIDENCE: The home provided comfortable accommodation and the grounds of the home were well kept. At a previous inspection it was observed that comfortable seating provided in lounge and other seating areas around the home was badly stained and that many of the chair would benefit from being cleaned thus reducing the potential for the spread of infection. At the time of this inspection it was observed that several chairs had been replaced and the registered manager advised the inspector that there were plans to eventually replace all comfortable seating. A number of service users rooms were seen, these were furnished and equipped to a comfortable standard, many had been personalised by the occupants. Since the last inspection the registered manager had addressed the odour problem that had been previously observed. Several bedrooms had been redecorated and had new flooring fitted. Corridor areas had been Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 17 recarpeted and there were plans to redecorate these areas. The dining room area had also been redecorated and had new window blinds fitted. At the time of the inspection the home was clean and tidy and free from odours. The home did not meet fire safety standards. Following a recent visit by the Greater Manchester Fire and Rescue Service in February 2006, a number of areas of non-compliance were found. The registered providers were aware of these and were in the process of dealing with the areas of non-compliance. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 18 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 and 30. The home was sufficiently staffed with a staff group that was trained to undertake their duties, and recruitment procedure ensured that service users were protected. EVIDENCE: At the time of the inspection the home was sufficiently staffed with a staff that was trained to meet the assessed needs of service users. A staff rota showing, which staff were on duty and in what capacity, was kept at the home. Since the last inspection two new members of staff had commenced employment at the home; the registered manager had followed appropriate recruitment procedures. 75 of care staff employed at the home held an NVQ qualification in care. Care staff on duty at the time of the inspection confirmed that they had undertaken further training to assist them in their role as carers and new staff had completed a period of induction at the commencement of their employment. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 19 Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 20 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36 and 38. The home was well managed for service users and care staff were appropriately supervised. The health and safety of staff and service users was safeguarded. EVIDENCE: Mrs Jean Hall was appointed as the registered manager on the 19th October 2005 and has managed the home since last time. Mrs Hall holds an NVQ Level 4 in management and Care and holds the Registered Managers Award. The registered manager had an open and approachable management style with both staff and service users. Relatives confirmed that the manager was very approachable. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 21 Belmont Court had a number of means of seeking feedback from service users and their relatives; these included relatives’ questionnaires, the key worker system, staff supervision, staff meetings and residents’ meetings. The registered manager was developing a relatives’ questionnaire specifically suited for Belmont Court. The registered manager was aware that this information should be collated and published in a report on an annual basis and made available to service users, relatives and other interested parties and was working towards meeting these requirements. Staff received regular supervision to support them in their work and records of such meetings were made available at the time of the inspection. Staff had updated their training in safe handling and moving procedures, fire safety, food hygiene and health and safety. The home recorded information in respect of falls and accidents by service users. This information was regularly reviewed and monitored to see if patterns were evident and measures to address emerging patterns were put in place. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 22 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 N/A 2 X X X X 2 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X X 3 X 3 Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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. 1. OP9 13 The registered person must ensure that handwritten recordings on MAR charts are checked and signed by a second member of staff. The registered person must take adequate precautions against the risk of fire in the care home. The registered person must arrange for comfortable seating provided in the home to be cleaned or replaced. (Timescale of 19.02.05 not met.) The registered person must continue to review the quality of care provided at the home and supply to the Commission a report in respect of any review conducted and make a copy of the report available to service users. 22/03/06 2. 3. OP19 OP24 23 13(4)(c) 22/03/06 22/08/06 4. OP33 24 22/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 24 No. 1. 2. Refer to Standard OP7 OP14 Good Practice Recommendations The registered person should continue to monitor and develop the information that staff record on daily records in respect of service users. The registered person should ensure that an independent advocate represents those service users who lack capacity to make decisions on a daily basis. Belmont Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Court DS0000008540.V283770.R01.S.doc Version 5.1 Page 26 - 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. 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