Inspection on 11/08/06 for Belmont Grange Care Home

This inspection was carried out on 11th August 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 Grange Care Home 18/07/07

Belmont Grange Care Home 30/12/05

Belmont Grange Care Home 28/06/05

Belmont Grange Care Home 12/01/05

Belmont Grange Care Home 05/08/04

Belmont Grange Care Home 11/02/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

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

CARE HOMES FOR OLDER PEOPLE Belmont Grange Care Home Broomside Lane Belmont Durham DH1 2QW Lead Inspector Mrs Sue Lowther Unannounced Inspection 09:30 11 & 14 August 2006 th th 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 Grange Care Home DS0000000695.V300958.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 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 Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belmont Grange Care Home Address Broomside Lane Belmont Durham DH1 2QW 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) 0191 3849853 0191 3869513 Four Seasons Health Care (England) Limited Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (2), Terminally ill (8) of places Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION onditions of registration: 1. Physical Disability. Up to 2 persons with a physical disability may be accommodated commensurate with the home’s statement of purpose. 30th December 2005 Date of last inspection Brief Description of the Service: Belmont Grange is a care home registered to provide care (including 24 hour nursing care) for persons aged 65 years or older. It is situated in the centre of Belmont and is within easy reach of the shops and local amenities. The main building is listed with a modern built extension added. It consists of a twostorey building. There are 25 single bedrooms and 4 double rooms, 1 of which is en suite. However double rooms are not routinely used unless specifically requested. There is a passenger lift available. Sufficient toilet and bathroom areas are located throughout the home, some with specialist adaptations for people who are less mobile. Lounge and dining areas are also available. The fees charged at the time of this inspection were between £365 and £579 per week. This does not include hairdressing, chiropody, newspapers, personal toiletries and clothing. The home and was purchased by the current owners Four Seasons Healthcare (England) Limited in 2000. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Belmont Grange Care Home took place on the 11th & 14th August 2006. Records were examined and a tour of the building took place. Time was spent talking to service users, staff and relatives. The acting manager supplied some information on a pre inspection questionnaire. Three service users and one relative returned surveys to the Commission for Social Care Inspection (CSCI). Information from these is reflected in the report. The inspection focussed on key standard outcomes for service users and to check that any requirements from the previous inspection had been met. What the service does well: Service users and relatives gave positive comments about the care provided at Belmont Grange Care Home. There were written care plans in place for each service user. This helps staff make sure that each resident gets the support and assistance that is needed for them to live safely and comfortably. One service user said, “ All the staff have made me feel welcome and I am grateful for their help and support. Another said, “ I am very well looked after, the staff are nice and come when I need them”. There are safe systems in place for the administration of medication. Although there is no one in the home at present who administers their own medication, the home would support them in this if they were able. Family and friends can visit the home at any time. Routines within the home are flexible and service users are encouraged to make choices. Residents said that their privacy is maintained and that they are respected. The acting manager is motivated and committed to having a fully trained workforce. The company has policies and procedures in place to support staff working in the home. Health and Safety systems within the home protect service users, staff and visitors. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 the following standard(s): 1, 2, 3 & 6 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Whilst admissions to the home are well managed some service users have not received a contract to tell them what is included in their fees. The home does not provide intermediate care and therefore assessment of Standard 6 is not applicable. EVIDENCE: Three people returned questionnaires. Two people said that they had not received a contract from the home and did not know what was included in their fees. Two care plans examined showed that a full pre-admission assessment had been carried out. The acting manager said that that she visits the prospective service user before admission to the home. The service user and their relatives are involved in this process. One family said that they had looked Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 9 around the home before their relative went to live there. They said that there was enough information available for them to decide whether or not their relative would like to live in the home. One relative said, “I chose this home because it is handy and I can visit everyday. I came to look around and staff were very pleasant and helpful”. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans are available to provide staff with the information they require to meet the care needs of the people who live in the home. Medication within the home is well managed promoting good health. EVIDENCE: The acting manager said that all of the service users have care plans. Three were looked at during the inspection and were found to contain sufficient information for staff to look after the people who live in the home. Two of the service users spoken to said that they were aware of their plan of care but there was no evidence to confirm that they had been consulted. Where possible care plans should be signed to confirm that the service user has been involved in the decision about their care. Records examined showed that service users receive visits from other healthcare professionals. These include district nurses, doctors, and care Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 11 managers. The inspector spoke to four people who said that they usually receive the support and care they need. One person said, “The staff are very helpful and considerate with the care and support they give”. Another said, “ Staff are very good at getting the doctor out when I am not well. They respond quickly and give the care and support I need”. Medication systems were looked at during this inspection. The home uses a monitored dosage system. An audit of medication was carried out and found to be in order. Service users and relatives said that the staff are polite, friendly and treat people with respect. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and service users are given a choice. EVIDENCE: The home employs an activities co-ordinator. Activities take place both inside and outside of the home. The indoor activities include bingo, board games, exercise classes and shopping trips. Outside entertainers visit the home from time to time. The activities organiser said that she tries to spend time with people on an individual basis so that she can find out which activities they like. People who returned questionnaires said that there are sometimes activities that they can take part in. One said that there were never suitable activities available. One service user said, “ The activities organiser started recently so this has improved. Trips out in a mini bus would be nice”. Relatives said that they can visit at any time. One relative said, “I visit my mother at various times and am always made to feel welcome”. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 13 The dining area is comfortable. During lunch the atmosphere was relaxed and unhurried. Staff who were helping service users with their food did this in a courteous and discreet manner. Service users said that they like the food and that they get a choice. Nutritional needs are assessed and a record kept in the care plan. One service user said, “The standard of food is very good”. Another said, “The food is beautiful and a good choice is available. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. People can be assured complaints will be investigated and outcomes recorded. Systems to protect people from abuse are in place. EVIDENCE: Information is available for service users and visitors to the home on how to make a complaint. Service users and families views are obtained through regular contact and an ‘open door policy’. Service users and relatives said that they feel confident in discussing any issues with the acting manager. One relative said, “The staff are lovely, I can just approach them and they will address any concerns I have”. The policies and procedures regarding protection of service users are regularly reviewed and updated. These provide information and guidance to staff. A copy of Durham and Darlington policy and procedures on safeguarding adults is held in the home. All staff have recently received training in this area. Staff were aware of the whistle blowing policy and said they would have no hesitation in reporting any concerns they may have. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 the following standard(s): 19, 23, 24 & 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The environment is clean, comfortable and safe for service users. EVIDENCE: The inspector looked around the home and found it to be comfortable and generally well maintained. Service users said that they could take their own possessions into the home to make their rooms more pleasant and homely. The communal areas of the home were clean and service users confirmed that their bedrooms are always cleaned to a good standard. There were no unpleasant smells apparent on the day of inspection. Two of the people who returned questionnaires said that the home is always clean and fresh. One service user said, “ Although cleanliness is usually ok, the home Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 16 needs refurbishment. Carpets are stained, chairs are tatty and bedroom furniture is old and needs replacing”. The acting manager told the inspector that since the last inspection some bedroom furniture had been replaced. Plans are in place to fit new carpets throughout the ground floor. Twelve armchairs have also been ordered for the lounge. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 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 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 & 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Staff are recruited properly and in adequate numbers to meet the needs of the people who live in the home. EVIDENCE: There is always one qualified nurse on duty. During the day there are four additional care staff on duty and two during the night. Staff felt that these levels are adequate. Most of the service users spoken to said that staff are always available when they need them. One relative said, “The staff are always pleasant and friendly. They are always busy”. One service user said, “Staff make themselves available at all times”. Staff said that they attend regular training, which enhances their knowledge and skills. This enables them to meet the changing needs of service users. Some staff required fire training, the acting manager told the inspector that this was planned for the following week. Due to staff changes within the home only 21 of staff are currently trained to NVQ Level 2. However several staff are currently enrolled on the course. When these have completed it there will be over 50 of staff with this qualification. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 18 Two staff files were audited. One was for a recently recruited member of staff. All contained evidence that the required checks are carried out before employment to protect service users. This includes two references, an enhanced criminal record bureau check (CRB) and a medical reference. Induction and training records are also available. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 19 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, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home does not currently have a registered manager in place. The acting manager is providing support and guidance to staff and residents. There are systems and safeguards in place to ensure the health, safety and welfare of service users and staff. EVIDENCE: The acting manager is well qualified, with several years experience in working with older people. She has applied to undertake the Registered Managers Award. She has also applied to be registered with the Commission for Social Care Inspection. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 20 The area manager carries out a quality assurance and monitoring visit on a monthly basis. This covers all aspects of care delivery and environmental issues. Copies of these were available in the home. The administrator is responsible for the record keeping with regard to service user finances. The company audits these on a monthly basis to ensure that residents are protected. The pocket monies held by the home for three people were checked and found to balance. The acting manager confirmed that staff supervision has commenced. Evidence of this was seen in staff files. She told the inspector about how she plans to develop this so that all staff receive supervision on a regular basis. This ensures that staff are supported and trained with regard to their roles and responsibilities. Staff told the inspector that they now feel well supported. One said, “It is good that the acting manager is here. She is approachable and always there for support”. The acting manager confirmed that the home carries out regular Health & Safety checks. The inspector checked some of the records. Those viewed were up to date. Although all staff had not received fire safety training, sessions were planned for the week after the inspection. Since the inspection the acting manager has provided written confirmation that all staff have now been updated with regard to fire safety. Belmont Grange Care Home DS0000000695.V300958.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 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 3 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP2 Regulation 5(1)(b) Requirement Each service user must be supplied with the statement of terms and conditions (a contract) so that they understand the service that they are entitled to receive. Timescale for action 31/10/06 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. 2. 3. 4. Refer to Standard OP7 OP12 OP19 OP30 Good Practice Recommendations Wherever possible care plans should contain written evidence that service users have been consulted with regard to their care. The activities programme should be reviewed so that individual preferences can be met. The current programme of refurbishment should continue to improve the environment for service users. The number of staff with an NVQ Level 2 or equivalent needs to increase so that the home meets the target of at least 50 of staff having this award. Belmont Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Grange Care Home DS0000000695.V300958.R01.S.doc Version 5.2 Page 24 - 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. 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