Inspection on 18/07/07 for Belmont Grange Care Home

This inspection was carried out on 18th July 2007.

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 11/08/06

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 18 July & 2 August 2007 th nd 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.V344074.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.V344074.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 belmont.grange@fshc.co.uk Four Seasons Health Care (England) Limited Julie Brown Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (2) of places Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2006 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 £399:50 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.V344074.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 took place on the 18th July and the 2nd August 2007. Records were examined and a tour of the building took place. Time was spent talking to staff, the people who live in the home and their relatives. The manager supplied some written information to the CSCI before the inspection. The inspection focussed on key standard outcomes for people who live in the homes and to check whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection? The administrator said that all of the people who live in the home now have a contract so that they understand the service they are entitled to receive. There was evidence within the plans available to confirm that people are now consulted with regard to their care. People said that the activities have improved and are more tailored to individual need. The number of staff trained to NVQ level two or above has increased and is now over 50 . Belmont Grange Care Home DS0000000695.V344074.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 Grange Care Home DS0000000695.V344074.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.V344074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3. The home does not provide intermediate care and therefore assessment of Standard 6 is not required. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. EVIDENCE: The administrator said that all of the people who live in the home now have a contract so that they understand the service they are entitled to receive. Everyone is assessed prior to living in the home. In addition to social service care manager assessments the manager normally visits the person in their Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 9 current place of residence. of the nurses. If she were on holiday this would be done by one The file of one person recently admitted to the home was found to contain comprehensive information. The family confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. One person said, “I came to look around the home and decided it was the one for me. Staff gave me all of the information I needed to make the decision about coming to live here and I am settling in well”. Belmont Grange Care Home DS0000000695.V344074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to ensure that health care needs of the people who live in the home are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. There was evidence within the plans available to confirm that people had been consulted with regard to their care. Some of the care plans seen had not been evaluated on a monthly basis. This should be carried out so that any changing needs are identified. This will make sure that people have plans which cover all of their needs. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 11 Evidence was seen in files of involvement with other people for example district nurses, doctors, and care managers to confirm that other professionals are involved. One health care professional visiting on the day of inspection confirmed that staff consult her on a regular basis. She said, “ I have no problems with this home. They consult me when needed and always listen to any advice I give them”. The medications of four people were checked. They were found to be in order. Procedures are in place for people to control their own medication should they wish to do so. A risk assessment will be made first to ensure this is safe. People said that staff treat them with dignity and respect. They said that staff always knock on bedroom doors and call them by their preferred name. One person said “Staff are lovely to me they are always polite and knock on the door”. One visitor said, “Staff are polite, friendly and very approachable”. Belmont Grange Care Home DS0000000695.V344074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a 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 people who live in the home are given a choice. EVIDENCE: Most of the people said that activities are suitable. One member of staff said, “The activities coordinator is good. She asks the people what they want to do and they are really enjoying them”. One person who lives in the home said, “I can go out on my own. I just have to tell the staff where I am going and when I will be back. The staff here are really good. One of them is coming back tonight to take me out in her own time”. Another said, “The activities are ‘so so’. I prefer more individual pastimes than group activities. I like to sit with people that I can just chat to”. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 13 Relatives said that they could visit at any time and that they are always made welcome. One said, “Staff here are really good. They are polite, friendly and always keep me advised when there are changes I need to know about”. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. The lunch looked nice. Staff who were helping people were doing this in a discreet and dignified manner. One person who lives in the home said, “The food is good. We get a choice and there is plenty of it”. One visitor said, “The food looks good. I could not eat the amount people are given”. Evidence was seen in care plans that nutritional needs are assessed and other professionals consulted if required. Belmont Grange Care Home DS0000000695.V344074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. One person said, “If I had a problem I would tell the manager, but I have never had to”. One relative said “I would approach any member of staff at any time and feel that problems would be addressed”. There were three complaints recorded in the home since the last inspection. These all related to environmental issues. They have been appropriately addressed using the procedure available within the home. The home has detailed adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the people they work with and to upholding the rights of the people who live in the home. One staff member said, “ I would be aware of abuse and would have no Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 15 hesitation with regard to whistle blowing. If there is something I don’t like I say”. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. EVIDENCE: During the tour of the building and whilst talking to people in their bedrooms, the inspector saw that people could bring in their own furniture and belongings should they wish to do so. The manager said that since the last inspection all of the bedrooms have been painted. Some bedrooms have had new carpets. The gardens have recently been landscaped to a high standard and provide a pleasant environment where people can sit. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 17 There was a range of specialist equipment seen around the home. This helps the people who live in the home maintain a level of independence. It also provides staff with a safe method of helping people who need assistance with mobility. During the tour of the building, the inspector found the building to be clean, tidy and free from offensive odours. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. EVIDENCE: Examination of the duty rota confirmed that there is always at least one qualified nurse on duty at all times. People said that the number of staff on duty is adequate. One person who lives in the home said,” The staff here are marvellous. They go over and above the call of duty. One came in early this morning to take me out for a hospital appointment”. Another said, “ There are enough staff most of the time. I sometimes have to wait a while for attention if they are busy. This tends to be during the morning time”. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce. Over 50 of care staff have now completed NVQ level 2 or 3 training in care. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 19 Recent training has taken place in nutrition, health and safety. fire safety and protection of vulnerable adults. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a registered manager who provides support and guidance to staff and residents. EVIDENCE: There was an open and friendly culture between the management team and the staff at the home. Staff said that they felt well supported in their work and the manager said that regular supervision of staff takes place and that staff are appraised. People who live in the home and their relatives confirmed that the manager is approachable and that they would go to her if they had any concerns. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 21 The company have a number of systems in place to consult the people who live in the home. The manager confirmed that the company carries out monthly audits. This covers all aspects of care and environmental issues. Views are obtained through regular contact and an ‘open door policy’. The manager said that attendance at meetings by relatives and the people who live in the home had been poor. She said that she speaks to all of the people who live in the home whenever she is on duty. She speaks to relatives as often as she can. The administrator is responsible for the record keeping with regard to the personal finances of the people who live in the home. She was able to identify the amount that each resident had in his or her account. The records for two people were checked and found to be in order. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were checked at this inspection were found to be in order. Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 X 3 X 3 X X 3 Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 23 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. 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. 1. Refer to Standard OP7 Good Practice Recommendations All care plans should be evaluated monthly so that any changing needs are identified. This will make sure that people have plans which cover all of their needs. The refurbishment programme should continue to provide a good standard of décor throughout the home. 2. OP19 Belmont Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Grange Care Home DS0000000695.V344074.R01.S.doc Version 5.2 Page 25 - 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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