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Inspection on 28/06/05 for Belmont Grange Care Home

Also see our care home review for Belmont Grange Care Home for more information

This inspection was carried out on 28th June 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Feedback from service users and relatives indicated that people felt very satisfied with the care provided at Belmont Grange. Staff were described as being `friendly` and `caring`. The acting manager was described as approachable and friendly with one relative stating that she dealt quickly with any problems brought to her attention.

What has improved since the last inspection?

Due to the acting manager only recently taking up post there has been limited progress since the last inspection. However both she and the Regional Manager demonstrated during the course of the inspection that plans are in place to move the service forward.

What the care home could do better:

Care planning within the home should be more consistent to ensure that all staff are aware of how to look after all of the people in the home. The activities programme is extremely limited and needs to be addressed. Service users indicated that this is the only negative aspect of the home and feel that sometimes the days are long with no social activity at all.

CARE HOMES FOR OLDER PEOPLE Belmont Grange Care Home Broomside Lane Belmont Durham DH1 2QW Lead Inspector Susan Lowther Announced 28 June 2005 th 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 Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Belmont Grange Care Home Address Broomside Lane Belmont Durham DH1 2QW 0191 3849853 0191 3869513 belmont.grange@fshc.co.uk Four Seasons Health Care (England) Limited 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) CRH 33 Category(ies) of OP - 33 registration, with number PD - 2 of places TI - 8 Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: PD: Up to 2 persons with a physical disability may be accommodated commensurate with the homes Statement of Purpose. Date of last inspection 12th January 2005 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 two-storey 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. The home and was purchased by the current owners Four Seasons Healthcare (England) Limited in 2000. The home is surrounded by which are generally well maintained. However on the day of inspection there was some unavoidable debris in the form of trees, which had been blown down during the very recent adverse weather conditions. The Registered Manager advised that arrangements were in place to address this issue. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. CSCI has a statutory duty to inspect all care homes at least twice a year. This announced inspection was carried out in accordance with this duty. The inspection took place on the 28th June 2005 between the hours of 09:30am and 3pm. During the inspection of the home, time was spent talking to service users, staff and relatives. Records were examined and a tour of the building took place. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. What the service does well: What has improved since the last inspection? Due to the acting manager only recently taking up post there has been limited progress since the last inspection. However both she and the Regional Manager demonstrated during the course of the inspection that plans are in place to move the service forward. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 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 Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 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) 2,3,&4 Information is given to prospective service users to help them make an informed decision about moving into Belmont Grange. Appropriate assessment procedures are in place but these needs to include more information about peoples mental health, psychological and physical needs to ensure that the home can meet the needs of service users. EVIDENCE: The contract for service users is being reviewed by the Company and is not yet available. Assessments from Care Managers are obtained for all new admissions funded by the Local Authority. The home also carries out its own assessments on service users; some of the areas within these were blank, not all had a completed social assessment and risk assessments were not fully completed. Assessments form the basis from which the individual plan of care will be written and demonstrate how the home will meet an individuals needs. The information provided within assessments must cover all areas of physical, social, emotional and psychological needs. Where possible service users and/or their relatives should be involved in the assessment process. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 9 Belmont Grange does not provide intermediate care; therefore the assessment of Standard 6 is not necessary. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 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 Individual care plans are in place, however these require further development to ensure they reflect all of the information obtained during the assessment process. EVIDENCE: Four care plans were reviewed during the inspection. The care records examined did not contain plans to meet all of the needs identified in the assessment. One service user who had been admitted on 2nd June 2005 had an incomplete assessment and no care plans available. Staff confirmed that the needs of these people were being met even though there was a lack of clear plans. This approach is dependant on informal communication systems. Residents are at risk of not having their needs met if these informal systems break down. Where appropriate, plans contained some evidence of input from other health care professionals. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 11 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 The range and choice of activities available within the home were extremely limited due to there being no dedicated activities organiser. EVIDENCE: Feedback from staff service users and relatives indicated that activities are limited with one service user stating that ‘there is nothing to all day, the staff attend well to our health needs but do not have time to even sit and talk never mind organising an activity or outing’. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 12 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) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 13 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) 19,24&26 The home is safe and well maintained however some furniture and carpets are showing signs of wear and tear. EVIDENCE: The home is generally well maintained; a number of maintenance files were examined and found to be up to date. The inspector looked around the building, which was found to be clean, tidy and free from offensive odours. Service users could individualise their rooms with their own furniture and personal belongings. The home was found to be clean and free from unpleasant odours. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 14 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) 29&30 Records viewed showed that staff are trained and competent to do their job maintaining the safety and well being of service users. EVIDENCE: Individual staff records were viewed which confirmed that robust recruitment procedures are in place. Individual staff training records were found to be up to date and applicable to the skills needed to deliver the care service to the people living in the home. Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 15 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) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 1 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Belmont Grange Care Home B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 17 YES 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 OP 2 Regulation 5(1)(b) Requirement The home must ensure that each service user is provided with a statement of terms and conditions at the point of moving into the home (or a contract if purchasing their care privately). (Previous requirement timescale of 31/03/05 unmet.) Comprehensive assessments must be undertaken upon admission and care plans formulated for all service users. These must be reviewed on a regular basis (at least monthly). The acting manager must make an application to be registrered with the CSCI. Timescale for action 30/09/05 2. OP 3,4,7 & 8 14(1)(b), 15(1)&(2) 17 & Schedule 2 8&9 30/09/05 3. OP 31 30/09/05 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 OP 12 Good Practice Recommendations The registered provider should give further consideration to the employment of an activities organiser to enhance the current provision by care staff. B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 18 Belmont Grange Care Home 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 B54 S695 Belmont Grange V236096 280605 Stage 4.doc Version 1.20 Page 19 - 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!