Inspection on 02/08/06 for Belmont House

This inspection was carried out on 2nd 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 House 24/09/07

Belmont House 15/02/06

Belmont House 03/11/05

Belmont House 16/02/05

Belmont House 19/10/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Belmont House Belmont House 13 Greenover Road Brixham Devon TQ5 9LY Lead Inspector Stella Lindsay Key Inspection (unannounced) 2nd August 2006 2pm 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 House DS0000018326.V301288.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 House DS0000018326.V301288.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belmont House Address Belmont House 13 Greenover Road Brixham Devon TQ5 9LY 01803 856420 01803 856420 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) Mr Patrick Simon Phillips Mrs Belinda Phillips RGN Mrs Belinda Phillips RGN Mr Patrick Simon Phillips Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability over 65 years of age of places (20) Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: Belmont House is registered to provide 24-hour care for up to 20 residents over the age of 65 years; their care needs are related to old age or physical disability. The home has seventeen rooms, three of which are large enough to be double rooms, though all are currently in single occupancy. Eight bedrooms have an en suite toilet. Occupants of rooms 17 & 18 must be able to manage five steps. A call system is provided throughout the building and appropriate bathing and mobility aids are available for service users that have mobility issues. There is shaft lift. There are two adjoining lounges which can be separated by glazed doors, and a large conservatory. Meals are taken in a dining room which leads from the conservatory, and can be separated with a curtain. At the front of the building is a well-tended garden area with a patio and raised pond with a fountain. On road parking is possible at the side of the home. The home is decorated and furnished to a high standard and a very comfortable environment is provided for residents. A competent and caring staff are employed. At night the two staff are on sleeping in duty. Fees range upwards from £310 per week, depending on care needs. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a Wednesday and Thursday in August 2006. It involved a tour of the premises, examination of care records and staff files, health and safety records and the medication system. As well as discussion with the home owners, the inspector met with ten residents, five staff on duty, and a visiting relative, and thanks all for their time. Staff, residents, and relatives returned feedback surveys to the Commission for Social Care Inspection, and their views will be represented in the text. The Home owners provided additional information in a pre-inspection questionnaire. What the service does well: What has improved since the last inspection? The Manager has consistently carried out careful pre-admission assessment to ensure that new residents are admitted appropriately. She has recently improved the format by which she records this assessment, to ensure that staff have wider information and are better prepared to provide good care. The management are continuing to consider and improve the methods they use to administer and record medication, to meet the standards of the Royal Pharmaceutical Society and to reduce any potential harm to residents. Staff and management had considered safety in the dining room, removing walking aids which were potential trip hazards. A new laundry had been built. It is in an outhouse, so as well as better and more efficient facilities for staff, it is also quieter for the residents. Belmont House DS0000018326.V301288.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. Belmont House DS0000018326.V301288.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 House DS0000018326.V301288.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): 1,3 Quality in this outcome area was good with useful information provided, and careful assessment carried out before offering accommodation. EVIDENCE: Useful information is provided for prospective residents, who are invited to come to Belmont House for day care before making up their minds to move in. The Manager meets with all applicants and carries out an assessment of their care needs before offering accommodation. She had introduced an improved format for recording her assessment, which ensured that full information was obtained, in order to be sure that Belmont House was the right place, and that the staff would be well prepared for their arrival. As well as daily care needs, it covered sleeping patterns and night care needs, any difficulties with communication, emotional needs, social and community links and hobbies and interests. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 9 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, with detailed care plans drawn up in consultation with residents, and health care accessed promptly. The system of administering medication has been revised in order to meet with good practice requirements and to continue to promote the health and safety of residents. EVIDENCE: Care plans are drawn up with care, and residents’ signatures were seen, showing that they had been consulted. There were specific care plans with regard to continence, diabetes and social needs. A personal profile or life history would be a useful addition. Risk assessments had been carried out with regards to Moving and Handling, and to smoking, and up-dated recently. The National Osteoporosis Society had been consulted with respect to assessing risk of falls, and calcium supplements and blood pressure checks provided as necessary. Separate records are kept of bathing, hospital visits, courses of anti-biotics, in order that these can be checked quickly. Staff are aware when any resident is vulnerable to pressure areas, and special mattresses made available. An optician comes to the home. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 10 The home has a policy and procedure with respect to the administration of medication. This was revised in order to avoid secondary dispensing, which is considered a potential risk to residents’ safety. The staff now give out medication to the individual resident and sign for it at the time of administration. The Manager and four staff are trained and competent to administer medication. Further staff had also received training on medication in order to be aware of possible side effects or other drug related problems that might occur. Two residents currently look after their own medicines. They had been assessed for their competence to do this safely – risk assessments were seen on file. A monitored dosage system was in use, with weekly deliveries of trays for each resident. It was not possible to check the contents of each tray until the time came for each compartment to be opened. A book was kept to record any discrepancies that occurred. Any drugs being returned to the pharmacy were recorded, and signed for by the driver on behalf of the pharmacist. There was a suitable facility for storing Controlled Drugs, but none in use at the time of this inspection. There was a medical fridge in the office, but no insulin currently in use. Staff were seen to treat the residents with respect at all times and to help them maintain their dignity. Residents confirmed that staff listen to what they say, and act on it. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 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 the following standard(s): 12,13,14,15 Quality in this outcome area was excellent, with residents appreciating the efforts made by staff to please them with regards to their activities of daily life and their meals. EVIDENCE: Staff make special efforts to make the residents’ lives pleasant and meaningful. A Red Heart Day was held on Valentine’s Day this year, with special food, flowers, and activities, and many photos kept to celebrate. One resident said that ‘staff are most helpful and an absolute delight to be with’. A popular weekly music and movement session has been introduced, lead by a staff member who is able to motivate the residents. Quizzes are frequently held. Residents’ social requirements are recorded in their care plans, and staff were aware of their interests and contacts in the wider community. One had been a cook in their own business, and had been pleased to make profiteroles with a Senior Carer. Staff confirmed that they have time during the day to sit and look at family photos with residents, if this will cheer them. Advice from the management is that meeting the residents’ needs must come before domestic tasks. Staff try and involve residents, for instance in folding towels or laying the table, if they are interested. During this inspection the weather was sunny but windy. The garden at the front of Belmont House is sheltered, so residents were able to enjoy time there. Some are able to come and go as they please. Staff were available to Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 12 assist others to their seats in the garden. Activity leaders are employed every fortnight. They provide a variety of activities within the home, and had provided two outings this season – to Buckfast Abbey and to Stoke Gabriel. Residents who went said that these were very enjoyable. The home has an unrestricted visiting policy and procedure and residents confirmed that they could have visitors at anytime and could come and go as they pleased. Residents’ individuality is appreciated, and many personal possessions were seen in their rooms. The meal served on the day of this unannounced inspection was seen to be wholesome and served with flair. A choice was provided, with the resident being consulted about what they would like with their salad. A book is kept, recording food served to each resident every day. This gives evidence of the range of choices consistently offered, as well as residents’ nutrition over time. Sherry is provided at main meals and wine is available on Sundays at no extra cost. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 13 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, with clear procedures in place, and residents having confidence in the staff’s good attitude and the home owners’ ability to deal with any problem. EVIDENCE: The Complaints procedure is on display in the entrance hall, and included in the information given to prospective residents. A complaints form is available on request. No complaints had been received by the home or by the Commission for Social Care Inspection. Residents confirmed that ‘if anything was troubling’ the home owner would deal with it. A full report was written and kept on file to record when one resident was upset about a particular issue, but declined to make a complaint. This good practice is commended. There is a Complaints and Suggestions’ file, though it has not been much used. The home owner proposed to use it to record staff’s suggestions, and any action taken in respect of a complaint to be presented to staff meetings. The home has a clear policy on the Protection of Vulnerable adults that includes the local reporting arrangements. Staff have received training in abuse awareness, and knew what they should do in the event of any allegation. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 14 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): 19,26 Quality in this outcome area is good, with an attractive and comfortable home well maintained with attention paid to safety and good hygiene. EVIDENCE: The location of Belmont House on the hill above Brixham is suitable as there is car parking space on the street at the side. The house is accessible, with a shaft lift and easy access to the garden from the conservatory. A call bell system has been provided which enables residents to carry their call button with them, and there is a pendant available for wearing in the garden, should a resident need to be able to summon help while outside. Eight of the 17 bedrooms have an en suite toilet. There are sufficient communal toilets, including one close to the lounge and dining room. Both bathrooms have bath hoists. The home does not have a hoist, and has no residents who are unable to weight bear. The home was seen to be clean throughout. Residents and visitors confirmed that it is always ‘spotless’. A good sluice is available for washing commode Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 15 pots. A new laundry had been provided. Staff were very pleased with the improved facilities, and as it is separate from the main building it is also quieter for the residents. The new washing machine has a disinfection cycle, and disposable red bags are available for washing soiled sheets or clothes, if needed. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 16 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, with competent and caring staff employed in sufficient numbers to provide good care for residents. EVIDENCE: Three care staff are employed each morning, and two in the afternoon. The Manager may be one of these, or may be additional. The cook is additional, and works until 2pm each day. At night there are two care staff, both sleeping in. This is kept under review, and when a resident has been ill and needing attention at night, a carer has been paid to work through the night. No resident told the inspector they had to wait for attention at night. Four of the current ten care staff have NVQ achievements to at least level 2, and some staff have qualifications in related fields. Staff were observed to be competent and caring throughout the inspection. Three staff files were examined, including the most recent appointments. There is a sound system of recruitment in place, the home owners are careful to interview applicants to assure the caring attitude, and all checks had been carried out with regard to recent appointments, for the protection of residents. A system for in-house staff training has been acquired, which covers theoretical aspects, and updates the home when any new legislation or equipment is introduced. The Manager is trained as a trainer for Moving and Handling – as well as being a qualified NVQ assessor. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 17 Training had been provided on control of infection, awareness of abuse, first aid, medicine management, moving and handling and care of people with dementia. Practical training in fire safety was planned. Training for particular care needs, including catheter care, had been provided. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, with the home run in the best interests of the residents, and with safe systems of work in place. EVIDENCE: The manager of Belmont House is a qualified nurse with over fifteen years experience of working in care. She has managed the home for the last six years and is well able to discharge her responsibilities fully. She maintains her nurse registration, and has qualified as a Moving and Handling trainer and an NVQ assessor. The home was seen to be run in the best interests of the residents, with staff encouraged to deal with individuals’ needs before household routines. The home owners are on the premises most days and fully involved in the life and work of the home. Feedback is gathered daily in an informal manner from residents and their relatives and other visitors. The home owner proposed to use the Complaints and Suggestions book to record staff’s suggestions, and Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 19 any action taken in respect of a complaint to be presented to staff meetings. In general, any suggestions have been considered informally, and actioned when possible. A professional survey of the premises was commissioned in May 2005, and action taken to meet the recommendations, and requirements previously made by the Commission for Social Care Inspection have been met. The home owners have plans for the home, under consideration. There should be an annual development plan for the home, based on a cycle of planning, action and review, and a quality assurance system involving residents. Cash is kept in a secure safe for four residents, with all receipts kept, and all transactions recorded and signed for. The home owner is appointee for one resident. The Manager has a certificate in Supervisory Development, 2005. She works alongside her care staff and is daily contact with them and aware of their performance, and any strengths and weaknesses. She has produced a supervision record which is well designed for recording staff progress and has carried out appraisals in the past, and informed staff in a recent staff meeting that these are starting again. Care staff have not received 1;1 meetings as required by standard 36, to consider their practice and their development needs. No accidents had been recorded since 22/08/06. The fire precaution system was serviced professionally on 10/05/06. The home has appointed one of its Senior Carers as a Fire Marshall, to ensure that the rolling programme of drills and alarm checks is maintained. Theoretical fire safety training has been provided recently, and a practical trainer is to be booked. The home owners must maintain vigilance to ensure that the kitchen door is shut when no staff are present. All equipment had been regularly serviced and records were maintained. The home had been assessed by an appropriately qualified occupational therapist and electrical checks are undertaken and recorded regularly. Risk assessments are in place and the home’s passenger lift is maintained under contract. Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 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 4 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 2 X 3 Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 21 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 Providers to consider carrying out. No. 1 2 3 Refer to Standard OP7 OP33 Good Practice Recommendations The care plans should include a personal profile, or life history, of the resident. There should be an annual development plan for the home, based on a cycle of planning, action and review, and a quality assurance system involving residents. Care staff should receive formal supervision sessions at least six times per year (including appraisals). OP36 Belmont House DS0000018326.V301288.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 House DS0000018326.V301288.R01.S.doc Version 5.2 Page 23 - 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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