Inspection on 07/05/08 for Belmont House

This inspection was carried out on 7th May 2008.

CSCI found this care home to be providing an Good service.

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 06/05/09

Belmont House 23/10/08

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Belmont House High Street Starbeck Harrogate HG2 7LW Lead Inspector Mrs Irene Ward Key Unannounced Inspection 7th May 2008 09:30 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 DS0000071091.V364314.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 DS0000071091.V364314.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belmont House Address High Street Starbeck Harrogate HG2 7LW 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) 01423 882 100 01423 855811 Southern Cross OPCO Ltd Manager post vacant Care Home 106 Category(ies) of Dementia (42), Old age, not falling within any registration, with number other category (73), Physical disability (5) of places Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 73; Dementia - Code DE, maximum number of places 42; Physical Disability, Code PD, maximum number of places 5 The maximum number of service users who can be accommodated is: 106 First Inspection - New Service 2. Date of last inspection Brief Description of the Service: Belmont House was built and opened in 2006, and is now owned by Southern Cross OPCO Ltd. It is situated between Knaresborough and Harrogate, near local shops and a park. The home is accessible by local transport from both Knaresborough and Harrogate. Belmont House offers residential, nursing and personal care for up to one hundred and six people, some from the age of fifty-five upward, with nursing needs and for people with physical disabilities and dementia. The home has three floors, with three vertical passenger lifts to aid access to the first floor and second floor. There are five separate units. On the ground floor there is the Courtyard Suite for people whom need residential help, and the Garden Suite for people with nursing needs. On the first floor there is the Promenade Suite for people with dementia and the Park Suite for people who need temporary care or rehabilitation and on the second floor the Spring Water suite for people with nursing needs. There are a number of bedrooms available for double occupancy and all have an en-suite shower room. There are gardens and internal courtyards for the residents to enjoy, and car parking is available on the site. Details provided on the 7th May 2008 outline the weekly fees between £580 and £720. This does not include hairdressing, chiropody services and individual items like newspapers and branded toiletries. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that people who use the service experience good quality outcomes. The Commission for Social Care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk This is what was used to write this report. • • A review of the information held on the homes file since its registration. Information gathered during a random inspection carried out in April 2008. The visit was following a complaint that was received by the Commission. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment. Comment cards returned from four people who live at the home and eight relatives. We used the Short Observational Framework for Inspection (SOFI) We used a thematic probe which was- Safeguarding. Looking at six people’s care files in detail. Discussions with three relatives and two visitors to the home. • • • • • • A visit to the home that was unannounced. This lasted eight hours and was carried out by two inspectors. During the visit time was spent talking to people who live at the home. Discussions were also held with members of the staff team including senior staff, the cook, domestic staff and activities co-ordinator. Documentation and records were also looked at as part of the site visit and time was spent observing the interaction between people at the home and staff. This all helped to gain an insight into what life is like for people living in the home. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 6 One inspector undertook an assessment (SOFI) where she sat for about one hour on the dementia unit observing the people who live there to assess both their well-being and how the staff interact with them. What she saw is included in the main part of the report. Both Inspectors carried out a safeguarding thematic probe. This is where we gather additional information on a particular theme from a key inspection. What the service does well: These are some of the comments made by relatives of people living at the home: “I visited the home before my relative was admitted and asked that he be moved here rather than any of the other nursing homes I had visited in Harrogate” “The staff at Belmont are fantastic. They have been responsible for improving my relative’s quality of life by a massive amount, thank you” “Fantastic staff levels and service” “My relative has been in Belmont House for nearly 5 months and he has received excellent care. Everyone is kind to me and keeps me fully informed when he is not well. I wish all nursing homes were to this standard”. “Thrilled with facilities and level of care”. “Always welcoming and inform me immediately of any problems or improvements in my relative’s health”. Staff encourage people to be independent and to make their own decisions. This enables people to have control over their lives. Staff are respectful to people and sensitive in meeting their needs. This helps in making sure people receive care in the way they prefer. People said that the food is very good and described the chef as “good and he listens to you”. This ensures that people receive a nutritious diet to help them stay well. The environment is homely, clean, comfortable and suitable for the needs of the people living there. The furnishings in the home are of a high standard. The atmosphere is relaxed and friendly and there is a lot of good humour and banter between people living in the home and staff. This makes the home a happy and pleasant place to live. The staff team are committed to providing good standards of care to improve people’s quality of life. This helps in making sure that they receive the proper care to meet their needs. Visitors and staff said the management of the home is good. Everyone spoken with said that the managers are also all “approachable”. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 and 6. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People can be confident that the home can meet their needs. This is because people are properly assessed before being admitted into the home. EVIDENCE: People’s care records were looked at and showed where someone had been recently admitted; the file contained a full assessment of the person’s individual needs and other information as necessary. The manager or one of the two deputies carry out all of the assessments. They visit people and get information from them as well as their relatives and other professionals to help them decide if they will be able to meet people’s needs before a place is offered. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 10 Although the home is registered for one hundred and six people, there were eighty-six in at the time of the site visit. People who had recently moved to the home confirmed that they had been provided with all the necessary information before making a decision if Belmont House was suitable for them and able to meet their care needs. Four people spoken with and twelve who responded to the surveys said they felt well informed before they moved into the home. Positive comments made were “ I was given all the information I needed before making a decision as to whether or not to move into the home and from relative’s “I visited the home before my relative was admitted and asked that he be moved here rather than any of the other nursing homes I had visited in Harrogate” “We were pleased that mum was able to go to the home of her choice, we were able to get plenty of information before she made her choice” Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People’s personal and healthcare is provided appropriately and sensitively according to individual needs. EVIDENCE: There have been many positive comments made by people who live at the home and their relatives about the care provided at the home. Examples from people who live at the home said, “The care here is very good that’s why I moved here to have somebody to look after me”. “On the whole its very good”. Eight relatives responded in the surveys that the care home does give the support or care to your relative/friend and that you expect or agreed. Comments made were: Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 12 “The staff at Belmont are fantastic. They have been responsible for improving my relative’s quality of life by a massive amount, thank you” “Fantastic staff levels and service” “My relative has been in Belmont House for nearly 5 months and he has received excellent care. Everyone is kind to me and keeps me fully informed when he is not well. I wish all nursing homes were to this standard”. “Thrilled with facilities and level of care”. “Always welcoming and inform me immediately of any problems or improvements in my relative’s health”. “Will call the doctor if needed, they make sure all the medication is available”. Six peoples’ case records were looked at in total in the different units, in order to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. Care records all contained detailed information about people’s health and social care needs such as, risk assessments for mobility, nutrition and pressure sores and daily reports for each person. However they were very different to each other and described the care and support people needed to maintain as independent a life as possible. There were risk assessments in place describing how the care staff would minimise the risk of a person, for example, developing a pressure sore or losing weight because of poor appetite or a specific health problem. People were allowed to take reasonable risks in their day-to-day lives. For example one person chose to undo their safety belt on their electric wheelchair. There was clear documentation of discussions held with the person and their family so that they were aware of the dangers should they choose not to wear the belt. One person was receiving PEG feeding. (Feeding through a tube directly into the stomach). Whilst this was included in a care plan named ‘Eating and Drinking’ a more specific care plan could have been written so that an unfamiliar carer would know exactly what kind of help this person would need at different times of the day. Another person had a urinary catheter. This catheter needed to be replaced routinely, however records of this nursing task were recorded in the ‘daily records’ rather than on a specific care plan. A specific care plan would be good practice, as it would help staff to easily check when the task was last done and help to identify if outside healthcare professional guidance should be sought. Medicines practices were checked in three areas of the home. The written records were completed appropriately and controlled drugs were also stored and recorded accurately. There was however only evidence of three temperature recordings in April for one drugs fridge, and in the other area although there was a daily record for April, a record for May could not be found. The home needs to demonstrate that medicines are being stored at the correct temperature as required by both the pharmacy and the manufacturers and this issue was discussed with the manager. Another area discussed was Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 13 the storage of dressings in people’s rooms. So that people only use the dressing that has been prescribed for them, and not the same dressing, which may have been prescribed for another person. Advice was sought from the pharmacy inspector employed by the Commission who advised that these are prescribed items and should be stored in a secure place, the same as medicines and ointments. People living at the home wherever possible have their own GP’s and have access to other health care professionals such as dentists and chiropodists. They visit the home or appointments are made. Harrogate District Hospital is used for all emergency and some outpatient’s appointments. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 14 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): Standards 12,13,14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are able to make choices about their lifestyle and are supported by staff to carry these out. EVIDENCE: Relatives said they are made to feel welcome and they can visit at any time. All relatives who we spoke to said the home was very good at keeping them informed. In the AQAA (Annual Quality Assurance Assessment) form the manager said that the home operates “open visiting”. In the main, surveys from people who live at the home and their relatives were positive about the standard of care. The following are a sample of typical responses and comments: “The staff are excellent”. “Very helpful and caring, no complaints at all”. When people were asked about activities in the home this is what they said, Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 15 “Not always to keen but plenty of opportunities”. “Very good activities organiser – very helpful activities are to our needs”. “Don’t know of any”. “Would like more activities such as bingo”. “I have suggested that the bus at the home be used for residents outings at the weekend, otherwise I do not think there are any activities for residents that I am aware of”. “Activities are arranged for residential residents and much less so for nursing care residents. Fund raising does not seem to benefit nursing residents”. There are now two activity organisers one is full time and the other works parttime. There was an activity programme that was seen for the month of May. There were various activities scheduled such as board games, working with people in their garden, bingo. Trips out have been organised as the home has its own mini bus such as shopping trips into Harrogate and to the Valley Gardens and Roundhay Park. There was also Holy Communion on one day in one of the lounges. There was also some 1-1 time scheduled so that people got individual attention from the activities organisers if they so wished. Daily/weekly papers are delivered to the home. There was opportunity to speak to one of the activities organiser who said that the home has a gardening club called ‘ late bloomers’ which people living at the home enjoyed to participate in. People who had patios had together with the activities organiser had planted up tubs/containers and borders with various plants. One person living at the home had varnished their own bench outside on their patio. There is a residents association that is run by people living at the home. Staff have to be invited if they want to attend. They are held every four weeks. The homes manager receives the minutes of these meetings by e-mail from the chairperson from the residents association. Relatives meetings are also held and the last meeting was held on the 19th march 2008. Copies of both minutes of meetings were seen. On one of the units the activities organiser had sing-along music on in the dinning room. There were four people playing dominoes on another unit. Two people were seen being taken out with the activities person. There were also people setting tables for lunch. During the day there was opportunity to talk with the chef who was enthusiastic about the food that is cooked on the premises. He attends monthly residents meetings on the residential unit to discuss people’s likes and dislikes and will cook whatever anyone wants. He relies on nurses on the other units to advise what people want and need to eat. Meals are usually ordered the day before except on the EMI unit where food is shown at the table to people on the day. The chef said that there is always plenty of fresh fruit/vegetables ordered daily. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 16 There was discussion with the manager about finger foods for people to eat at night on the EMI unit, as some people are prone to wandering. The manager agreed that this area needs addressing. There are satellite kitchens in the home that are sometimes used during the day and it was felt that these could be used better utilised especially after 6.30 pm and it was something the home could look in to. The time spent observing people’s daily lives and staff care practices on the dementia nursing unit found that staff were generally very patient, showed good listening skills and acknowledged people’s different interests. They also came to the lounge area regularly to check whether people were all right. One person though was upset and said they were hungry. This could have been managed more positively and the person could have had extra food, when it was requested, rather than wait for coffee-time. If a greater variety of foods was readily available in the satellite kitchens, this would mean that people would be able to eat when they were hungry rather than at set times. People on the whole spoke positively about the food and these are the comments they made: “You always have choices” “ they make lovely cakes and biscuits with afternoon tea” “ The chef is good he listens to you”. “The night staff always ask if you want a drink or a sandwich”. “The food on the whole is very good”. “The food is good, you get a menu it also depends who is cooking. But on the whole it’s good”. “Monotonous, boring and a shortage of fruit”. “Enjoyed the few I have eaten with my daughter”. “ My relative is on a peg feed at the moment but when he was allowed meals they seemed quite good”. “Quality of food has reduced since change of ownership”. “The meals are very nice and hot, always a good choice”. “My diet is somewhat restricted but can always find something suitable on the menu” Menus were on display on the tables in the dinning room on the ground floor. There were choices available for both lunch and tea. There were three choices including a vegetarian option for the main course at lunchtime. There were also four desert options. At tea time there was a cooked or a cold meal available or a selection sandwiches and a desert. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 17 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): Standards 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People are protected by staff who will listen and act on any areas of concern. EVIDENCE: Seven of the eight relative surveys said they know how to make a complaint about the care provided if they need to; one said they did not know. People living at Belmont said that they knew who to talk to if they had a concern or a complaint. People said, “The managers are all approachable”. “No I don’t know how to make a complaint, but I am sure I could quickly find out if needed. The staff and managers are approachable”. The home has a complaints procedure that is available for people to look at which is on display in the entrance foyer. People living in the home knew who to speak to about any concerns and had ‘full confidence’ in the management that these would be listened to and properly dealt with. Two complaints have been received by the home. One was regarding overseas staff not understanding English and the other was about the laundry going Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 18 missing. The home’s management appropriately dealt with both complaints and the people who made the complaints were satisfied with the outcome. Complaints are logged in the complaints file and monitored as to how they are progressing by the organisation. The manager explained the home has a copy of North Yorkshire Protection of Vulnerable Adults procedure and the organisations policy is in place and was looked at. The policy was clear as to what action staff take and what part the police and local authority have. Discussions were held with staff who said they had received some training about safeguarding adults when they first started working at the home. Other staff spoken to said they had not received any training since they started working at the home six months ago. However most staff were aware of how to alert and who to go to if they suspected abuse in the home. One senior nurse spoken to was clear which agencies would take the lead in any safeguarding investigation. Future safeguarding training for staff was discussed with the homes manager. This had been addressed as Protection of Vulnerable Adults training had been organised to take place on the 8th 12th and 13th May 2008 for all staff working in the home. Since the previous inspection visit there have been two safeguarding matters. Both were referred to the appropriate agency and dealt with properly. The management of the home in line with the organisations policy follows rigorous recruitment procedures. This protects people living in the home by making sure that only the appropriate people are employed. There was a recent anonymous complaint received by the Commission For Social Care Inspection The person making the complaint said that people living on the dementia care unit were being got up at 5:00am. A Random Inspection was carried out to the home by two inspectors on the 24th April 2008. The outcome was as follows: Inspectors arrived at the home at 6:00 am and found no one to be up this also included people living on the dementia care unit. The senior nurse on duty informed us that there were eighty-six people living at the home and that there was a total of ten night staff on duty at the time of our visit. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 19 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): Standards 19 and 26. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. People live in a clean, homely and comfortable environment. EVIDENCE: The home is newly built and was only opened in November 2006, and has 106 bedrooms over three floors, which is split into five units, providing for people with different needs. The furnishings throughout the home are to a high standard. Some of the bedrooms on the ground floor have patio doors leading to the garden. All the rooms have an en-suite bathroom, which have a toilet, wash hand basin and shower. Some rooms can accommodate two people. Call bells are within reach of residents and on the whole are responded to quickly. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 20 It was possible to look at some of the rooms available during the site visit when we had the opportunity to speak to people in their own rooms. People spoken to were very pleased with the accommodation and especially with the shower facilities in their rooms. There are enclosed gardens to the rear of the building and enclosed courtyards within the building. Some people living at the home had patio doors leading onto their own patio, where there had been plants and tubs and containers full of flowers on display. In discussions with them they said that they had designed and planted some of the flowers with help from one of the activities organisers. This had given an enormous amount of pleasure to those people as they had all previously had their own gardens. They felt that they were still able to use their skills although they were now being cared for. There has been a lot of work gone into the gardens that were well maintained and cared for. There was also a corner of the garden, which was called ‘quirky corner’ which had been planted with some unusual objects. People said that this was a real talking point for both visitors and people who live at Belmont House. There is a car park to the back of the home. One relative said that the car parking was poor considering the size of the home. There is a range of communal space where residents can meet with their families. There are communal bathrooms, which have the appropriate aids and adaptations. The lounge door on the dementia-nursing unit was being held open with a chair. This was because people would not always have the strength to open the door, and it would stop them moving from the lounge into other parts of the unit. The staff said that the organisation was aware of this issue and is looking into addressing this. The corridors are wide and give ample space for wheel chair or electric chair use. The home is clean and fresh and decorated to a high standard. People who live at the home and relatives made positive comments about the cleanliness and said it was always clean and fresh. Comments made were: “Very high standards” “Excellent in terms of cleanliness it never smells” “Very pleasant surroundings, fresh flowers, always immaculate”. “Thrilled with facilities and level of care”. “ I think I have made a good choice as I am able to have my own furniture”. Gloves and aprons were available throughout the home. People’s personal clothing and bedding is attended to in a separate laundry area. People looked smartly dressed and their clothes were clean. The laundry Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 21 was suitable equipped with industrial washers and dryers. The home employs a housekeeper and two laundry assistants. There have been issues regarding clothes going missing. This was discussed at the last families meeting and is currently being addressed by the home. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 22 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): Standards 27,28,29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Staff are trained and competent to meet peoples needs. Sufficient staffing levels and proper recruitment procedures meant that people’s needs are met and their interests were safeguarded. EVIDENCE: All the people spoken with and surveyed said the staff are excellent. Comments from people living at Belmont House were: “ There are some marvellous staff” “Staff are very good on the whole, they are a nice lot”. “The staff are all very nice but the older staff are excellent, so thorough even the young ones are attentive and they all work as a team, they all get on and there is no backbiting”. Relatives stated, “The staff are always helpful and attentive” “The staff at Belmont are fantastic. They have been responsible for improving my father’s quality of life by a massive amount, thank you” “Fantastic staff levels and service” Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 23 “The staff are very polite and attentive with both residents and visitor, always willing to give you coffee or tea”. One person said that they felt that there were occasions when it took a longtime before the call bell was answered and this could be due to a shortage of staff. At present, there are eighty-six people living at the home. This can increase to one hundred and six which is what the home is registered to take. The staff roster was looked at and showed that the home employs sufficient care staff for meeting the needs of the people living at Belmont House. The home also employs catering, domestic and admin staff they also have a handyman. The home has three floors with the different units, which are staffed as follows: The ground floor has nine care staff in the morning going down to six in the afternoon. The second floor has eleven care staff in the morning and nine in an afternoon. On the top floor there are two staff as there are only seven people accommodated at the time of the inspection visit. There are ten staff on duty each night. These figures also include the qualified nursing staff. The home has one manager and two deputy managers. We looked at the files of three staff two of which were newly appointed and they showed that all the required checks are completed before new staff start work in the home. The records showed that new staff are given induction training when they start working at the home to make sure they have the right skills, knowledge and attitudes to care for people properly. The home has a training matrix in place for staff training. This makes sure that people receive the appropriate training and that it is regularly updated. Staff training records showed that staff had received training such as fire safety, food health and hygiene, moving and handling and health and safety. Five staff whose first language is not English have had the opportunity to attend an English Language course at Harrogate College two days a week. They have now all nearly completed the course and the manager said that this has helped staff to speak better English. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 24 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, 35,36 and 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is well managed in the best interests of people who live there. EVIDENCE: The new manager is in the process of submitting her application to be registered with the Commission For Social Care Inspection. She has vast experience of caring for the elderly. Two deputy managers and a team of unit managers support her in her role. During the site visit both the manager and one of the deputy managers were available throughout the day. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 25 People said that they felt ‘safe and secure’ and felt ‘totally confident’ that any concerns would be properly dealt with. The home does have a quality assurance system in place with various audits being undertaken. There are audit systems in place to look at accidents, medication and different aspects of the environment. There is a residents association, which is very active in feeding back to the management of the home. There are family meetings, which also give relatives opportunity to share their views. However there are no systems in place to seek feedback from others about the quality of care and services on offer at the home, which can be anonymous such as questionnaires/surveys. These have not been sent out periodically to people living at the home or other stakeholders in the community such as health care professional. The home would be able to measure their success better if they also involved others who have interests in the home. The Operational Service Manager for the organisation carries out the Regulation 26 visits as required. Personal allowances are held by the home for some people. These were looked at and the balance report showed that they are accurately kept. Any money that comes into the home is recorded and receipts are kept to account for any monies that have been spent. People can have access to their monies at all times. Supervision and appraisal systems have just been introduced into the home so that staff receive the support they need to carry out their jobs and management can address any issues. All accidents are recorded as required and an accident book is maintained in line with the requirements of Data Protection. Information provided from the (AQAA) Annual Quality Assurance Assessment and the examination of selected health and safety documents show that regular checks to fire safety equipment are regularly undertaken. The manager explained the home has a handyman that is responsible for the health and safety checks. The handyman checks water temperatures and fire alarms weekly and records showed that this was carried out. This makes sure that people living at the home are not put at risk. Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 26 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 4 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 2 X 3 2 X 3 Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 27 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 OP9 Regulation 13(2) Requirement The management must be able to demonstrate that people’s drugs are always stored at correct temperatures, according to the manufacturers instructions, so that they work properly. Timescale for action 07/07/08 Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 28 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. Refer to Standard OP9 OP33 Good Practice Recommendations To make sure that only authorised people have access to prescribed items, it would be good practice to store all prescribed items securely. To make sure that the home is meeting it’s aims and objectives, and that the home is run in the best interest of people living there. The quality monitoring system should be developed further to give people the opportunity to express their views anonymously and also should seek the views of other stakeholders. To make sure people receive a consistent service, all staff should be provided with supervision every 8 weeks. 3. OP36 Belmont House DS0000071091.V364314.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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