Inspection on 10/11/05 for Belmont House, Bodmin

This inspection was carried out on 10th November 2005.

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, Bodmin 01/11/06

Belmont House, Bodmin 07/06/05

Belmont House, Bodmin 05/01/05

Belmont House, Bodmin 14/07/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOMES FOR OLDER PEOPLE Belmont House Love Lane Bodmin Cornwall PL31 2BL Lead Inspector Elaine Bruce Unannounced Inspection 10th November 2005 09:15 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 DS0000038589.V253951.R01.S.doc Version 5.0 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 DS0000038589.V253951.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Belmont House Address Love Lane Bodmin Cornwall PL31 2BL 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) 01208 75057 01208 78836 Almondsbury Care Limited Mr Paul Seels Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (40) Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 40 adults aged over 65 with dementia (DE(E)). Service users to include up to 40 adults aged over 65 with a mental illness (MD(E)). Variation in age in respect of one named person under 65 years Additional variation in respect of one named person under 65 years with Dementia (DE) Total number of service users not to exceed a maximum of 40 Date of last inspection 7th June 2005 Brief Description of the Service: Belmont House is a large mature property with a purpose built extension on the outskirts of Bodmin. The home is situated in a pleasant residential area and provides nursing care for older people with a dementia or a mental disorder. Car parking is available in the grounds of the home. The grounds include attractive gardens with a patio area. Accommodation is spread over three floors with an inter-connecting shaft lift available if required. The top floor of the home provides bedroom accommodation only. The ground and first floor have bedrooms and communal areas. Security in the home is supported by the use of key pads which allow the service users freedom of movement on each floor of the home. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection at Belmont House took place on the 10th November 2005 over 6 hours and was carried out as an unannounced inspection. Care records, staff files and policies and procedures were inspected. Staff were spoken to during the course of the inspection. Direct feedback (on standards in the home) from the service users is difficult to obtain due to their high care dependency levels. The registered manager was at the home during the course of the inspection. What the service does well: What has improved since the last inspection? Although the environmental standards were not assessed at this inspection it is noted that ongoing improvements to the premises have taken place since the last inspection. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 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 DS0000038589.V253951.R01.S.doc Version 5.0 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 DS0000038589.V253951.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 The home’s statement of purpose and service user guide documentation (as well as a brochure) provide prospective service users/family with details of what the home provides helping an informed decision about admission to the home. A contract of care is provided to each service user/family which details the terms and conditions of their placement. Senior management staff are involved in the service user pre admission assessment procedure to ensure that the home will be able to meet their care needs. EVIDENCE: The home has a statement of purpose document in place that meets all the requirements of The Care Homes Regulations (2001). The statement of purpose document is available in the home as is the service user guide. In addition a brochure is available which gives detailed information on Belmont Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 9 House. All this information is provided to the service user and or their family member or representative. Each service user is provided with a contract of care. This document clearly states the terms and conditions of the placement. All potential new admissions to the home are assessed by the registered manager or one of his senior nursing staff prior to admission. A pre admission assessment document is then completed and signed and dated as required by this standard. Belmont House is providing a specialised service for service users with a dementia and all staff receive regular training in this area by one of the senior nursing staff members. Documentation is in place to evidence that service users and their representatives are welcome to visit the home prior to admission. There is also a policy and procedure in place to guide staff on the full pre admission process. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,10 and 11 The service user’s health, personal and social care needs are being met by the staff and multidisciplinary staff as required. During the course of the inspection the care team were noted to treat the service users with considerable kindness and patience. Documentation is in place to guide staff on good practice procedures in the difficult time re death/dying of a service user. EVIDENCE: Each service user has a care plan in place. Each care plan includes a large amount of information to include a risk assessment, current mental health needs assessment, moving and handling assessment and emotional well being assessment. There is evidence of regular reviews of the care plans taking place and the daily records that complement the care plans are very good. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 11 The daily records clearly evidence that the care needs of the service users are being met. Health care needs are identified in the service user care plan and how the home is meeting these needs. In addition other health care information/services to include chiropody and optician for example are documented. Evidence is in place that the service users are being weighed regularly. During the course of the inspection a multidisciplinary meeting took place on behalf of one of the service users. The home appears to have a good working relationship with health care professionals. Each service user is registered with a general practitioner. Evidence of nutritional screening is available in care planning documentation. During the course of the inspection it was noted that the care team were very patient and very kind with the service users. They ensured for example that drinks were given and finished with assistance in many cases and conversations with the service users evidenced how well they know them. The home has in place a policy and procedure on death and dying to guide staff in this sensitive area. In care planning documentation it is recommended that more information is gathered on the future wishes of the service user under the heading of “saying goodbye”. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 The home provides the service users with opportunities to meet their social care needs. Visitors to the home are encouraged and welcomed. The meals provided in the home are good with special diets catered for. EVIDENCE: Staff at Belmont have worked considerably hard to gather life history information on each service user. This information is nicely collated and presented in a “life history” book. It is from this life history book that the social care needs of the service users are identified. A social activities diary is kept which evidences that the identified social care needs of the service users are being met. An example of the activities that are taking place include Holy Communion, Accordian player and Ti Chi for example. Individual one to one activities include the regular painting of nails for example. The registered manager was arranging for a clothes show to happen at the home which will give the service users an excellent opportunity to make important choices on what they wear. The home is supported by a very good league of friends who fund raise on behalf of the home and make purchases for the home to the benefit of the service users. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 13 Records evidence the regular visitors to the home and it was noted during the course of the inspection that all visitors to the home are welcomed by the staff. All visitors to the home are asked to sign the visitors’ book in the entrance of the home. The meal at the home on the day of the inspection was lancashire hot pot with fresh cabbage, frozen vegetables and potatoes. This was to be followed by peaches and cream. The main meal of the day is at midday. An alternative meal is always available should the service user prefer. The menu is traditional in presentation to include a roast dinner on a Sunday and fish and chips on a Friday. It was noted that the breakfasts in the home were very varied in their time to fit in with the waking and rising times of the service users. The home employs two cooks and a kitchen assistant over seven days of the week. The cooks have obtained their intermediate food handling certificates. Staff were noted to be attentive in helping the service users where required with their drinks and meals. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 The home has a satisfactory complaints procedure provided to the service users in the service user guide/statement of purpose. The home has in place adult protection policy and procedures and training to provide staff with the knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The home has a complaints policy and procedure that is clearly displayed in the home. The complaints policy and procedure is also available in the service user guide and statement of purpose documentation. The home has in place a policy and procedure on adult protection. Policies and procedures are available to all staff in the office and the adult protection policy and procedure is individually issued to staff. Documentation is also available on whistle blowing. The registered manager provides basic adult protection awareness training to the staff with a training certificate issued. Adult protection training also includes the watching of an adult protection video. Two senior staff members have recently attended adult protection training at the local social services department and one more is due to attend. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The environmental standards were not assessed at this inspection. It was though noted during the course of the inspection that considerable improvements to the environment have taken place since the last inspection. EVIDENCE: Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 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 and 30 Staffing levels are appropriate to meet the needs of the service users. Staff training is ongoing and enables the staff team to meet the complex care needs of the service users. The staff and management team are a stable group to the benefit of the service users in the home. EVIDENCE: Staff work a variety of shifts to include twenty four hour cover with a qualified nurse always on duty. An inspection of the staffing rota confirms compliance with the home’s staffing notice and that a minimum of six carers are employed for the busy morning shift. It is noted that the staff team to include management are a very stable team and there has been no recent use of agency cover. The stability of the staff and the resulting continuity of care is of benefit to the service users. Recruitment procedures have been followed correctly for the employment and appointment of the one new staff member. The recruitment of overseas staff has worked very well at Belmont. A number of overseas staff were spoken to during the course of the inspection. They expressed very positive comments on the support and welcome by the staff team at the home which has enabled them to settle in well to their jobs. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 17 Staff members receive an induction training when they join the home. The induction training includes specialised training on meeting the care needs of the service user group. Statutory training is taking place regularly to include moving and handling, first aid and fire drill training. It is recommended that the fire drill training is logged in the Cornwall County Council Fire department book which is a good easy reference document for training and the testing of the fire alarm system. Good practice training regularly takes place at the home alongside the statutory training and presently includes infection control. It is recommended that individual training records are brought fully up to date to evidence all the training that is taking place. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 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): 31,32,35,36 and 38 The manager is supported well by the senior staff in providing clear leadership throughout the home. Regular visits from a representative of the Company take place to the home. The good standard of care being delivered at Belmont House is a credit to the manager and his team. EVIDENCE: The registered manager is a long standing staff member supported by a long standing senior management team. The registered manager is a qualified nurse and is undertaking his registered managers award qualification. In addition he regularly undertakes statutory training. He is supported in his duties by two senior staff members who each have been given specific individual tasks and responsibilities. One of these senior staff members is also undertaking studies to obtain a management qualification. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 19 A representative from the Company regularly visits the home and supplies to The Commission for Social Care Inspection evidence of monthly visit report. Staff are involved in regular meetings which are minuted. These are planned to take place approximately every two months and one took place on the day of the inspection. The home has an equal opportunities policy and procedure in place which is evidenced by the staff recruitment application form. The home employs an administrator who has responsibility for the service user’s finances. Individual records of the service user’s money are in place and only small amounts of money are being held on the premises. Regular staff supervision is taking place in the home with members of the senior management team supporting the manager in these duties. All records as required by legislation were found to be in place on the day of the inspection. All requirements of health and safety legislation are being met. A central file is held in the home with all contracts in place for the maintenance of all equipment in the home. In addition the file evidences where for example electrical hard wiring tests are required and have taken place. Room safety check lists are in place as are all health and safety policies and procedures to guide staff. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 4 11 3 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 3 18 3 x x x x x x x x 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 4 3 x x 3 3 3 3 Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 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 Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP11 OP30 OP30 Good Practice Recommendations To gather more information on the wishes of the service re “saying goodbye”. To record fire drill training in the Cornwall County Council reference book. To evidence in the individual staff training records all the training that has taken place. Belmont House DS0000038589.V253951.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 DS0000038589.V253951.R01.S.doc Version 5.0 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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