CARE HOMES FOR OLDER PEOPLE
Belmont View Hailey Lane Hailey Hertford Hertfordshire SG13 7PB Lead Inspector
Mrs Sheila Knopp Unannounced Inspection 18th January 2006 01:20 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 View DS0000019286.V278302.R01.S.doc Version 5.1 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 View DS0000019286.V278302.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Belmont View Address Hailey Lane Hailey Hertford Hertfordshire SG13 7PB 01992 450304 01992 459067 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) www.quantumcare.co.uk Quantum Care Limited Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Belmont View is a care home providing personal care and accommodation for 60 older people, including those with a physical disability or dementia. It is owned by Hertfordshire County Council and operated by Quantum Care. The home is situated on the outskirts of Hoddesdon, with local shops a short distance away. The home was opened in 1996. It is purpose built and consists of a two storey building with two units for 15 people on each floor. All the bedrooms are single and have en-suite facilities. There is a passenger lift. There is a large garden that is well maintained and landscaped in order to provide access to all parts. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second of the two planned unannounced inspection for April 2005 – March 2006. The majority of the key standards inspected by the Commission were reviewed on 6 June 2005 and are detailed in the published report of that inspection. The standards were fully met and the standard on social care was exceeded. This inspection focussed on staff training, recruitment, resident accommodation and health & safety. This inspection again reflected the high standards of support provided to residents seen on previous visits. The previous inspection reported that a high level of satisfaction had been expressed by doctors and social workers in contact with the home. The findings of this inspection are based on discussion with 4 residents, 4 visitors and 4 staff as well as the acting manager, assistant manager and finance auditor. Records related to staff recruitment and training and maintenance of the building were reviewed. No requirements have been made as a result of the last 2 inspections. No complaints have been received by the Commission. A total of 4.5 hours has been allocated to this inspection. What the service does well:
There is a calm friendly atmosphere at Belmont View with a lot going on in terms of interaction with staff and social activities. The residents and their visitors are very positive about the support they receive from staff and describe them as being ‘very good’ ‘kind’ ‘very nice’ and ‘helpful’. Staff are very good at interacting and communicating with residents who have dementia. The residents and relatives spoken with felt involved in decisions about their care and support. The residents are supported by a well trained and consistent team of staff who know them and are responsive to their changing needs. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 6 The home is well maintained and was found to be fresh and clean throughout. 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. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 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 View DS0000019286.V278302.R01.S.doc Version 5.1 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): Not inspected. Standard 6 does not apply to this service. EVIDENCE: Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 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): Not inspected. EVIDENCE: A recommendation to develop the skills of staff in identifying and recording the cultural and religious needs of residents is being taken forward through care plan training and a course the deputy manage plans to attend. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 10 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): Not inspected. EVIDENCE: Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 11 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): Not inspected. No complaints have been received about this service by the Commission between inspections. EVIDENCE: Following a recommendation made at the last inspection training updates for long standing staff members on the protection of Vulnerable Adult sis being identified in the 2006 training plan. New staff receive this training as part of their induction. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 12 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 The residents of Belmont View live in a comfortable, well maintained home which has been thoughtfully decorated and furnished to provide a homely, relaxed atmosphere. A high standard of housekeeping maintains a clean fresh atmosphere. EVIDENCE: The home continues to benefit from regular redecoration and upgrading of carpets, furnishings and furniture. New kitchens and flooring have been installed on each of the units in the last year and redecoration has continued. Great thought has gone into each area of the home in terms of the soft furnishings, rearmaments, pictures, points of interest and accessories which give each area the feel of a domestic house. The residents have been able to personalise their rooms and created very individual spaces within them. A resident was very positive about the help form the maintenance man in putting up shelves and pictures.
Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 13 No further plans were reported with regard to enlarging the Rowan Unit dining room which were reported at the last inspection. All areas of the home were found to be fresh and clean. The laundry is suitably equipped and the conscientious staff ensure residents are provided with fresh clean linen and infection control standards are met. The infection control procedures for managing soiled linen and access to disposable gloves, aprons and liquid soap were discussed with staff. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 28 & 29 Overall there are very good systems in place for staff to receive training as they take up their posts and continue in their jobs. However standard 28 is based on services achieving a ratio of 50 of care staff with a qualification in care at NVQ level 2 by the end of 2005 and this has not been met. The Information provided indicates 23 of staff have achieved this award. The induction now being completed by new staff will provide a foundation for continuing to NVQ and should improve this position. The required employment checks are carried out on staff before they start work in the home to ensure they are suitable to work with older people. A recommendation to make the application form clearer has been made. EVIDENCE: The acting manager reported that out of 39 permanent care staff 9 had achieved an NVQ qualification in care at the required level and 10 were working towards it. The recruitment records of 3 staff were reviewed and the criminal records checks for staff which had not been previously seen by an inspector were reviewed. It was confirmed that criminal records bureau clearances are being received before staff start work and two references are being obtained and include the previous employer. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 15 It was recommended that the managers ask the company to review the application form in use to make it clearer that a full employment history with start and finish dates is required. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 16 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): 33, 35 & 38 Quantum Care has systems in place, which include obtaining the views of residents and their relatives, to keep the quality of the services provided at Belmont View under review. Residents are supported to maintain their independence over their affairs. However there is a secure system in place to enable residents to have access to personal money should they wish to keep it in the home. The health & safety of residents and staff within the home is supported by the company procedures in place, staff training and the maintenance of the building and equipment. EVIDENCE: The views of residents and relatives are obtained by sending out questionnaires and carrying out quality audits into specific areas.
Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 17 Residents and relatives have the opportunity to share their views on the service and receive feedback from senior managers within the company on the audits and questionnaires carried out as well as future developments and plans for the home. The systems for managing personal money held in the home on behalf of individual service users was checked. Individual records of transactions supported by receipts are kept. The system is checked by a company auditor who happened to be in the home and was able to discuss the systems in place with the inspector. Staff demonstrated awareness of following up financial issues on behalf of residents to ensure they received their personal allowances. Staff receive induction training followed by annual updates in health & safety, fire, first aid, moving and handling and food hygiene. A review of the fire records, safety audit and maintenance records confirmed the required checks are being. The hot water supply to 2 baths was checked and found to be within the required safety range. Accident records are maintained and are reported to the Commission as required. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 18 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x 3 Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP29 Good Practice Recommendations Quantum Care to review format of application form for care staff to clarify a full employment history with start and finish dates is required. Belmont View DS0000019286.V278302.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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