Inspection on 23/11/05 for Belmont Villa Care Home

This inspection was carried out on 23rd 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 Villa Care Home 27/09/07

Belmont Villa Care Home 22/08/06

Belmont Villa Care Home 15/09/05

Belmont Villa Care Home 01/03/05

Belmont Villa Care Home 29/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Belmont Villa Nursing & Residential Home 58-62 Weymouth Road Frome Somerset BA11 1HJ Lead Inspector Barbara Ludlow Announced Inspection 23rd November 2005 10:00 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 Villa Nursing & Residential Home DS0000003242.V256730.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 Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Belmont Villa Nursing & Residential Home Address 58-62 Weymouth Road Frome Somerset BA11 1HJ 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) 01373 471093 Belmontvilla@aol.com Belmont Villa Residential & Nursing Home Ltd Mrs Sharon Welsh Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to 27 places for elderly persons of either sex, not less than 60 years, who require general nursing care. Up to 5 places for personal care. Up to five persons of either sex, in the age range 18-59 years, who require general nursing care. 15th September 2005 Date of last inspection Brief Description of the Service: Belmont villa is a family run Nursing and Residential Care Home set in a residential area of the town of Frome. The home is registered for 32 service users. There are twenty-seven places for the provision of nursing care (includes one twin room that can be used by married couples or those wishing to share) and five places for residential care. The service is set in two joined Victorian houses. The residential care area is in one house and nursing care the other. Both houses are designed to meet the needs of the service user groups. Currently there are twenty-nine single rooms with en-suite facilities. The service has four bathrooms, two shower rooms and eight separate W.C’s. In addition there are five day/ quiet rooms. The service also has accessible gardens to the rear. All laundry is done “in house”. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by B Ludlow for CSCI. The homes Registered Manager, Mrs S Welsh was present throughout the inspection to assist with the inspection process. The National Minimum Standards were discussed and the findings of the last report and the pre inspection questionnaire completed for CSCI. Quality Assurance was also discussed. A tour of the premises was made; Service Users were seen and were spoken with both in the communal areas and in private in their rooms. Staff were observed at work and were consulted about their employment, training and their work at the home. Medications management was seen and records were sampled. The records included care plans, staff recruitment and maintenance. Visitors to the home were seen. A visiting GP was seen from the local medical centre that offers a regular visiting service to the Home. What the service does well: What has improved since the last inspection? Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 6 Environmental health and safety requirements made at the last inspection had been completed. The management of medication has improved. The trolleys were found to be clean and tidy, surplus and out of date stock had been discarded. The dining room has been recently redecorated and fully refurbished with the provision of new light coloured wood tables and comfortable dining chairs. New carpets have been fitted in the conservatory and this has been redecorated. Bedroom doors are being replaced or refurbished. Seven height adjustable beds have been purchased; all nursing beds are now height adjustable. New wheelchairs have been purchased. 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 Villa Nursing & Residential Home DS0000003242.V256730.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 Villa Nursing & Residential Home DS0000003242.V256730.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,NMS 6 does not strictly apply. The home has a Statement of Purpose and Service User Guide to assist prospective service users to make an informed choice. Visits to view the home are welcomed. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide (last revised in April 2005) The inspector was informed that large print versions are available on request. Copies of these documents are held by CSCI. Three service user contracts were seen at this inspection, there was a clear breakdown of the fees and the Registered Nurse Care Contribution (RNCC) for nursing clients had been assessed and was documented. Fee rates were increased in April 2005 and Nursing places are £625.00 excluding the Free Nursing Care contribution. The home does not offer its own intermediate care service. Social services have block-contracted places known as ‘step down’ beds for persons leaving Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 9 hospital and requiring 4 to 6 weeks care. One bed place is paid for by the PCT and is used as for intermediate care provision but with the supplementary services such as physiotherapy and occupational therapy being provided by the PCT and not by the home. The home receives the single assessment process paperwork for new service users and new admissions to the home. The homes Manager would meet and assess potential service users for their suitability for the home to ensure that care needs can be met. The exception may be when an urgent placement is made into the PCT funded bed if there is not sufficient time; the Manager explained that such placements might be made after discussion with the hospital liaison nurses. These clients would have specialist community support from health care professionals. Examples of community care reviews were seen on the care plans sampled. The pre-inspection questionnaire identified service users with sight and hearing impairment. These clients were discussed to explore the extent of their specialist needs, the manager confirmed the input of the specialist social worker, the follow up of aids, access to day care services and the use of special aids such as talking books. Belmont Villa Nursing & Residential Home DS0000003242.V256730.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): 7,8,9,10,11 The four care plans sampled had received attention to their reviews. The home has good relations with the local healthcare services. Medications management in the home has improved; a small number of requirements were identified. EVIDENCE: Service user care plans were sampled. Pre admission information was recorded with the details of multidisciplinary team assessment and input. A good level of personal information and contacts were recorded. Reviews of care needs had been made and appropriate risk assessments were in place. One care plan was identified that lacked some detailed care needs information for oral hygiene and chiropody needs. Care must be taken to ensure that all assessed care needs are addressed. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 11 The home has good communication with the local hospital and community health care services. The home also benefits from having a regular weekly visit from one of the local G.P practices; this visit occurred on the day of the inspection. The G.P was spoken with. Service users were seen who were identified as unwell and those whom the nurses identified for a review of their health care needs and medications or those who request a consultation. Medication storage was not examined, the MAR charts were. Where hand transcribed entries had been made these were not always signed or the drug count entered, this process must be completed. Opened skin creams in service users rooms require to be monitored for their opened on date, one was seen in use that had been prescribed in June 2004, another had no opening date. The management of medications had overall improved since the last inspection. Service users were addressed appropriately and were observed to be treated kindly by staff. Service users spoke positively about staff and one commented that ‘all staff are nice and kind’, another two service users reported that the staff response to the nurse call bell was good. One relative had responded to say one call bell was not available for use. Also CSCI in the written feedback heard that where continence pads are used toileting is not prioritised; this was discussed with the Manager at the inspection. No concerns were raised by the service users spoken with at this inspection. Staff should be reminded to attend to care needs and to give assistance with toileting as required. Belmont Villa Nursing & Residential Home DS0000003242.V256730.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): 13,14,15 Families and visitors are welcomed. Service users are able to spend their time as they wish. The dining rooms are nicely presented; service users said the food was good. EVIDENCE: Four visitors were seen and spoken with and all confirmed that they felt welcome when visiting the home. The written feedback from 13 relatives indicated that all felt welcomed and could meet their relative in private if they wished to. Thirty service users were seen in different areas of the home and 15 were spoken with, those who were able to respond confirmed that they are able to spend their time as they wish and can join in with activities and events as they choose. The home advertises ‘whats on’ each month in a guide for service users. Service users are encouraged to maintain their community links with clubs and friends. One commentator felt their relative did not receive enough stimulation. Activities and social care input will be thoroughly inspected at the next inspection. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 13 The service users have their meals in the homes dining rooms but can eat in their rooms if they wish. Service users asked confirmed that ‘the food is ‘good’. One service user had found the meat in the stew ‘tough’ at lunchtime, others asked found it satisfactory. This variance was also reflected in the written service user feedback where 4 out of 7 service users said the food was good and the 3 other commentators said sometimes. Belmont Villa Nursing & Residential Home DS0000003242.V256730.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): 16,18 The home has policies and procedures in place to protect service users from harm. Staff recruitment was generally improved; one POVA First check had been received after an induction programme commenced. EVIDENCE: The home has a complaints procedure; a copy is included in the service user guide. CSCI has not received any complaints about the service and the home had received one complaint this year and this had been dealt with. The written feedback indicated that 6 service users felt safe at the home and one said sometimes. 4 service users said they would know who to speak to if unhappy with their care 2 said no and one said sometimes. Relatives responded in writing with 8 of the 13 respondents saying they were not aware of the homes complaints procedure. 11 had not ever made a complaint and one had. The Manager should consider this feedback in case there is a deficit in the homes procedure for sharing information with families and service users. The through overseas recruitment was now further improved with a CRB obtained in this country. One POVA First check had arrived after the staff induction had commenced, these should be obtained in advance of new staff commencing work at the home. Belmont Villa Nursing & Residential Home DS0000003242.V256730.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): 19,20,21,22,23,24,25,26 The home has been suitably fitted to meet the registration categories. There is level access around the home and passenger lifts between floors. Communal rooms are all well appointed and individual bedrooms can be personalised. The home was clean, tidy and hygienic. EVIDENCE: The home is on three floors and provides spacious accommodation both in bedrooms and communal rooms.29 bedrooms have en suite facilities. The home has adapted bathing facilities and sufficient toilet facilities. Staff hand washing facilities were available and staff have access to gloves and aprons. There are appropriate waste disposal facilities. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 16 The laundry room was not seen. Service users were well presented and no concerns were raised about the laundry process. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 17 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 The home had a sufficient staff number on the duty at this inspection. CRB checks are now made for all new staff. EVIDENCE: The home had sufficient staff in number at this inspection and demonstrated on the home duty sheets. There is a skill mix of staff with cover for all departments. Staff have received training and development in their roles at the home. The recruitment files for three staff were examined. Overseas recruited staff had been thoroughly recruited and had the necessary documentation on file. Recruitment practice had improved; the home having taken up CRB checks for their overseas staff. However satisfactory POVA First checks must be confirmed before staff commence working at the home, this was discussed at the inspection. Staff appraisal and supervision was evident in the files sampled. Staff have supervision and dedicated time is timetabled to incorporate this as routine practice. The home has an NVQ Assessor for 14 hours per week to provide staff support, mentorship and training. Belmont Villa Nursing & Residential Home DS0000003242.V256730.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): 31,32,33,35,37,38 The home has an experienced Registered Nurse Manager who is open to new ideas and any suggestions from service users and their families for improving the care. The home does no hold service users finances. Contracts were seen and invoices for fees, these were satisfactory. Records were stored safely and appropriately. Maintenance and servicing was good, one bath hoist was identified that requires servicing. EVIDENCE: The inspector was informed that new information packs had been introduced to each service user when the fees were increased in April. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 19 At the last inspection: The manager confirmed that the home is viable and investment in the home was evident. Servicing and maintenance records and pre-inspection information indicated: • • • • • • Hoists had been serviced in August 05. One bath hoist could not be confirmed as having been serviced. The passenger lifts had been serviced in October 05. The homes electrical wiring had been safety tested in September/ November 05. The patient weigh scales had been calibrated in March 05. Wheelchairs were serviced in November 05. The homes syringe driver was with medical physics. The nurse call had been checked and the manager had recently audited call bell leads and had added one longer lead where required. Hot water temperatures are also checked at regular intervals. Fire safety records indicated that: • • • • • Fire training had been given in November 05. The most recent fire drill was in October 05. In House fire alarm tests had been made at weekly intervals. The fire alarm and emergency lighting had been serviced in February 05 /October 05. Fire extinguishers had been serviced in April 05. Bed rails were discussed and the Manager confirmed that bed rails are checked on a monthly basis. Belmont Villa Nursing & Residential Home DS0000003242.V256730.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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 3 3 3 2 Belmont Villa Nursing & Residential Home DS0000003242.V256730.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. 1 Standard OP9 Regulation 13(2) Requirement Hand transcribed medication must be signed for, to demonstrate checking with the amounts received, all entered onto the MAR chart. CRB/POVA First must be obtained before a service user commences working at the home. Care plans must contain all relevant personal health care information such as oral hygiene and chiropody care. Staff must be reminded to attend to the continence and toileting needs of dependent people. Timescale for action 24/12/05 2 OP29 19(1)(b) (i) 15(1) 24/12/05 3 OP7 24/12/05 Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 22 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 OP16 OP38 Good Practice Recommendations The Manager should ensure that all service users and relatives are aware of the complaints procedure at the home. Confirmation of the one bath hoist servicing record not seen at the inspection should be made with the inspection response. Belmont Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Villa Nursing & Residential Home DS0000003242.V256730.R01.S.doc Version 5.0 Page 24 - 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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