This inspection was carried out on 10th May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
CARE HOMES FOR OLDER PEOPLE
Belton House Retirement Home Littleworth Lane Belton-in-Rutland Rutland LE15 9JZ Lead Inspector
Martin Hefferman Unannounced 10 May 2005.10:00
th 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 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. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Belton House Retirement Home Address Littleworth Lane Belton-in-Rutland Rutland Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01572 717682 01572 717682 Mr David Arthur Salter Ms Julie Elizabeth Flaherty Care Home 22 Category(ies) of OP- Old Age registration, with number of places Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: No additional conditions of registration. Date of last inspection 21/01/05 Brief Description of the Service: Belton House is a 22 bedded residential care home for older people located in the small village of Belton in Rutland. Most bedrooms are well in excess of the Minimum Standard sizes. The home has been the subject of major renovation, which has significantly improved its facilities. This work is nearing completion. A new patio area has been built with level access so that residents can enjoy the well kept gardens. A range of facilities have been provided in the grounds a new putting green, croquet area and petange area with a tea hut (with inside and outside seating area, a disabled toilet and small kitchen for residents / relatives to make drinks). The home orders taxis for residents. There is also a frequent bus service, which able residents can use, and the home has now purchased their own minibus. There are also self-contained bungalows as part of the site where residents can develop wider social contacts. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over the course of four hours thirty-five minutes (0915 – 1350). The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they receive through review of their records, discussion with them, the staff and observation of care practices. The relative of a fourth resident was also spoken to during the course of this inspection. What the service does well: What has improved since the last inspection? What they could do better:
The home must ensure that it keeps an accurate record of the administration of medication as any shortfalls in this area could have a detrimental affect upon the health of service users. The home was in the process of complying with two requirements, which were made at the time of the last inspection. These relate to an area of damp in bedroom 11 and surveying the views of residents and other stakeholders. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 6 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. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 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 standard(s) 3 Assessment practices are thorough, ensuring that residents’ needs are identified prior to their admission. EVIDENCE: The home had completed its own assessments of the three residents who were chosen for the purposes of case tracking. Records of those assessments were detailed, covering a wide range of health and social care needs. The registered manager stated that she had assured the residents that the home would be able to meet their needs. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 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 standard(s) 7 & 9 Individual plans are clear and comprehensive, providing staff with the information they need to meet residents’ needs. Arrangements for the handling of medication provide an adequate level of protection for residents. EVIDENCE: Individual plans for the three residents who were chosen for the purposes of case tracking set out their care needs. Each of the plans that were inspected had been reviewed on a monthly basis. They had been signed by either the resident or their representative to indicate that they were in agreement. The home had also completed a risk assessment – covering a wide range of issues - for each of the residents. Whilst records of the receipt and disposal of medication met relevant requirements, administration records contained a number of omissions. The registered manager stated that the errors were due to staff members having to familiarise themselves with a new system for the administration of medication. Records indicate that staff members have received medication training. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 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 standard(s) 12 & 15 Arrangements for social activities and the provision of meals are well managed with the result that both appear to meet residents’ expectations. EVIDENCE: Two of the three residents who were chosen for the purposes of case tracking stated that they are able to participate in activities if they wish. The registered manager stated that the third had received a copy of the current activity programme and agreed to go through it with her again. Records indicate that a varied programme of activities takes place. Residents confirmed that they are able to attend regular religious services. Residents stated that they enjoy the meals that are provided. They confirmed that a choice of meals is available. Records indicate that residents receive a varied and nutritious diet. Meals are served at two sittings, enabling residents to choose the time that suits them. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 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 standard(s) 16 Arrangements for dealing with complaints support the protection of residents’ rights. EVIDENCE: Residents stated that they felt that any complaints would be listened to and acted upon. The registered manager agreed to amend the home’s complaints procedure to reflect changes to the regulatory authority. Details of an advocacy service are available in the entrance hall. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 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 standard(s) 19 & 26 The standard of accommodation is excellent providing residents with comfortable and homely surroundings in which to live. EVIDENCE: Residents expressed satisfaction with the environment in which they live. The areas of the home that were inspected were decorated and furnished to a high standard. They were clean and free from offensive odours. A number of residents have furnished their rooms with their own possessions. The home has been the subject of major renovation, which has significantly improved its facilities. This work is nearing completion. The registered manager stated that action had been taken to address patches of damp in bedroom 11 but that these have begun to reappear. She reported that further action would be taken as soon as work on the roof had been completed. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Staff members are deployed in sufficient numbers to meet residents’ needs. The home’s recruitment practices support the protection of residents. EVIDENCE: Staffing levels comply with the requirements set by the previous regulatory authority. Residents stated that staff members are very helpful and that they always respond quickly to calls for assistance. The relative of a resident stated that he is made to feel welcome when he visits and that he found staff members to be very supportive. The records relating to two staff members were inspected. Both contained two references and a copy of a Criminal Records Bureau disclosure. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 Residents are protected by the home’s current working practices. EVIDENCE: The registered manager stated that she was in the process of undertaking a survey of residents’ views as part of the home’s Quality Assurance system. Staff members have received training in first aid, fire safety, food hygiene and moving & handling. The registered manager stated that further training on moving & handling and first aid was planned for the weeks following the inspection. Records indicate that fire tests and drills have been completed at the required frequency. Since the date of the last inspection, the home has reviewed its risk assessments for all safe working practices. Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 2 x x x x 3 Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 16 Yes 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. 1. Standard 9 Regulation 13 Requirement The registered person must ensure that accurate records are kept of the administration of medication. The registered person must ensure that an area of damp in bedroom 11 is addressed. The registered person must publish the results of its survey of residents’ views and seek the views of other stakeholders (a previous timescale of 10/08/04 was not met). Timescale for action With effect from 10/05/05 17/07/05 17/07/05 2. 3. 19 33 16 36 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 Good Practice Recommendations Belton House Retirement Home C51 X00015 S6458 Belton House V226311 100505 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection 1st Floor Newland House Campbell House Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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