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Inspection on 29/09/05 for Belton Lodge Nursing Home

Also see our care home review for Belton Lodge Nursing Home for more information

This inspection was carried out on 29th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People living in this home are happy and contented. Staff know how to care for the residents. They are lead by a manager who knows the needs of the residents and the staff. There is a relaxing atmosphere in the home. Residents enjoy the food, which is served.

What has improved since the last inspection?

Radiator covers and devices to prevent residents being scalded have been installed. Three adjustable nursing beds have been provided to aid the staff to help people who require nursing care.

What the care home could do better:

The manager must ensure that any person admitted to the home receives written confirmation that the home can meet their assessed needs. The manager must ensure that all staff have a written induction programme to enable them to be prepared to care and meet the needs of people living in the home. This must also include abuse prevention. The manager must ensure that care staff receive formal supervision.The owner must ensure that the conservatory is repaired and made available for people to use. The manager must ensure that information in care plans is expanded and wherever possible residents are involved in their care plans. The owner must ensure that a report is made of his monthly visits to the home.

CARE HOMES FOR OLDER PEOPLE Belton Lodge Nursing Home 213 Belton Lane Grantham Lincs NG31 9PW Lead Inspector Mr Toby Payne Unannounced Inspection 29th September 2005 08.20 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 Belton Lodge Nursing Home DS0000002587.V253955.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. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Belton Lodge Nursing Home Address 213 Belton Lane Grantham Lincs NG31 9PW 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) 01476 579798 01476 579798 R S Medicare Limited Mrs Indra Nathan Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration The maximum number of service users in the home with nursing does not exceed 10 and the maximum number of service users with personal care only does not exceed 3. 3rd November 2004 Date of last inspection Brief Description of the Service: Belton Lodge is registered as a care home with nursing for 13 older persons. The home is a modern bungalow situated in Belton, a village located on the outskirts of Grantham. A garden area is located at the rear of the home and there is car parking space to the front of the property. All accommodation is situated on the ground floor. The majority of bedrooms are single although there are 3 double bedrooms. The home has one lounge/dining room and an adjacent sunroom, which is heated for continued use throughout the year. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and started at 8.20 a.m. It took place over 4 hours. The inspector spoke to 6 residents, two visitors, 2 staff and the manager. The main method of the inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them and the care staff. The inspector also observed how care was delivered and how staff responded to other residents living in the home. On the day of the inspection there were 5 people who required nursing care and 8 personal care. What the service does well: What has improved since the last inspection? What they could do better: The manager must ensure that any person admitted to the home receives written confirmation that the home can meet their assessed needs. The manager must ensure that all staff have a written induction programme to enable them to be prepared to care and meet the needs of people living in the home. This must also include abuse prevention. The manager must ensure that care staff receive formal supervision. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 6 The owner must ensure that the conservatory is repaired and made available for people to use. The manager must ensure that information in care plans is expanded and wherever possible residents are involved in their care plans. The owner must ensure that a report is made of his monthly visits to the home. 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 Lodge Nursing Home DS0000002587.V253955.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 Belton Lodge Nursing Home DS0000002587.V253955.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): 3 and 4 Belton Lodge meets the needs of residents coming into the home. The home provides information to enable them to make a choice whether or not to come into the home. People receive an assessment before entering the home, which results in their needs being met. However this is not confirmed in writing. EVIDENCE: All people had been assessed before entering the home and detailed information was kept in the care records. Residents did not however receive written confirmation that the home was able to meet their assessed needs. Staff knew how to care and meet the needs of residents. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 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): 7 and 10 There is a clear care planning system in this home. Staff respect the resident’s privacy and dignity. The way care is recorded needs to be further developed to enable staff have sufficient information to ensure that the health and welfare needs of people living in the home are fully met. However, the health and welfare needs of residents were being met. EVIDENCE: All residents had care records and care plans. However they need to be developed further to identify the specific needs of the residents. as they remain basic. This to ensure that staff are able to meet all their health and welfare needs. Since the last inspection assessment of risk has been carried out. Records showed evidence of review every month. However there was no evidence to show that the care plan had been produced with the resident or relatives involvement. There were however signatures of the resident or their relative where there was any risk involved in caring for the resident. Care plans also showed evidence of promoting the resident’s independence, respect, dignity and choice. This was confirmed by residents and visitors and Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 10 observed during the inspection. Staff were seen to speak to residents in a calm, polite and friendly manner. Comments from residents were “the staff are very kind and friendly” and “nothing is too much for them”. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 11 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, 14 and 15 A programme of social activities is available which provides stimulation and interest for people living in this home. Visitors are made to feel welcome and supported. Residents have nutritious and varied meals. EVIDENCE: There are no restrictions concerning how residents spend their time. Residents said they were satisfied with the amount of activities provided and meetings are held with them twice a year at which this is discussed. There is not a great deal of information in the care records about how people wish to spend their time and what interests they have. All residents said they liked the food. There is a 4 week menu displayed on the notice board at the entrance to the home. The home received an inspection by the Environmental Health Officer on the 10/2/2005. There were no concerns. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 12 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 and 18 Any complaints received by the home are handled properly and residents know that any complaints they have will be listened to and taken seriously. Staff are recruited to ensure that residents are protected from abuse. However staff do not receive training on this subject, which could put residents at risk. EVIDENCE: Each resident receives a copy of the complaints procedure when admitted to the home. The complaints procedure is also displayed on the notice board at the entrance to the home. No complaints have been received by the home. and the CSCI since the last inspection. None of the residents or visitors had any concerns about the home. Comments were “I feel I can discuss anything with the staff or manager if I have any concerns”. Records showed that new staff had been recruited correctly. Even though staff have not received formal training both members of staff knew what constituted abuse and what to do if abuse was suspected. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 13 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, 24, 25 and 26 Residents live in clean and safe accommodation. Any risks to the resident’s safety have been identified and acted upon. The conservatory leading from the lounge cannot be used due to a leaking roof. This prevents residents using this facility. EVIDENCE: Residents who spoke to the inspector said how they liked their rooms and how clean the home was. Since the last inspection radiator covers have been installed throughout the home and water systems fitted with devices to prevent people being scalded by being in contact with hot surfaces. Residents commented, “I like my room” and “my room is clean and tidy”. Residents said they could not use the conservatory as it leaks. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 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): 27, 28, 29 and 30 There is a competent staff team. The numbers of staff were sufficient to meet the needs of the residents. Staff were correctly recruited, trained and supported in their work. EVIDENCE: None of the residents, visitors or staff expressed any worries about the level or availability of staff. During the inspection, staff were seen to attend to residents promptly. Staff also said they had sufficient time to care and support the residents. Comments were “we work as team”, “I can spend time with the residents” and “I feel safe working here”. Staff receive training and a number are to commence national vocational qualifications in the future. Not all training provided is however recorded on staff files. The fire officer visited on the 19/1/2005 and was satisfied with the detailed fire risk assessment. There were records kept of up to date fire tests and drills. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 15 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, 34, 36, 37 and 38 The home is well lead by a competent, experienced and committed manager. People living in the home have confidence in the staff and management of the home. However, efforts must be made to ensure that staff are formally supervised. EVIDENCE: The manager is a registered nurse and has extensive care and management experience. However she has not yet started a management qualification although this is being arranged. Also being arranged are national vocational qualifications for care staff. Formal staff supervision has not been introduced yet. Residents were satisfied with the home. Comments were “the staff are very good”, “we want for nothing”, “I am very happy”, “If I need anything they are Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 16 there to help” and “I have been living here for 5 years and the staff are very kind”. There are also policies and procedures, which enable staff to care and meet the needs of residents in the home. The owner makes monthly visits to the home but does not make a report of his visits. Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 17 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 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x 3 3 3 STAFFING Standard No Score 27 3 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x x 2 3 2 Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 18 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 OP3 Regulation 14(1)(d) Requirement The manager must write to the person who has been assessed to confirm that based on this assessment the home can meet their health and welfare needs. The owner must ensure that people living in the home can use the conservatory leading off from the lounge. The leak must therefore be repaired. The manager must ensure that all staff receive a documented appropriate induction programme, which prepares them for the work they are to carry out. All staff must receive instruction concerning adult abuse prevention. All training must be recorded. The manager must ensure that the monthly monitoring visits made to the home are unannounced and a record kept in the home and made available to CSCI for inspection. The records must be in accordance with this regulation. The time scale of the 28/2/2005 has not been met. DS0000002587.V253955.R01.S.doc Timescale for action 29/12/05 2 OP19 23(1)(h) 28/02/06 3 OP30 18(1)(c) 29/12/05 4 OP33 26 29/11/05 Belton Lodge Nursing Home Version 5.0 Page 19 4 OP36 18(2) 5 OP7 15 The manager must ensure that all nurses and care staff receive formal supervision 6 times a year. The supervision should include all aspects of practice, philosophy of the home and their career development needs. Records should be kept. The timescale of 28/2/2005 has not been met. The manager must expand the care plan for people living in the home. This to ensure that all their health and welfare needs are clearly outlined to enable staff to understand how to care and manage the resident’s needs. Care plans must also wherever possible involve the resident in identifying their health and welfare needs. 29/11/05 29/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Belton Lodge Nursing Home DS0000002587.V253955.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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