Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 06/02/06 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 6th February 2006.

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 content. 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?

Corridors throughout the home have been repainted. All the carpets have been shampooed.

What the care home could do better:

Once again, the owner and manager must address outstanding legal requirements from previous inspections. Agreed timescales have not been met and the Commission has been given no reason why these could not be met. The manager must expand the information in care plans to indicate to staff how they can care and support the people living in the home. This must be done wherever possible with the involvement of the residents. The owner must ensure that repairs are made to the conservatory in order to allow residents to use this throughout the year. In addition, that safe hot water temperatures are provided in order to prevent vulnerable elderly people being scalded by being in contact with hot water.The owner must ensure that a report is made of the monthly visits made to the home and a copy sent to CSCI.

CARE HOMES FOR OLDER PEOPLE Belton Lodge Nursing Home 213 Belton Lane Grantham Lincs NG31 9PW Lead Inspector Mr Toby Payne Unannounced Inspection 6th February 2006 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.V281500.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. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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.V281500.R01.S.doc Version 5.1 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. 29th September 2005 Date of last inspection Brief Description of the Service: Belton Lodge is registered as a care home with nursing for 13 older persons. On the day of the inspection there were 7 people requiring nursing and 3 people requiring personal care. 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. There are 7 single bedrooms one with en-suite and 3 shared bedrooms each with en-suite The home has one lounge/dining room and an adjacent conservatory. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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, 2 staff and the manager. The main method of the inspection was called “case tracking”. This involved selecting one resident 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 7 people who required nursing care and 3 personal care What the service does well: What has improved since the last inspection? What they could do better: Once again, the owner and manager must address outstanding legal requirements from previous inspections. Agreed timescales have not been met and the Commission has been given no reason why these could not be met. The manager must expand the information in care plans to indicate to staff how they can care and support the people living in the home. This must be done wherever possible with the involvement of the residents. The owner must ensure that repairs are made to the conservatory in order to allow residents to use this throughout the year. In addition, that safe hot water temperatures are provided in order to prevent vulnerable elderly people being scalded by being in contact with hot water. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 6 The owner must ensure that a report is made of the monthly visits made to the home and a copy sent to CSCI. 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.V281500.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 Belton Lodge Nursing Home DS0000002587.V281500.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): 1, 2, 3, 5 and 6 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 and receive written confirmation that the home can meet their needs. EVIDENCE: The home has a detailed statement of purpose, which includes a service user’s guide and this gives information about the services provided, the aims and objectives, the philosophy of care and also rights of each person. A copy of this is in each bedroom within the home. Each person has a copy of their terms and conditions. Records showed a new resident had been assessed by the manager and written confirmation sent to them that based on this assessment the home could meet their health and welfare needs. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 9 Residents and their representatives are initially invited to visit the home without a prior appointment to enable them to gain a clearer picture of life within the home. They are then invited to stay at the home on a trial basis prior to any decision being made and this period is flexible. Details of the trial period are included with the homes statement of purpose. The home does not provide intermediate care. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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 and 10 There is a clear care planning system in the home. Staff respect the resident’s privacy and dignity. The way care is recorded has improved but still needs to be further developed to enable staff to have sufficient information to ensure that the health and welfare needs of people living in the home are fully met. Medication is safely administered. EVIDENCE: All residents had care records and care plans. Care plans had improved since the last inspection. However they need to be developed further to give information as to how the staff were to provide the support and care to each person. This to ensure that staff are able to meet all the resident’s health and welfare needs. Where required risk assessments have been included. Records showed evidence of review every month. However there was still 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 and detailed the care carried out every day. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 11 The inspector spoke with 6 residents. Each person was satisfied that their care needs were appropriately met. Comments included: “If I am unwell staff will contact the Doctor” and “the care is good and given when you need it”. The home had a medication policy and medication is administered by Registered Nurses who have received training on this subject. Records examined were seen to be well maintained. The home has a policy on the subject of ageing and death. Residents, their families and the staff are given support at this sensitive time. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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 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 however, not a great deal of information in the care records about how people wish to spend their time and what interests they have. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 13 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 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. Staff receive training on this subject during their induction. 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 had any concerns about the home. Comments were, “I have no worries and if I do I can talk to the staff or the manager”. Residents are supported and assisted to vote during elections and transport would be made available. Postal votes were used during the most recent elections. Where required information is provided to residents about the advocacy services available. Information regarding the resident’s legal rights is included within the home’s statement of purpose. Since the last inspection the induction programme has been reviewed and now includes information about abuse. Staff knew what constituted abuse and what to do if abuse was suspected. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 14 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, 25 and 26 Residents live in clean 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. However this is to be addressed in the future. Residents could be at serious risk if the hot water temperatures are not correctly regulated/monitored. EVIDENCE: Residents who spoke to the inspector said how they liked their rooms and how clean the home was. The home has one lounge leading to a conservatory and a dining room. Residents have access to all these areas of the home, which are on the ground floor level and systems are in place to minimise risks to people who are confused. This includes door alarms. The conservatory however cannot be used as a result of it leaking. This however is to be addressed in the future. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 15 The home has one operational bathroom with a bath hoist. Toilets are situated close to lounge and dining areas. There is an enclosed disinfector sluice facility. Grab rails are situated in the corridors. The home has a call bell system. Where required the home can contact occupational therapy services and other relevant services as required. The home has one mobile hoist and one static bath hoist to enable people to be moved safely. There were also a variety of slings and a number of special pressure relieving mattresses. There are 7 single bedrooms one with en-suite and 3 shared bedrooms each with en-suite. Resident’s bedrooms were personal with pictures, small items of furniture, television and personal mementoes. All areas of the home appeared clean. Health and safety policies and procedures are in place and a fire risk assessment was carried out in December 2004 and the last fire safety officer’s inspection was on the 19/1/2005. There were no concerns. During the inspection the inspector tested using a calibrated thermometer the hot water temperatures from hot taps in 4 bedrooms. The temperatures tested ranged from 77.2° to 77.6° Centigrade. As the safe temperature recommended by the Health and Safety Executive is 43° Centigrade the inspector issued an immediate safety notice. As a result of this during the inspection the temperature controlled on the new water boiler was reduced and a message was sent to CSCI on the same day that the temperature had been reduced to a safe level of 40° Centigrade. The monitoring of temperatures needs to be addressed. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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 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 and supported in their work. However, staff must receive training in care (National Vocational Qualifications). EVIDENCE: None of the residents or staff expressed any worries about the level or availability of staff. During the inspection, staff were seen to attend to residents promptly. Staff commented. “I have time to care for the people” and “I feel safe working here”. The home has Link Nurses for palliative care, tissue viability and incontinence. These link up with specialists from the NHS Primary Care Trust to promote good and latest practice in these important care practices. Since the last inspection, a detailed induction programme has been produced which includes information on abuse recognition and all aspects of care in order to prepare staff to care and support people living in the home. None of the staff in the home were studying for a care qualification (NVQ) and this needs to be addressed. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 17 Since the last inspection, formal staff supervision (6 times a year) for each member of the care and nursing staff has been introduced to give support to staff. Records were kept. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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 and 36 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. Staff are now formally supervised. EVIDENCE: The manager is a Registered Nurse and has extensive care and management experience. Since the last inspection, she has started studying for a management qualification to NVQ level 4. Since the last inspection formal staff supervision has been introduced. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 19 Systems are in place to monitor the quality of the service offered. Residents meetings are held approximately twice each year. Also, quality satisfaction questionnaires are sent to each person each year. The last questionnaires were sent out on the 1/10/2005 and 5 returned. There were no negative comments. The questionnaire concerned the quality of care, friendliness of staff, response to phone calls, decoration and ambience, response to complaints, meals and their overall impression of the home. Residents were satisfied that they were supported to express their views regarding life within the home and that suggestions or comments would be acted upon. Although the registered provider visits the home every month no written report of this visit was in the home or sent to CSCI. This has been outstanding for several inspections. Health and safety policies and procedures were in place. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 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 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 x x 3 3 3 2 Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation 15 Timescale for action The manager must ensure that 06/05/06 the care plan identifies how the staff are to provide the care and support 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. The owner must ensure that 28/05/06 people living in the home can use the conservatory leading off from the lounge. The leak in this room must therefore be repaired. The owner must send written proposals to the CSCI with dates when this work will commence and how long it will take to make the facility suitable for the use of residents. The timescale of the 28/2/2006 has not been met. The owner must ensure that at 06/04/06 least 50 of care staff have DS0000002587.V281500.R01.S.doc Version 5.1 Page 22 Requirement 2 OP19 23(1)(h) 3 OP30 18(1)(c) Belton Lodge Nursing Home 4. OP33 26 5 OP37 13(4)(a)(C) been trained to NVQ level 2 (required since the 31/12/2005). The owner must send to the CSCI written proposals concerning when staff will commence this training with dates and number of staff. The manager and owner must 06/04/06 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 and 29/11/2006 has not been met. The owner and manager must 06/02/06 ensure that measures provided to regulate hot water are set to ensure that a safe hot water temperature is provided which does not exceed 43° Centigrade. Regular monitoring must take place, records kept of tests and where this temperature has been exceeded the temperature must be adjusted. 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 OP19 Good Practice Recommendations It is recommended that the owner addresses the condition of the external woodwork, which was showing bare wood in places as a result of wear and tear and double glazing panes of glass in bedroom 8 and the conservatory, which DS0000002587.V281500.R01.S.doc Version 5.1 Page 23 Belton Lodge Nursing Home 2 OP37 needs replacing, as they can no longer be seen out of. In addition a preventative maintenance programme should be identified. It is recommended that the home introduce clinical procedures into the home in order to ensure that nursing procedures are up to date and in line with current researched practice. Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI Belton Lodge Nursing Home DS0000002587.V281500.R01.S.doc Version 5.1 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!