Inspection on 11/09/06 for Belvidere Nursing Home

This inspection was carried out on 11th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Belvidere Nursing Home 12/04/07

Belvidere Nursing Home 12/12/05

Belvidere Nursing Home 08/12/04

Belvidere Nursing Home 18/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Belvidere Nursing Home 85/89 Seabank Road Wallasey Wirral CH45 7PB Lead Inspector Jeanette Fielding Unannounced Inspection 11th September 2006 09:30 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 Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belvidere Nursing Home Address 85/89 Seabank Road Wallasey Wirral CH45 7PB 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) 0151 639 7773 0151 691 1090 Belvidere Nursing Home Limited Karen Pickford Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 named adults under 65 years of age Date of last inspection 12th December 2005 Brief Description of the Service: Belvidere Nursing Home is owned by Belvidere Nursing Homes Limited, and is managed by Miss Karen Pickford, who is a first level nurse with experience in caring for the client group. This care home is registered to provide nursing care for 40 older people. Belvidere is a large imposing building, which is located in the residential area of Wallasey, close to the promenade and local amenities. Communal areas are bright pleasantly furnished and furbished, and ornaments, flowers and pictures result in a comfortable environment. Televisions, videos, piano, electric organ and a music centre are available. The home is double glazed throughout and ramp access is available at the side front entrance. A lift serves all floors. There is a reception hall with leather seating, desk, fireplace, plants and photographs, and there is a choice of lounges and dining rooms. A conservatory and other quiet sitting areas are located in various parts of the building and one small lounge is designated for those residents who wish to smoke. A hairdressing salon is provided. Both single and shared accommodation is provided on three floors and many have the benefit of en-suite facilities. A selection of bathrooms, toilets and a shower are provided on each floor. All are well appointed and assisted bathing facilities are available. The well-maintained rear garden has walkways, sitting areas, gazebo and a summerhouse. Car parking is provided at the front and rear. The fees charged are £438.46 per week including the nursing care which is in line with Wirral Local Authority payments. No top up charges are made. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted in one day over a period of six hours. During the inspection, records relating to the care required by and afforded to service users were inspected and found to be excellent. Staff records were well maintained and contained comprehensive training records. Service users spoke highly of the home, the staff team and the care they give. The home was decorated and furnished to a high standard and was found to be clean throughout. Service users are stimulated through a comprehensive activities programme. No requirements or recommendations are made following this inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 6 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 Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 7 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed and comprehensive assessments are made on all prospective service users to ensure that the home can provide the facilities and services to meet the service users needs and wishes and ensure their protection. EVIDENCE: The home has produced a comprehensive Statement of Purpose and Service User Guide which give full information about the home and the service and facilities provided. These documents are available from the home on request and are also displayed in the foyer, together with a copy of the most recent inspection report, to give full access to all service users and visitors. All service users are issued with a contract or statement of terms and conditions on admission. The home’s copies are securely held in the home. Prospective service users are assessed by the manager or deputy manager prior to being admitted to home. This is undertaken to ensure that the home Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 8 can meet the service users identified needs and to enable any specialist equipment to be provided prior to the service user being admitted to the home. The manager and deputy have devised their own assessment form which was found to be extremely helpful in evaluating the needs of prospective service users. The comprehensive assessments are undertaken with the service user, their family and other professionals involved in their care. The care files for service users recently admitted to the home were inspected and were found to contain detailed assessment records. The assessment is also an opportunity for the home to record all preferences and choices to ensure that the service users individual wishes can be provided and to form the basis of the plan of care. Prospective service users and their relatives are welcome to visit the home prior to admission to view the rooms and to meet with staff and other service users. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. EVIDENCE: Comprehensive care plans are prepared for each service user to provide staff with full information regarding the care needs and preferences of each service user. Inspection of the care plans showed that care needs had been identified and action plans set in place to address those needs. Risk assessments had been undertaken and risk management strategies set in place where necessary. Evidence of visits to and by GP’s, Chiropodist, Dentist, Tissue Viability Nurse Specialists, Dietician, Speech and Language Therapists and other health care professionals was seen, together with information given to the home by these professionals. The records completed by staff following these visits are Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 10 detailed and informative and give full information and instruction to the staff team. Daily reports provide evidence of the actual care given by the staff. These reports are detailed and informative. All records are clearly written by the staff. Medications are dealt with in accordance with the home’s policy and procedure. Records were well maintained and up to date. The medications storage area was clean and organised. Unwanted medications are disposed of appropriately and no unnecessary medications are held in the home. Information regarding individual medications is held in the home to advise and inform staff as necessary. Policies and procedures are in place to ensure that privacy and dignity are maintained. These documents are reviewed on a regular basis and amended in accordance with good practice. Staff are given training on this during induction and additional information is detailed in the staff induction handbook. A handbook is issued to all new staff to enable a comprehensive induction training programme to be followed. Specific topics within the book are signed by the manager when competency in specific tasks is established. Service users may meet with their visitors in the privacy of their bedroom or in one of the communal areas as they wish. A pay telephone is available although some service users have chosen to have their own telephone installed. Mail is delivered unopened and service users are addressed by the name of their choosing. Service users spoken to during the inspection spoke very highly of the staff and confirmed that their privacy is respected at all times and that the staff did all they could to meet their needs and individual preferences. Screens are used in shared bedrooms to provide privacy and to protect service users dignity. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number and range of activities and social events provided by the home enrich service users social and educational opportunities. EVIDENCE: A high number of activities are provided for service users and a record of these is held in the home. Service users spoken to said that they enjoyed the activities and there was always something going on that they could participate in or enjoy watching. Recent activities include pottery, crafts – many of which are sold at the home’s summer fair, growing tomatoes in tubs and filling hanging baskets. Other activities include cake decoration, quizzes, bingo, board games, darts and music. The Library Service visits the home on a regular basis and can provide books in large print as necessary. Service users are also given the opportunity to go on trips and recently, two trips on canal boats have been made together with trips on the Mersey Ferry and Knowsley Safari Park. Some service users have enjoyed more local trips to places such as shops and Vale Park. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 12 A high number of visitors were seen in the home during the inspection and those spoken to were extremely complimentary about the home and the staff. Ministers provide services on a regular basis to provide for service users spiritual needs and service users who wished to attend church would be given all assistance to do so. Service users take their meals in the dining room or in their own bedroom as they choose. Dining tables are attractively laid and provide a pleasant environment to take meals. A selection of meals is offered at all mealtimes and any special requests can usually be met. The chef discusses the meal of the day with the service users and the menus provide evidence that a varied and balanced diet is offered. Special diets can be provided on request or on the advice of the GP or dietician. Service users spoken to during the inspection were extremely complimentary about the meals and the choices available and commented on the quality of the food and the attractive way it was served. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected from abuse through a robust complaints procedure and a well trained staff team. EVIDENCE: The home has a comprehensive complaints procedure which is detailed in the Statement of Purpose and the Service User Guide and is displayed in the foyer of the home. No complaints have been received by the home or by CSCI since the last inspection. Service users spoken to during the inspection said that they spoke with the manager or deputy every day and would feel comfortable in expressing any concerns that they had. Training on abuse is given during the induction and foundation training programme and has been given to staff to assist them in understanding the various forms of abuse. Evidence of training is held in the home. Information regarding abuse and additional training is given to staff on a regular basis. The manager and deputy manager are fully aware of the action to be taken in the event of abuse being suspected and of the people to be contacted. Staff spoken to during the inspection were able to demonstrate that they were aware of the action to be taken if they suspected abuse. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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, 24, 25, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Continued investment in the home provides service users with a homely and pleasant environment in which to live. EVIDENCE: The home is decorated and furnished to a high standard with a rolling programme of redecoration and improvement. Several bedrooms have been redecorated since the last inspection and all areas were seen to be bright and welcoming. The home is well maintained and no maintenance issues were identified during the inspection. Bedrooms are personalised with personal items to reflect the service users individual personalities and preferences. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 15 The lounges and conservatory are pleasant and service users are free to use all communal areas at any time. One service user said that she enjoyed using one particular area of the home where she could look out of the window and watch the birds. The home was seen to be extremely clean and fresh throughout and free from unpleasant odours. Infection control and laundry policies and procedures are in place and training is included in the induction programme. Service users personal laundry is attended to by the home and was seen to be handled with care and consideration. A pleasant and well maintained garden is provided with seating and shaded areas where service users can sit or participate in gardening tasks if they wish. Sufficient bathrooms and toilet facilities are provided and all bathroom ceilings have been redecorated. Assisted bathing facilities are provided to aid service users with mobility difficulties. New cupboards have been fitted in sluices and a new linen room has been provided. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home employs a well trained staff team that work positively with service users to improve their quality of life and to ensure their protection. EVIDENCE: The home employs qualified nurses and care assistants to provide nursing and personal care to service users. The staff rotas provide evidence that the home is employing and deploying staff in sufficient number to meet the needs of the service users. Training has been given to all staff on the different types of abuse and the action to be taken in the event of it being suspected. Induction and foundation training is given to all staff and a record of this is held on the staff files. 50 of the care staff hold NVQ qualifications and a further three staff are working towards this at level 2 with one additional member of staff working towards level 3. All staff are given training and recent training includes NVQ training, accredited medication training, NVQ assessors course, tissue viability, manual handling, food hygiene, first aid and an update on the management of care for service users with Parkinson’s disease. Additional training has been planned which includes Dementia training for all qualified nurses. The Head Chef is working Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 17 towards an NVQ in catering and the Maintenance man is working towards a qualification in health and safety. The home has produced comprehensive policies and procedures and these are accessible to all staff. The deputy manager is planning to undertake a diploma in the care of the elderly at John Moores University. Records are held of all training undertaken by staff. The home has a policy and procedure for the recruitment of staff which is accordance with equal opportunities legislation. All prospective staff are required to complete an application form and then attend for interview. Two references are taken and checks made with the CRB and POVA and evidence of qualifications is required to be produced. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home regularly reviews aspects of its performance through a good programme of self-review and consultations which include seeking the views of service users, staff and relatives. EVIDENCE: The manager of the home is a qualified nurse who has considerable experience in the management of a care home for elderly persons. She holds an NVQ in management at level 4. The home has developed a quality monitoring system and questionnaires are sent to all service users, relatives and staff to obtain their views of the home and of the service provided. The home holds all responses to the questionnaire and the action taken to address issues raised as a result of Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 19 these. Staff meetings and service users meetings are held on a regular basis to disseminate information and to obtain views and suggestions for improvement. The manager or deputy manager speak with service users on a one to one basis each day. Service users confirmed that they were given every opportunity to express themselves both openly and confidentially to the management. Supervision is given to all staff six times each year and annual appraisals are held. Records of these are held on staff files. The home does not deal with any of the service users personal monies. Family members or advocates are invoiced for any additional charges incurred by the service users. This information is detailed in the service user guide. A written statement for maintaining safe working practice is included in the homes policies and procedures and work based risk assessments are undertaken, documented and regularly updated. Tests are made on the fire detection equipment as required and is duly recorded. Training on fire prevention and fire drills is given to all staff on a regular basis. All contracts, tests and safety certificates inspected were found to be well maintained and up to date. Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 3 4 3 4 STAFFING4 Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 4 3 3 Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Belvidere Nursing Home DS0000020932.V303811.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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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