Inspection on 12/04/07 for Belvidere Nursing Home

This inspection was carried out on 12th April 2007.

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 11/09/06

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 12th April 2007 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.V332059.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.V332059.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.V332059.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person aged under 65 years for nursing care One named person aged over 65 years for personal care Date of last inspection 11th September 2006 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 service users 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 £446.22 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.V332059.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in one day, over a period of five hours. It involved the examination of records relating to the care required by and afforded to residents and of staff personnel records. Records relating to the safety of equipment used in the home were also inspected. The deputy manager, staff, visitors and service users were spoken to during the day. The registered manager had completed a pre-inspection questionnaire that gave information about the current status of the home. A tour of the premises was undertaken and all areas were inspected. No requirements or recommendations are made following this inspection. What the service does well: What has improved since the last inspection? Considerable redecoration has taken place throughout the home since the last inspection. All areas of the home are bright and welcoming. A plan has been prepared for ongoing redecoration and improvement of the home. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 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 Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 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. A copy of the Service User Guide is issued to all service users and the care files provide evidence of the date that it was issued to them. Contracts are issued by the funding authority or by the home for those service users who pay privately. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 9 Pre-admission assessments are undertaken by the manager or the deputy manager prior to the service users’ admission to the home. These assessments are undertaken to identify the service users medical, care and social needs and to enable any specialist equipment to be made available prior to admission. The manager and deputy have prepared a designated assessment form which identifies with all the information that is need to confirm that the home can meet the service users’ needs. The prospective service user, their family and any health care professional involved in their care are requested to contribute to the assessment. A record is held of all those who have contributed to the assessment and given information. The assessment is also an opportunity to identify service users individual preferences and choices to be recorded to enable the home to meet all their needs. The care files for three recently admitted service users were inspected. The assessments were extremely detailed and informative and provided sufficient information to enable a plan of care to be developed. Prospective service users and their relatives are encouraged to visit the home prior to admission to view rooms and to meet with staff and other service users. The home does not offer intermediate care. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans contain sufficient detail to ensure that service users health, care and social needs are met and thereby improve their quality of life. 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 and informative care plans are prepared for each service user to provide staff with full information regarding the care needs and individual preferences of each service user. The care plans of five service users were inspected and showed that the care needs had been identified and action plans set in place to address those needs. Risk assessments had been undertaken Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 11 and risk management plans put in place to reduce or remove those risks 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 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. A work sheet is prepared each day to inform staff of their role and responsibilities for the day. This system works extremely well. 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 the competency that task 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.V332059.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The high number and range of activities and social events provided by the home enrich service users social and educational opportunities. EVIDENCE: An extensive range of activities is provided for service users and a record of these is held in the home. On the day of the inspection, the activities coordinator was assisting service users to put tomato plants into pots. A new greenhouse has been provided and service users spoken to said that they were looking forward to watching the tomatoes grow, and then eating them. Service users confirmed that something was ‘going on’ every day and that they were free to choose whether or not they participate. Activities include entertainers, parties, barbeque, ten-pin bowling, pottery, quizzes, bingo, board games, darts and music. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 13 The Library Service visits the home on a regular basis and can provide books with large print as needed. The home holds its’ own fund raising events and all monies made are used to fund the social activities within the home. Regular trips are arranged for service users who are involved with choosing the places of interest to visit. Planned trips include Parkgate for fish and chips and pub lunches. Some service users visit local shops and parks and are accompanied by staff or family members. An activities programme is displayed within the home. One service user has been making bright rugs during the winter months. These have been put up on the walls and are extremely attractive. Cheshire Health also provides the home with a masseur who provides allocated service users with massage therapy. Visitors are welcome to visit the home at any time and a few were in the home at the time of the inspection. Those spoken to were extremely complimentary about the home, the staff and the care that they gave. 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 with cloths and table centres 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.V332059.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. Only one complaint has been received by the home and the records show that this was responded to appropriately to the satisfaction of the complainant, and within the required timescale. Service users confirmed that the manager and deputy manager spoke with them each day and that they would be comfortable in raising any issues that concerned them. 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 any changes to the reporting procedure 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 Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 15 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.V332059.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24, 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An ongoing programme of improvement ensures that service users have a bright, homely and pleasant home in which to live. EVIDENCE: The home is decorated, furnished and maintained to a very high standard. Considerable improvements have been made since the last inspection. Redecoration and improvements have been made to a number of bedrooms and the front lounge and conservatory have been redecorated together with a number of staircases and landings. Lighting has been fitted to external areas and a CCTV camera has been installed at the rear of the building to enable staff to monitor the car park area. This camera does not overlook any areas or windows of rooms that service users occupy or use and is for security purposes Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 17 only. A plan of further improvements has been prepared and includes redecoration and some refurbishment. The new pictures that have been installed are bright and pleasant. Bedrooms are personalised with personal items to reflect the service users individual personalities and preferences. The lounges and conservatory are pleasant and service users are free to use all communal areas at any time. 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. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 18 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. 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. The home employs a full staff team with very few hours requiring to be covered by agency staff. Additional staff hours are provided where service users require a higher level of care. 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. A comprehensive range of training opportunities are available for staff and these are well attended. 65 of the care staff now hold NVQ qualifications and all staff are encouraged to undertake training to further their knowledge Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 19 and understanding. A record of all training undertaken by staff his held and additional training opportunities are displayed on notice boards. Training on specific medical topics is arranged for all nurses and two of the nurses have been given training on dementia by John Moores University. The manager is planning to commence training at John Moores University later this year to further develop her knowledge. Training is also undertaken by domestic, catering and maintenance staff and this is recorded in their files. Regular training is given to all staff on fire prevention and of the action to be taken in the event of fire being suspected. A training course is held each month to ensure that all staff are given regular updates. The home has a robust policy and procedure for the recruitment of staff which is in 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. The files for four members of staff were inspected and were found to contain all necessary information. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality in this outcome area is excellent. 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. Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 21 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 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. The home has recently achieved an Investors In People Award. Regular visits are made by the owners’ representative who makes reports on her findings at the visit as required. 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.V332059.R01.S.doc Version 5.2 Page 22 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 4 X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X X X 4 X 4 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 Page 23 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.V332059.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Belvidere Nursing Home DS0000020932.V332059.R01.S.doc Version 5.2 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. 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