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Inspection on 25/07/06 for Five Bells Residential Care Home

Also see our care home review for Five Bells Residential Care Home for more information

This inspection was carried out on 25th July 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Residents were all very positive about the home; one resident said `I`ve no complaints at all about the place` and another said `It`s wonderful`. Residents were also complimentary about the food and said they had choice and variety. There is evidence of residents being able to make choices and to give their views on the running of the home and there is a wide range of activities and events for residents to choose from. The home benefits from having a very comprehensive training programme.

What has improved since the last inspection?

The office has been re-arranged and all policies and procedures have been reviewed.

CARE HOMES FOR OLDER PEOPLE Five Bells Residential Care Home 28 Market Place Folkingham Lincs NG34 0SF Lead Inspector Julie Western Key Unannounced Inspection 25th July 2006 09:00 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 Five Bells Residential Care Home DS0000002440.V305175.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. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Five Bells Residential Care Home Address 28 Market Place Folkingham Lincs NG34 0SF 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) 01529 497412 Mr Ronald Bruce Bridle Mrs Barbara Mary Bridle Care Home 25 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (22), of places Physical disability (1) Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The part of the home identified as Unit 2 is used for couples only when used as a shared room. 24th November 2005 Date of last inspection Brief Description of the Service: The Five Bells is a Grade II Listed former coaching inn, originally built in 1629 and located in the centre of the village of Folkingham, which is a conservation area. Folkingham is of equal distance from the towns of Grantham and Sleaford and has a shop, restaurant, pub and post office. The home is registered as a care home and mainly provides care for older service users; it is also registered to provide care for service users with those needs associated with dementia and for one service user who falls within the category of physical disability. On the day of the inspection 20 service users were being accommodated. The home comprises a main home, the coaching inn, which was extended in 2001, four modern terraced properties in Tannery Lane, which is adjacent to the main building and three bungalows within the grounds of the home. These have been built in keeping with the village setting and provide self-contained accommodation for less dependent service users. The home has a courtyard garden where residents can sit out in good weather. Across the road from the main home there are offices from which a domiciliary care service is operated. Accommodation in the main home is provided on ground and first floors, which are accessible via stairs or a stair lift. Access to the first floor flat of one of the self-contained houses in Tannery Lane is via an external staircase. The owners of the home live in Scotland; one of the owners is in touch with the home by telephone on a daily basis and visits the home fortnightly. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two residents’ records and assessing their care. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Four residents and three care and ancillary staff were spoken with. One of the proprietors was present at the beginning of the inspection and the Senior care staff member on duty was present throughout. What the service does well: What has improved since the last inspection? What they could do better: Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Five Bells Residential Care Home DS0000002440.V305175.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 Five Bells Residential Care Home DS0000002440.V305175.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home clearly sets out what it intends to do for its residents and this information is freely available to residents. Contracts set out clear terms and conditions and initial documentation demonstrates that the home is able to meet residents’ needs. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis EVIDENCE: The statement of purpose and the service user guide were comprehensive and up to date. Staff said that the Manager usually carried out the pre-admission assessment, either in the resident’s home or a care setting such as hospital or another care home. Some residents had been to the home to spend a day and have coffee or meals in the home; one resident said she had previously stayed at the home for a week’s respite care and had liked it so much she had returned for long term care. Intermediate care is not provided by this home. Five Bells Residential Care Home DS0000002440.V305175.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 - 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The two care plans looked at in depth contained assessments and were signed where possible by the service user or relatives/advocates. Care plans were clear about the health care needs of the resident but would be improved by containing more in-depth information on social and emotional needs. The home has a key worker system and several residents had regular visits from a District Nurse. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. A wide range of events and activities is available for residents. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: The home has an activities organiser who works two days a week. On the day of the inspection a church communion service was being held. The notice board and various posters displayed a range of activities and events taking place, including regular singing entertainers. Regular events included ‘sing-alongs’, board and card games and keep fit. Staff members described how they regularly took residents for accompanied walks around the village. One resident spoken with said she had no wish to participate in any of the events and preferred to stay in her room. Others said they still went to the village pop-in club and lunch club, or to the local pub. The activities organiser had developed a library for the home, with an extensive range of books. Residents were observed eating breakfast; one said ‘the food’s excellent – if we don’t like the meal we have another choice’ The menu was balanced, with a use of fresh meat, vegetables and fruit. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for 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 the service. The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: Residents all said they did not wish to complain but knew how to make a complaint. The home had a ‘compliments, comments and concerns’ book for the use of residents and visitors and the most recent entry was a letter of praise from a visitor whose relative had stayed in the home for respite care. Residents spoken with said they preferred to go directly to the management if they had any issues. There was a clear adult protection procedure, which was linked to the Local Authority procedures. Staff members spoken with had received training on adult protection and demonstrated that they knew what to do in the event of an incident concerning adult protection issues. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The residents live in a comfortable and pleasant environment with both private and communal space, which is generally safe and suitable for their needs. EVIDENCE: Externally, the building was in a good state of renovation, and internally the standard of decoration was generally good and afforded residents a good degree of comfort. The gardens were well tended with flower tubs and a water feature in the courtyard area. The home has a rolling maintenance programme. The furniture in the conservatory had been re-arranged to provide an improved sitting area for residents. Residents’ rooms were well appointed and had been personalised by their occupants. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 27-30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent; they undergo an induction programme before commencing their duties. EVIDENCE: The residents were positive about the care they received; one ‘I’m very happy with the care given; the staff are very nice indeed’. A staff member described how she had given two references, which were followed up and had a CRB check before commencing work and on the day of the inspection one of the proprietors was carrying out induction with two new staff members. The core staff group has been stable for some years; however there are currently vacancies for the Manager, a cook and two carers. Training records showed that five care staff members were working towards the National Vocational Qualification at Level 2 and five at Level 3. Recent training included the medication for Senior carers, dementia care at Level 2 and hoist training and future training included first aid, basic food hygiene and moving and handling courses. The staffing rota showed that there were enough staff numbers on duty to care for the needs of the residents. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 33, 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents are listened to and they are involved in decisions affecting them. EVIDENCE: The registered Manager has recently resigned her post and the home is being managed on a temporary basis by the proprietors, while a suitable Manager is being recruited. Residents spoken with said they were constantly asked for their views on matters concerning the running of the home. Quality assurance was carried out with letters sent to relatives/advocates; any issues from these and from the residents’ meetings were addressed as they occurred. Staff members confirmed that they had regular team meetings and supervision. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 16 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. 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. 1 Refer to Standard OP3 Good Practice Recommendations It is a recommendation that needs assessments cover social interests, hobbies, religious and cultural needs, carer and family involvement and other social contacts/relationships as per National Minimum Standard 3.3. Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 17 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 Five Bells Residential Care Home DS0000002440.V305175.R01.S.doc Version 5.2 Page 18 - 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. 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