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Inspection on 27/07/05 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 27th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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`m quite happy here and I feel safe` 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 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?

Recent refurbishment and redecoration included major repairs to the frontage of the main building, including the roof and bow window. The exterior of the Tannery Lane properties has been painted and the corridors in the main building have also been redecorated. The Manager has begun to review all care plans.

What the care home could do better:

Care plans are being reviewed at present and although assessments are comprehensive the distinction between the assessment and the actual care plan needs to be made clearer.

CARE HOMES FOR OLDER PEOPLE Five Bells Residential Care Home 28 Market Place Folkingham Lincolnshire NG34 0SF Lead Inspector Julie Western Unannounced 27 July 2005 09.30 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 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 C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Five Bells Residential Care Home Address 28 Market Place Folkingham Lincolnshire NG34 0SF 01529 497412 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Ronald Bridle Mrs Barbara Bridle Mrs Della Graham Care Home 25 Category(ies) of Old Age (OP) - 22 registration, with number Physical Disability (PD) - 1 of places Dementia (DE) - 2 Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The part of the home identified as Unit 2 is used for couples only when used as a shared room. Date of last inspection 2/3/05 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, pub and post office. The home is registered as a care home and provides in the main care for older service users; however it is 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 19 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, more recently three bungalows within the grounds of the home. These provide self-contained accommodation for less dependent service users. These properties have also been built in keeping with the village setting and form part of the home’s registration. 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. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours. A partial tour of the premises took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussions with residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Four of the 19 residents and three of the 15 care and ancillary staff were spoken with. The Manager was present throughout the inspection and one of the owners was present for part of the 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. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 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 standard(s) 1-5 The home clearly sets out what it intends to do for its residents and this information is freely available to residents. 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; it was suggested that they were kept in residents’ rooms. Some residents had also been to the home to spend a day and have coffee or meals in the home; the Manager related how one resident had previously stayed at the home for a week’s free trial. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 8 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 standard(s) 7-10 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 Manager was currently reviewing and updating all care plans. The three care plans looked at in depth contained assessments and were signed where possible by the service user or relatives/advocates. A more clear distinction needs to be made between the assessment and the care plan. There was a clear medication policy and the next visit from the pharmacist was due in August. One resident commented ‘I’m quite happy here and I feel safe’ 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 C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 12,15 A 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 on two days a week. The notice board and various posters displayed a range of activities and events taking place, including a visiting theatre company and regular singing entertainers. Forthcoming events included a garden party in August, which villagers attended. Two residents spoken with said they had no wish to participate in any of the events and preferred to stay in their rooms. The activities organiser had developed a library for the home, with an extensive range of books, which were ordered. Residents were observed eating the mid-day meal, and comments such as ‘it’s very suitable for older people’ and ‘it’s very good’ were made. One resident had diabetic meals and one had a liquidised diet. The home has recently employed a new cook, who was undergoing her induction on the day of the inspection. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 16-18 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. One formal complaint from an anonymous source had been sent direct to the CSCI in the last twelve months; any issues from this were addressed. The home had a ‘compliments, comments and concerns’ book for the use of residents and visitors but 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 issues. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 19-22,26 The residents live in a comfortable and pleasant environment with both private and communal space, which is generally suitable for their needs. EVIDENCE: The standard of decoration internally was generally good and afforded residents a good degree of comfort. The gardens were well tended with flowers and a water feature in the courtyard area. The home has a rolling maintenance programme and. recent refurbishment and redecoration included major repairs to the frontage of the main building, including the roof and bow window, the repainting to the exterior of the Tannery Lane properties and the redecoration of the corridors in the main building. Risk assessments are carried out on the premises to ensure that residents are safe from any potential hazard. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 12 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,30 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 very positive about the care they received from the staff; one said ‘they’re very kind and communicate well with me’. The most recent staff member to be appointed confirmed that she had given two references, which were followed up, a CRB check and undertaken an induction programme before commencing work. Training was undertaken by in house and external trainers and showed that staff had received statutory training with future specialist training being a distance learning update on medication and correct use of incontinence needs. The next fire lecture was planned for 3rd August. Two staff members had National Vocational Qualification at Level 2 with one undertaking it. The staff rota showed that there were enough staff numbers according to the staffing. There was one vacancy for a gardener/handyman and on the day of the inspection the newly appointed cook was undergoing induction training. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 13 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-33, 38 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 Manager, who was appointed to the post in February of this year is unregistered at present and is applying to become the Registered Manager. She has worked in a hospital setting for 21 years and in a management position within this for 6 years. She is currently progressing towards the NVQ Manager’s award at Level 4. Residents spoken with said they were constantly asked for their views on matters concerning the running of the home. The Manager said that a meeting with the residents was scheduled for the following day. Quality assurance was conducted by sending letters to relatives/advocates, with any issues from these and from the meetings being addressed as they occurred. Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 14 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 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 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x x x 3 Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 15 none 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 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 OP7 Good Practice Recommendations It is a recommendation that care plans are revised to make a more clear distinction between the assessment and the care plan Five Bells Residential Care Home C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 16 Commission for Social Care Inspection Unity House, The Point Weaver 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 C53 C04 S2440 Five Bells V240731 270705 Stage 4.doc Version 1.40 Page 17 - 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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