Inspection on 27/07/05 for Belmont Lodge Care Centre

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 Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Belmont Lodge Care Centre 20/12/07

Belmont Lodge Care Centre 15/09/06

Belmont Lodge Care Centre 26/01/06

Belmont Lodge Care Centre 20/12/04

Belmont Lodge Care Centre 28/06/04

Belmont Lodge Care Centre 11/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Belmont Lodge 392/396 Fencepiece Road Chigwell Essex IG7 5DY Lead Inspector Sharon Thomas Unannounced 27th July 2005 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. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Belmont Lodge Address 392/396 Fencepiece Road, Chigwell, Essex, IG7 5DY 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) 0208 500 5222 0208 559 8100 Diomark Care Ltd Care Home 46 Category(ies) of Old age, not falling within any other category 46 registration, with number Both of places Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, age 65 years and over, who require care by reason of old age (not to exceed 46 persons) Date of last inspection 20th December 2004 Brief Description of the Service: Belmont Lodge is a large detached house located in a residential area in Chigwell. The home is registered to provide residential care to 46 older people (i.e. over the age of 65), with varying degrees of dependency. Residents are accommodated in 36 single rooms and 5 double rooms. The home has several lounges and a dining room. The home provides facilities, aids and adaptations that enabled staff to deliver quality care. The home promotes the rights of service users and provides care with privacy and dignity. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 27th July 2005, and took 5.5 hours. Ten of the thirty-eight National Minimum Standards were inspected: three were met, and seven were nearly met. For the purpose of this report the individuals living in the home spoken with on the day stated that they would prefer to be called residents. The inspection process included: discussions with the acting manager, two members of staff, the cook, and three residents. The tour of the premises included observation of four bedrooms, the bathrooms and toilets, the communal areas, the kitchen and the laundry. There was an opportunity to spend a considerable period of time observing the care being provided by the staff. The inspection included the examination of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). The home was warm clean and tidy. The residents spoke highly of the care that they receive in Belmont Lodge and spoke highly of the efforts of the staff. The home has had difficulty in recruiting to the manager’s post and this may have contributed to the recent fall in standards. The home has a number of residents who appear to have dementia, it was agreed that a re-assessment of these residents would be completed with a view to the home applying to vary the registration to residential care with specific beds for dementia. What the service does well: The home provides a warm and homely atmosphere for residents. The home provides a well-balanced and varied diet for residents. The kitchen was well stocked, clean and well maintained. The staff group in Belmont Lodge are enthusiastic, well trained and skilled. All of the residents spoken with on the day stated that the staff were ‘kind and caring’ and the home was ‘very nice’. Residents reported that relatives and visitors are welcomed into the home at all times. The staff were observed to Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 6 chat continually with the residents and involve them as they went about their work throughout the day. The home has close links with the health care team in the area, and works with both professionals and residents to promote and maintain the residents health. What has improved since the last inspection? What they could do better: The home did not ensure that it received a professional assessment prior to the admission of residents. The care plans in the home did not fully reflect the care needs of the residents. The care plans were not reviewed or updated on a regular basis. The home did not accurately record the administration of medication. The home did not provide appropriate activities for the residents who live there. The home did not ensure that all the staff recruitment checks required prior to employment were carried out. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 7 The home did not ensure that the residents were offered choice in their daily lives. The home does not accurately record hot water temperatures. 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. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 8 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 Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 9 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) 3 The home did not receive all of the appropriate information required prior to admission. The lack of information may result in the inappropriate admission of a resident and place that person at risk. EVIDENCE: One of the care plans looked at was that of the newest admission into the home. It did not contain a social services assessment and there was no evidence that the resident and their family were involved in the care planning process. The home had used its own pre-admission assessment and the information gathered was insufficient. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, Evidence examined indicated that the home’s care planning systems are insufficient. The residents care needs were not fully identified, planned for, or monitored in an appropriate manner. The shortfalls identified have the potential of placing resident at risk. The administration of medication is unsafe, and places residents at risk. EVIDENCE: Three care files were examined. All contained information regarding the resident’s needs, the action taken to address these needs, and the long-term outcome of the care given. The care plans did not cover all aspects of a resident’s physical, mental and social needs, and were not reviewed on a monthly basis. There was no evidence that residents signed care plans or were involved in the planning process. Residents spoken with confirmed that the staff in the home provided them with a good level of support and assistance. They commented that the staff knew “the things that I need” and that staff “do a very good job to look after all of us”. Staff were observed treating residents with care and sensitivity, one resident who became distressed received calming re-assurance from staff. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 11 The home has a clear and comprehensive medication policy and procedure. The medication administration records of all medication used in the home were not accurate and major gaps were found in the recording. The records of the receipt and disposal of medication were accurate and up to date. The staff spoken with confirmed that they have received appropriate training and support, with regard to medication and were confident that they ensured the safety of the residents when giving medication. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 & 15. The home does not provide an appropriate range of activities for residents. Routines in the home are not flexible and residents are not enabled to exercise choice. The home provides the residents with a varied, nutritional and wellbalanced diet that addressed specific individual need. EVIDENCE: Discussion with residents indicated that routines in the home were not flexible and the residents’ individual choices were not fully addressed. One resident reported that “I am usually put in the living room but I would like to sit in my bedroom”. Two residents confirmed that there was a programme of activity, when the programme was examined it was found to be inappropriate and did not offer a range of activity for residents. During the inspection residents were found in the communal area sitting in their wheelchairs one behind the other, no effort had been made by the staff to transfer these residents into armchairs. Two of these residents reported that they “always sit in their wheelchairs” and are “not asked to sit in a chair”. The menus examined reflected that the home provided residents with a variety of well- balanced, nutritional meals. The kitchen was clean and well organised, and the food stocks were high and of good quality. Meals are freshly prepared and cooked by the chef who has a great deal of experience. The chef was skilled and has undertaken over and above the required training for their role. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 13 The meal presented on the day was appealing and the residents stated that the quality of food in the home was “good”. Residents confirmed that the meals provided in the home were “always tasty” and “well prepared”. Fresh fruit and snacks were available throughout the day, and residents confirmed that they could have a drink or snack at any time. When required, meals are liquidised and special dietary needs are catered for. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected. EVIDENCE: Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 15 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 &26. The residents live in a safe, well - maintained, clean and comfortable environment. EVIDENCE: Belmont Lodge is a home that meets the needs of the residents. The home has an annual maintenance programme that is held by the head office. The home is clean, bright and airy, and had a homely feel. The grounds of the home are well maintained and safe. The Fire Officer and Environmental Health reports were available for inspection. The home’s laundry facilities are located away from communal areas and individual bedrooms reducing the risk of cross infection. The equipment in the laundry is suitable for the needs of the residents. The washing machines in use have a sluice cycle that ensures that laundry is washed at appropriate temperatures. The home has a sluice in operation and this was clean and wellmaintained. Residents confirmed that their clothes were returned from the laundry “smelling nice” and “were well cared for”. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 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 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) 29 The recruitment procedure in the home was not robust and did not provide the safeguards to ensure that appropriate staff were employed, potentially putting the residents at risk. EVIDENCE: The four staff personnel files examined did not contain information necessary to ensure the safety of residents through the recruitment process. Two files did not contain the two required references. Two staff files did not contain a CRB check and the references attached did not contain enough information regarding the skills and knowledge of the individual. One of the staff had started work while another had not been given a start date. This issue was discussed on the day, and the manager was reminded that staff must not commence employment until the appropriate documentation was in place. There is a requirement made regarding this issue and this may be found below. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 17 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 & 38 The home did not have a permanent manager however there are clear lines of accountability in the home. Overall there were comprehensive health and safety systems in operation to ensure the ongoing welfare of both residents and staff. EVIDENCE: The acting manager confirmed that the most recent manager had not passed their probationary period and had resigned a week prior to this inspection. The home has put in place interim management cover until a manager has been recruited. The home has been without a permanent manager for some time and the inspector urged that this situation be rectified as soon as possible. The home provided staff with appropriate Health and Safety training. Risk assessments of the premises are undertaken and regular Health and Safety checks of facilities and equipment are also in place. The acting manager was Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 18 aware of relevant Health and Safety legislation and was committed to the welfare of both the residents and staff group. Hot water records were neither accurate nor up to date. The staff spoken with are committed to the safety of the residents and were able to discuss the potential hazards in the home. Staff were aware of Health and Safety issues around the home and wore personal protection clothing when needed. Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 19 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 x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 1 x x x x x x 2 Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 20 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (1) (a) Requirement The registered person must ensure that all professional assessemnt are received prior to the admission of prosective resident. The registered person must ensure that care plans include all relevant and up to date information. The care plans must be reviewed on a monthly basis. The care plans must provide evidence that the resident is involved in the decision making process. This is a repaet requirement. The registered person must ensure that the records regarding the administration of medication are accurate and up to date. This is a repeat requirement. The registered person must ensure that service users are consulted with prior to any changes that impact upon their care and quality of life. The registered person must ensure that service users are enabled to make decisions regarding the care that they receive, regarding their health and welfare. Timescale for action 27.07.05 2. OP7 15 (1) (2) 27.07.05 3. OP9 17 (1) (a) Schedule 3 27.07.05 4. OP12 16 (2) 12(2) 31.08.05 Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 21 5. OP29 7, 9, 19 Schedule 2 6. 7. OP31 OP38 12 (1) (a) 13 (4) (a) (c) The registered person must 27.07.05 ensure that all recruitment checks are undertaken prior to appointment. No member of staff should work in the home until all checks have been carried out. The registered person must 30.09.05 ensure that the home has a permenant manager. The registered person must 31.08.05 ensure that the hot water temperatures are recorded on a weekly basis. 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 Good Practice Recommendations Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Fairfax House Causton Road Colchester CO1 1RJ 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 Belmont Lodge I56-I05 s17768 Belmont Lodge v241968 270705 stage 4.doc Version 1.40 Page 23 - 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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