Inspection on 14/07/05 for The Bell House

This inspection was carried out on 14th 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 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

The Bell House 09/05/06

The Bell House 01/11/05

The Bell House 29/11/04

The Bell House 24/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Bell House 61 Wilshaw Road Meltham Huddersfield HD7 3DX Lead Inspector Karen Summers Unannounced 14 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. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Bell House Address 61 Wilshaw Road Meltham Huddersfield HD7 3DX 01484 850207 01484 852101 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 Parvaiz Ahmad Mrs Lynda Margaret Quinn CRH 24 Category(ies) of PC - OP OLD AGE registration, with number of places The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 29/11/04 Brief Description of the Service: The Bell House is a privately owned care home registered to provide accommodation and care for up to 24 older people. The establishment is situated in a rural area on the outskirts of the village of Meltham, with panoramic views over the surrounding countryside. Public transport is accessible with a bus stop directly outside the home. The property, an extended bungalow, is generally well maintained to an acceptable standard. all bedrooms being for single occupancy, with eight having the provision of ensuite facilities. Communal areas are spacious and comfortable, with a well ventilated smoking area for the user of the service users who smoke. Well maintained garden and grounds are povided for the use of service users in the warmer weather. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to an unannounced inspection at The Bell House on Thursday 14th July 2005, commencing at 10.30am, and the duration of the inspection was 4.25 hours. Mrs K Summers, Regulation Inspector was accompanied by Ms C Stovin, Regulation Inspector, and the Head Senior Carer, Mrs M Balmforth, was also present at the inspection. The following methods have been used in the production of this report: sampling of records, care plans, individual discussion with 7 service users, tour of the premises and document reading. 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. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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 The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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) 3 No service user moves into the home without having had his/ her needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. EVIDENCE: Prospective service users and their relatives are encouraged to visit the home, and spend some time there before deciding to move in. All service users are admitted following a full assessment undertaken by people trained to do so, and to which prospective service user, his/ her representative (if any) and relevant professionals have been party. Each service user then has a plan of care for daily living based on the pre admission assessment. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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, 8 & 10 The care planning is not detailed enough to provide staff with the information they need to meet service users needs in a satisfactory way, or ensure that their health and social care needs are maintained. EVIDENCE: A lot of time and effort has gone into the recording of the care documentation, and included in that documentation were manual handling assessments and plans, monthly weight recording, risk assessments, including the risk of falls, however the plans did not set out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. The documentation should also include nutritional screening, (diet & fluids monitoring) which should be carried out on admission and then reviewed at regular intervals; and a tissue viability assessment (to identify the risk of developing pressure sores) should also be carried out at admission, using a recognised assessment tool and also be reviewed at regular intervals. The daily record should also reflect the care that has been given to the service user. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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, 13 &15 The lifestyles of the service users match their expectations and preferences. Service users are encouraged to maintain contact with family and friends, and they are made to feel welcome. A variety of meals are offered that take into account the likes and dislikes of the service users. EVIDENCE: Each service user had a record of their interests recorded, and the activities available reflect their expectations and preferences. Activities include “sing along”, ball games, board games, jigsaws, watching the television, and reading books and the local papers. One service user said that she ordered a daily paper, and also a magazine. There were satisfactory stock of food, which included fresh fruit and vegetables. The menus offered a variety of food, and the food preferences of the service users had also been taken into consideration. The types of sandwich fillings should be recorded, as the records would show the variety of food on offer, and also should there be an outbreak of food poisoning then the food served that day could be traced. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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 has robust systems to ensure that service users are safeguarded from abuse and that complaints are dealt with promptly. EVIDENCE: The establishment holds and adheres to a complaints procedure, which is displayed within the home. All staff have received training in adult protection procedures. The home holds and displays a ‘whistle blowing’ procedure. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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, 21, 25 & 26 Service users live in a homely environment however, not all areas of the home are well maintained, clean and a pleasant place to live. Until the radiators and hot water pipes in service users areas are appropriately covered service users are potentially at risk of being burnt. EVIDENCE: A number of bedrooms and a lounge had been redecorated and the main lounges were comfortable and satisfactorily decorated however, the corridors, bathrooms and toilets are showing signs of wear, and wallpaper was lifting away from the wall in a number of areas. In the bathroom located opposite the office, and the adjacent toilet, the floor coverings were stained and lifting away from the floor at the edges. The carpet in one of the bedrooms was also heavily stained, and there was a very strong unpleasant odour in that room. The registered owners are requested to re-decorate these areas and replace the bathroom and toilet floor coverings. Mrs M Balmforth said that the relatives of the service user, who occupied the bedroom, had expressed their wishes that the carpet not be replaced at this moment in time even though the home had a replacement carpet. In the interest of the health of the service The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 12 user, the manager should explain the situation to the relatives of the service user, and the carpet must be replaced. All unprotected hot water pipes and radiators in service users’ areas must be boxed in or, in the case of the radiators, be appropriately covered or have guaranteed low temperature surfaces. The temperatures of the hot water in service users bathrooms is been monitored however, it should not exceed 43 degrees Centigrade. Two bathrooms were been used for storage area. The bathrooms must not be used as storage areas. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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 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 The staffing levels and skill mix were sufficient to meet the number and needs of service users. Staff are also trained and competent to do their jobs. EVIDENCE: There was a sufficient number and skill mix of staff on duty to care for the number of service users in the home. 84 of care staff have achieved an NVQ level 2, or equivalent, and a further three staff, including the manager have an NVQ level 4 in management and care. The manager and her staff are to be complemented on the high percentage of staff that have the qualifications. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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 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) 33 & 38 Quality assurance and quality monitoring systems are in place based upon seeking the views of service users to ensure that the home is run in their best interest. EVIDENCE: The home attained the Investors In People award in March 2004. Satisfaction questionnaires are sent annually to staff, service users/ visitors, and visiting profession, and the comments that were received were most favourable. The comments included “I am always made to feel welcome.” “All staff are very friendly.” “Staff are appropriately trained.” One of the comments was that the interior of the building could do with a facelift. The outcome of the questionnaires were collated and made available to us. The fire records were not available at the time of the visit and therefore will be followed up at the next inspection. The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 1 x 1 x x x 1 x STAFFING Standard No Score 27 3 28 4 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 1 x x x 1 The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 16 NO 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 OP19 Regulation 23.-(2)(d) Requirement The registered provider ensures that - all parts of the home are kept clean & reasonably decorated. The registered provider is requested to provide a redecoration programme of the areas that are showing signs of wear by 22/8/05. The registered provider is also requested to confirm in writing by 22/8/05, when the bathroom and toilet floor coverings are to be replaced. FAILURE TO COMPLY WITH THIS REQUEST MAY LEAD TO FURTHER ACTION BEING TAKEN BY THE COMMISSION. 16.-(2)(j)make suitable arrangements for MAINTAINING SATISFACTORY STANDARDS OF HYGIENE in the care home; 16.-(2)(k) KEEP THE CARE HOME FREE FROM OFFENSIVE ODOURS. The provider must replace the stained, odourous bedroom carpet. FAILURE TO COMPLY WITH THIS REQUEST MAY LEAD TO FURTHER ACTION BEING TAKEN Timescale for action 22nd August 2005 2. OP19 23.-(2)(d) 22nd August 2005 3. OP19 16.(2)(j)(k)2 3.-(2)(d) 19th July 2005 The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 17 BY THE COMMISSION. 4. OP19 The registered provider is requested to CONFIRM IN WRITING by 22/8/05 when the work detailed in Schedules 1 & 2 of the Fire Safety officers report, dated will be addressed. (You were requested to complete the work by March 04 & then Aaugust 04 ) FAILURE TO COMPLY WITH THIS REQUEST MAY LEAD TO FURTHER ACTION BEING TAKEN BY THE COMMISSION. 23.-(2)(j) Bathrooms must not be used for storage areas. 13.-(4)(c) 13. -(4)(c)”unnecessary risks to the health or safety of service users are identified and so far as possible eliminated. ”Standard 25.5 – As stated at the last two inspection in May 2004, & November 2004, all UNPROTECTED HOT WATER PIPES AND RADIATORS in service users’ areas must be guarded or, in the case of the radiators be guarded or have guaranteed low temperature surfaces. The registered provider is requested to provided a schedule as to WHEN THE WORK WILL BE COMPLETED by 22/05. FAILURE TO COMPLY WITH THIS REQUEST MAY LEAD TO FURTHER ACTION BEING TAKEN BY THE COMMISSION. 25 A business & financial plan is requested to be sent to the Commission by 22/8/05. The request was previously made at the inspection in November 2004 Regulation Documentaion relating to fire/ 17.drills/tests/ training etc. Must be (2)Schedu kept at the home. le 4 J51J01_s26265_The Bell House_v223476_140705.doc 23.-(4) 22nd August 2005 5. 6. OP21 OP25 Ongoing 22nd August 2005 7. OP34 22nd August 2005 Ongoing 8. OP38 The Bell House Version 1.30 Page 18 paragraph 12. (d) & 14. 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 * The service users plan should set out in detail the action which needs to be taken by the care staff to ensure all aspects of the health, personal and social care needs of the servcie user are met. * The daily record should reflect the care that has been given to the service user. 8.3 - A Tissue Viability assessment should be used to identify those service users who are at risk of developing a pressure sore, or who have developed a pressure sore. 8.9 - Nutritional screening using a recognised assessment tool, should be carried out on admission and on a periodic basis. The types of sandwich fillings should be recorded. To prevent scalding, the pre-set valves on hot water taps should be set no higher than 43 degrees centigrade. 2. OP8 3. 4. 5. 6. OP15 OP25 The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 19 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 The Bell House J51J01_s26265_The Bell House_v223476_140705.doc Version 1.30 Page 20 - 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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