Inspection on 24/06/05 for The Bell Memorial Home

This inspection was carried out on 24th June 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

The Bell Memorial Home 25/07/07

The Bell Memorial Home 10/05/06

The Bell Memorial Home 29/11/05

The Bell Memorial Home 04/11/04

The Bell Memorial Home 22/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE The Bell Memorial Home 164 South Street Lancing West Sussex BN15 8AZ Lead Inspector Mrs. Kerry Leppard Unannounced 24 June 2005, 16:00 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 Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Bell Memorial Home Address 164 South Street, Lancing, West Sussex, BN15 8AZ 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) 01903 752020 The Bell Memorial Home Mrs Maureen Condick CRH (PC) Care home only 46 Category(ies) of OP-Old age, not falling within any other category registration, with number of places The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 46 persons in category OP Date of last inspection 4 November 2004 Brief Description of the Service: The Bell Memorial Home is a detached building which is set back off the main road, close to local shops, amenities and the sea front in Lancing. The home offers care and support to service users but is not registered to provide nursing care. The Bell Memorial Home is registered to provide accommodation for 46 service users in the category OP (Old age, not falling within any other category). The home offers separate sitting and dining rooms and additional areas where activities can take place. A smoking room is also provided on the ground floor. Twelve rooms provide en suite facilities. There is a well maintained garden at the rear of the home.The registered manager is Mrs. Condick and the Responsible Individual for the home is Mr. Bennett. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted on Friday 24th June between 4pm and 9pm. Two regulatory inspectors and the business relationship manager for the West Sussex area office carried out the inspection. Prior to the inspection two health & social care professionals and two GP comment cards were received. Feedback from these has been used in this report. The inspectors spoke with eleven residents who were in their own rooms and communal areas about their experiences of living at The Bell Memorial Home. Comment cards were left in the home and any feedback received from these will be used in preparation for the next inspection of the home. The registered manager accompanied two inspectors on a tour of the premises and was able to discuss areas of improvements to the building since the last inspection. The inspectors also spoke with five staff on an individual basis. What the service does well: Feedback from residents about the staff, the care and food they get at the Bell Memorial Home was very positive, comments from residents included “the staff are very kind” “the staff are excellent” “they’re always willing to help you” “I am very happy, I think it’s a lovely place. They look after me very well”. Staff said that they enjoyed working at the Bell Memorial Home, that communication and support was good and that the management are approachable. The Bell Memorial Home has the benefit of being an accredited training centre and therefore has the resources to provide a good standard of training to its staff. Staff are enthusiastic about the training opportunities available to them. The inspectors found that the management of medication in the home was of a very good standard. All arrangements including record keeping were appropriate and accurate. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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 standard(s) 3 & 5 Residents and their families are invited to look around the home before deciding to live there. Assessments of need are not always done to ensure that the home will be suitable for the resident. EVIDENCE: Prospective residents and the families are invited to look around the home. A new resident said she came to see the room before she came to live at the home. Full assessments had not been done in relation to a new resident and someone who was due to arrive for respite 2 days following the inspection. Inadequate assessment information puts staff and service users at risk of providing and receiving inappropriate care. Through sampling resident records it was evident that two residents have been admitted to the home although they have a diagnosis of dementia. The Bell Memorial Home is not registered to accommodate residents with dementia and The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 9 this impacts significantly on training for staff and staffing levels to meet these needs. It is recommended that Community Mental Health Team input is sought in relation to residents with dementia and training and staffing levels be reviewed to meet these needs if the Bell Memorial remains a suitable placement. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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, 8 & 9 Care plans set out the health, personal and social care needs of residents. Health care input is good, monitoring of nutrition could be improved. Medication is well managed in accordance with the home’s policies and procedures. EVIDENCE: Resident care plans were sampled, they contain comprehensive information about the needs of residents. Responses from health and social care worker comment cards indicate that staff demonstrate a good understanding of the care needs of residents and that any specialist advice that is given is incorporated into the care plan. Care plans include disclaimers which residents have signed to say they do not want to be consulted about their care plan, however three residents who spoke with the inspector did not know about their care plan. One resident was very well informed about his care plan. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 11 Residents said they could see their doctor when they wanted and one resident said that district nurses visit her regularly. Responses from GP comment cards indicated that both were satisfied overall with the care provided, that senior staff are available to confer with and that the home communicates clearly and works in partnership. Although resident’s records included an eating and drinking plan, nutritional assessments had not been undertaken for any of the residents whose records were sampled and weight monitoring is not done regularly. Medication is well managed at the Bell Memorial; including risk assessments in relation to residents who wish to self medicate to ensure this is safe. Both GPs who completed a comment card felt that medication is appropriately managed in the home. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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, 13, 14 & 15 Routines in the home could be more flexible. Opportunities are offered for residents to be involved activities and for contact with family, friends and the local community Residents are offered a choice of food and refreshment throughout the day. EVIDENCE: From observations and discussion it is evident that the Bell Memorial is substantially routine driven as a home, particularly in relation to meal times and the provision of personal care. There is little flexibility about where residents can take their meals and rotas are in place for getting up, bathing and room cleaning. Staff are nominated as key workers for residents and said that this might include doing some shopping and helping with correspondence. A programme of activities is provided and staff are encouraged to share their skills, interests and hobbies with residents through this programme. Activities mentioned and enjoyed by residents include flower arranging, movement, cards, outings and the pub quiz. Residents also mentioned that they go out to church. Staff spoke enthusiastically about spending their own time with The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 13 residents to provide additional enjoyable activities inside and outside of the home. Residents said that the food is very good and there is plenty of it, comments included, “. Food is very good. home made..very good chef” “the food is very good, 2-3 choices” “the food is very good, plenty of choice and lots of it”. A drink is served to residents in the evening. Feedback indicated that biscuits are not always offered with this drink, when an evening snack is not provided, the time without food exceeds twelve hours. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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) 18 The homes training and practises help protect residents from abuse. EVIDENCE: Staff know their responsibility for reporting possible abuse. One member of staff said that she is currently doing a training course in dementia, which includes strategies for dealing with and diffusing aggression. Risk assessments in relation to challenging behaviour were evident on some of the care records sampled. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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, 22, 24 & 26 The environment is subject to ongoing improvement, which is needed to maintain and raise the standard of accommodation. The building is old and décor and lighting need to be kept under constant review in order to promote a homely environment. Specialist equipment has been obtained to meet residents needs. More equipment could be provided to maximise resident’s independence. Bedrooms are furnished with some items of residents own belongings and meet their needs. The home is clean and hygienic. EVIDENCE: Substantial work has been done to improve the appearance of the home but many ceiling tiles need replacing and paintwork needs attention to improve the surroundings and create a homely environment. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 16 However, residents rooms have been made comfortable with their own belongings and residents who spoke with the inspectors were happy not to have a lock on their bedroom door, one resident said she was happy with the arrangements for respecting her privacy and dignity. Aids and equipment are in use in the home to aid independence and support staff with good moving and handling. However it was noted that there are no hand rails in corridors and one resident said she would like a grab rail in her bedroom, it would therefore be appropriate to have an assessment of the premises as set out in the National Minimum Standards. The premises were clean and tidy on the day of the inspection. It was noted and brought to the registered manager’s attention that cleaning products are being stored in bathroom and therefore they present a risk to service users. This is in contrast to previous good practice within the home. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 17 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 & 29 Staffing levels and recruitment procedures could be improved to ensure the protection of residents. Good progress is being made with National Vocation Qualifications. EVIDENCE: To adequately reflect the dependency of residents, particularly those with dementia who were observed to need more support during the afternoon and early evening, staffing levels should be reviewed. Most residents spend most of the daytime in communal areas and those with limited mobility do not have access to a call bell during this time, therefore some residents have to find staff to assist others, a review of the deployment of staff should address this issue. Recruitment records were sampled for two recently employed staff all necessary checks are made prior to employment commencing including a PoVA First check if the applicant is to begin work supervised before receipt of the full CRB disclosure. To ensure the protection of residents, gaps in employment must be explored and written records made of the explanations given. The Bell Memorial Home has the benefit of being a training centre and has achieved 56 of staff trained to NVQ Level 2. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 18 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) 32 & 36 The homes management are approachable and staff feel they are supported Regular supervision is provided to care staff. EVIDENCE: Staff were very positive about the working environment at The Bell Memorial Home and said that communication is good, handover is given at the beginning of each shift and staff meetings are held regularly. Staff said they received regular supervision from the deputy manager 2-3 monthly and records confirmed this. The registered manager must ensure that supervision is done every other month to meet the National Minimum Standards. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 1 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x 2 x 2 x 2 STAFFING Standard No Score 27 2 28 3 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 3 x 3 x x x 3 x x The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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 3 Regulation 14(1)a&b Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so-the needs of the service user have been assessed by a suitably qualified or suitably trained person; the registered person has obtained a copy of the assessment. The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety Timescale for action 24th July 2005 2. 26 13(4) 24th July 2005 3. 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 7 Good Practice Recommendations It is recommended that the care plan be drawn up with the involvement of the service user, agreed and signed by the service user H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 21 The Bell Memorial Home 2. 8 3. 4. 5. 6. 14 22 27 29 It is recommended that nutritional screening be undertaken on a periodc basis, a record maintained of nutrition, including weight gain and loss and appropriate action taken It is recommended that routines in the home be driven by service users choices It is recommended that an assessment of the premises be undertaken in relation to aids and equipment. It is recommended that staffing levels and the deployment of staff in the home be reviewed to ensure service users needs are being met. It is recommended that the homes recruitment process include exploring gaps in employment and recording the explanations given. The Bell Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Memorial Home H60-H11 S14768 The Bell Memorial Home V221495 110505 Stage 4.doc Version 1.20 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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