Inspection on 07/06/05 for The Belmont

This inspection was carried out on 7th 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 Belmont 14/09/09

The Belmont 15/09/08

The Belmont 28/09/07

The Belmont 27/02/07

The Belmont 23/05/06

The Belmont 10/11/05

The Belmont 19/10/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Belmont Schools Hill Cheadle Stockport SK8 1JE Lead Inspector Kath Oldham Unannounced 7 June 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 Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Belmont Address Schools Hill, Cheadle, Stockport, SK8 1JE 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) 0161-428-7375 0161-428-7374 The Belmont Care Homes Ltd Ms J McManus CRH Care Home 40 Category(ies) of OP Old Age (40) registration, with number of places The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Maximum number of service users - 40. Service users to include up to 40 OP. A minimum of ten bedrooms must be refurbished in line with the National Minimum Standard by 1st September 2004. A minimum of a further ten bedrooms must be refurbished in line with the National Minimum Standard by 1st December 2004. All bedrooms must be refurbished in line with the National Minimum Standard by 1st June 2005. All radiators throughout the home must be covered or provide guaranteed low temperature surfaces by 1st September 2004. Bathrooms and toilets must be refurbished by 1st December 2004. Date of last inspection 19 October 2004 Brief Description of the Service: The Belmont is a large, two-storey house set in its own extensive grounds. In the past, the home belonged to the Kendal Milne family, although its history extends further back. The home provides a service to 40 older people. The home has four lounge areas and two dining rooms on the ground floor. Stairs and a passenger lift are available to enable service users to access the upper floors. The home is situated near to the village of Cheadle and is well placed to a large retail shopping outlet. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 7th June 205. Action had been taken in relation to some of the requirements made as a result of previous inspections. Some had been fully addressed, but others required further improvement to meet the National Minimum Standards and the Regulations, and there were others for which no action had been taken. The inspector spoke with some of the residents, the owner, manager, deputy and care staff. A partial inspection of the premises and an examination of a sample of records were undertaken. Verbal feedback of the findings of the inspection was given to the manager, during and at the end of the inspection. What the service does well: What has improved since the last inspection? All residents now have a terms and conditions of residency which clearly indicate the arrangements in place in the home. The service user guide has been amended, which again informs residents of the facilities and services within the home. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 6 Some alterations have been made to the environment which improve residents’ comfort. All residents’ bedrooms have a table which they use in a variety of ways. Additional laundry and domestic staff have been appointed since the last inspection, which has improved the cleaning and laundry service. 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 Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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 Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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) 1, 2, 3, 4 & 5 Residents are provided with information to enable them to make a decision as to whether the home can meet their needs. EVIDENCE: Residents are provided with details about the home within the service user guide. A contract for residents who are funded by the local authority is in place in addition to a terms and conditions of residency for all residents. Staff were able to give a clear and detailed account of the care each resident needed. They were aware of the residents’ particular likes and dislikes and their preferred daily routine. Staff knew residents’ families and the amount of involvement they wished to have in planning their care. Examination of three care files showed that assessments had been completed for all of them, which had been reviewed and updated during their stay with extra information as it became known. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 9 One resident accommodated at the home has communication difficulties due to deafness and being without speech. Staff had acquired some abilities in communication. However, thought had not been given to additional aids and appliances and more structured specialist communication for the resident. A resident’s family provides for one resident’s cultural needs. Prospective residents and their friends or families are able to visit the home. One resident said prospective residents are introduced and ask questions about the home which they are glad to answer. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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 & 10 Systems are in place to ensure, as far as possible, residents maintain good health. Care plans did not fully indicate residents’ needs. EVIDENCE: Residents are registered with a GP. Residents said they received visits from the chiropodist, dentist, optician and their GP. One resident said they had been taken to a hospital appointment. Relatives said that any concerns or deterioration in their cared for relative’s health or physical condition was responded to quickly and they were appreciative of being kept informed. One relative told the inspector that staff were wonderful and that they wouldn’t want their relative to live anywhere else. Residents said that they were always treated with respect. Each resident’s file inspected contained a care plan. However, the detail needs to be developed and attention taken to ensure that the needs of residents are recorded. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 11 Risk assessments were on file but need updating to record the risks to specific residents. One resident said they had everything they needed at the home in relation to care and attention. Another resident said it was the next best thing to home. Medication administration was recorded. Some residents are prescribed controlled drugs: these records contained defaced entries. The name of the medication was not always recorded. Improvements to the administration of medication have been introduced which provide additional safeguards for residents. Residents said they were able to meet their visitors in private if they wished and received medical attention in the privacy of their bedrooms. Service users have access to a telephone on the ground floor. One service user stated it would be beneficial for an additional telephone to be situated on the first floor. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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 Residents were, in the main, able to make their own day-to-day decisions and choices. Independence was promoted, as were dignity and privacy. Meals were enjoyed by residents. EVIDENCE: Residents said they were able to get up and go to bed when they wished. Staff were aware about residents’ preferred routines when they were unable to express themselves. Some residents were able to go out of the home with relatives and friends. The activities co-ordinator was aware of residents’ likes and dislikes in regard to activities and has developed activities to suit individual residents’ wishes and interests. Residents go out of the home on organised activities and have entertainers visiting the home. Residents said that they discuss with the activities co-ordinator what they want to do. Residents said that visiting took place at any reasonable time, and their visitors were made to feel welcome by the staff. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 13 The food was enjoyed by residents, which they said was good and plentiful. The dining room was pleasantly presented and mealtimes tended to be a focal point of the day when residents met to socialise. The kitchen contained defective equipment that was still in use. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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) 16 & 18 Complaints and adult protection procedures were in place. complaints and adult protection issues need to be improved. Recording of EVIDENCE: The home has a complaints policy and procedure; there were a couple of entries in the record since the last inspection. A number of entries in the record were not complaints but a record of events that should be recorded in residents’ care files. Residents told the inspector that they knew who to complain to and felt that their complaint would be dealt with in a suitable manner. One relative said that they were aware of the complaints procedure and any concerns they had raised in the past had been dealt with promptly and effectively. Residents said they felt safe living at the home. The home has a procedure for responding to allegations of abuse. A number of staff have attended in-house training on the subject to increase staff’s awareness of adult protection. The manager and deputy have attended local authority training and the staff group are due to attend on future dates. Staff said that if they suspected abuse they would report their concerns to the manager. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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, 21, 23, 24, 25 & 26 The environment was not fully maintained to ensure the safety of residents. Bedrooms and communal areas were clean. EVIDENCE: The bathrooms and toilets were found to be poorly decorated, in that, wallpaper was hanging off the walls and floor coverings were in need of replacement. Service users commented that the bathrooms and toilets were shabby. A call system is provided in the home, which enables service users to call for the assistance or support of staff. Service users commented that when asking for assistance, this is provided, however they are, on occasions, left for long periods of time awaiting the return of staff. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 16 There is awareness by the registered person of the work, which needs to be undertaken to improve the bedrooms and this has commenced. Examples of comments made by service users were: that their bedroom, although comfortable, did need redecoration. Other service users did not feel that their bedrooms were in need of refurbishment. One service user said their bedroom was warm and she had a comfortable bed. One resident said it was frustrating that her clothes were becoming creased and squashed. Some residents said they still did not have a lockable cupboard or drawer in their room. One resident said that other residents who are unsteady on their feet could burn themselves if they fell against the uncovered radiators. Residents said they were satisfied with the laundry service. The safety of the service users was compromised by the practice of wedging open fire doors. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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 & 30 The number of staff on duty during the day and in the evening was not sufficient to meet residents’ needs. Staff training is in place to assist in the provision of care and to safeguard residents. EVIDENCE: Information provided for inspection showed there were a maximum of five staff on duty and, on occasions, only four staff to provide personal care for the residents. Residents have previously commented on waiting considerable time to receive care and attention. Service users said that there are times when there are not enough staff on duty. Staff said that the workforce was stable and when agency staff are used, they were the same staff, ensuring that staff who know the residents cared for them most of the time and who were aware of the needs of those with difficulty communicating. A number of staff have obtained NVQ Level 2 qualifications and a number were in the process of completing the training. Staff had received training in keeping with safe practice guidelines. Service users commented on feeling confident in the staff’s abilities. Residents and relatives spoke highly and fondly of the staff. One resident said that staff were polite and caring towards them. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 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) 31, 32, 33, 36 & 38 The home had a qualified manager who, in the main, supported and directed staff. Some health and safety issues in the home need to be addressed. EVIDENCE: The manager at the home has NVQ Level 4 in management and care and has attained the registered manager’s award. The manager has continued her studies to ensure her abilities and skills are improved upon. Formal supervision of the manager needs to take place to further develop her skills in management issues. Residents said they could and do approach the manager on any issues that they have and said the regular meetings they have make them feel involved in the running of the home. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 19 Staff receive regular appraisal to support them in their work. The recording of staff appraisal needs to detail the content of the meeting. The registered person has nominated a representative to undertake monthly visits to the home, the reports of which are not routinely sent to CSCI as required by Regulation. Health and safety records and certificates inspected included fire safety and accident records. Inspection of these records identified that a report of accidents experienced by residents had not been sent to CSCI as required by Regulation. The fire records identified that some staff had not received fire training as prescribed by the Fire Authority. Checks to the fire safety systems were not recorded as having been undertaken since 20th May 2005 which has the potential for resident and staff safety. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 20 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 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 x 2 x 1 1 3 3 STAFFING Standard No Score 27 2 28 4 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 2 3 3 x x 3 x 2 The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 Requirement The registered person must ensure that staff have the skills, expertise, experience and training to meet the assessed needs of service users prior to their admission. The registered person must ensure that the risk assessments in place record the risks identified. The registered person must develop the care plans ensuring all areas of residents needs and interventions are detailed. The registered person must ensure that the controlled drugs record does not contain defaced entries and that the name of the medication is clearly indicated. The registered person must further develop recording in the complaints book to detail all aspects of the complaint, the investigation and outcome. The registered person must cease the practice of wedging bedroom doors open. The registered person must provide evidence that the bathrooms and toilets are equipped to meet the needs of Timescale for action Immediate & ongoing 2. OP7 13(4) 31/08/05 3. OP7 15 4. OP9 13 31/07/05 5. OP16 Schedule 4 31/08/05 6. 7. OP19 OP21 23 23(1)(2) Immediate & ongoing 30/09/05 The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 22 service users. The registered person must redecorate all bathrooms and toilets. (Timescale of 01/09/04 not met). The registered person must ensure that service users needs are addressed in a timely manner and that they are not waiting long periods for the return of staff to assist in their personal care. (Timescale of 30/11/04 not met). The registered person must provide all service users with a lockable drawer/cupboard in which to place items securely and privately. (Timescale of 30/11/04 not met). The registered person must replace the carpets in the identified service users bedrooms. (Timescale of 30/11/04 not met). The registered person must fit covers to all the radiators in the home. (Timescale of 30/11/04 not met). The registered person must redecorate all bedrooms, giving priority to the vacant bedrooms. Consult with service users and/or their relatives/representatives on the choice of wall covering and funiture. (Timescale of 30/11/04 not met). The registered person must replace the furniture, i.e., drawers, cupboards and wardrobes, where identified at the time of inpsection. (Timescale of 30/11/04 not met). The registered person must provide the manager with formal structured supervision. (Timescale of 21/12/04 not 8. OP22 12(1) 31/07/05 9. OP23 16(1)(2) 13(4) 23(2) 31/08/05 10. OP23 16(1)(2) 13(4)(c) 31/08/05 11. OP23 16(1)(2) 13(c) 16(1)(2) 31/08/05 12. OP23 30/09/05 13. OP23 16(1)(2) 31/08/05 14. OP31 18(1)(2) 31/07/05 The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 23 met). 15. OP31 26 The registered person must, as part of the Reg 26 visit and subsequent report, interview, with their consent and in private, service users, their representatives and persons working in the home in order to form an opinion of the standard of care provided. (Timescale of 30/11/04 not met). The registered person must introduce an annual development plan for the care home, based on a systematic cycle of planning, action and review. (Timescale of 30/11/04 not met). The registered person must ensure that all staff have undertaken fire drill training six monthly. (Timescale of 30/11/04 not met). The registered person must ensure that fire safety checks are undertaken and recorded at the frequency recommended by the Fire Authority. 31/08/05 16. OP33 10(1) 12(1) 24 31/08/05 17. OP37 23(4) 31/08/05 18. OP37 23 Immediate & ongoing 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. 2. Refer to Standard OP7 OP7 Good Practice Recommendations The registered person should arrange for staff to have training in risk assessments and how to identify risk for individual residents. The registered person should further develop the staff team to enable them to complete the daily/night reports in sufficient detail to give an indication of how service users have spent their day. The registered person should consider ways of providing a telephone for service users on the first floor. F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 24 3. OP10 The Belmont 4. 5. OP15 OP18 6. OP36 The registered person should ensure the cook has access to a safely functioning food mixer. The registered person should provide staff with specialist training in the definitions of abuse, how to recognise abuse in a care home setting and methods of reporting such abuse. The registered person should include the specifics discussed within the staff supervision sessions to enable the notes to be used as a development, guidance and assessment tool. The Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 2nd Floor Heritage Wharf Portland Place Ashton under Lyne, OL7 0QD 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 Belmont F54 F04 the belmont U s60734 v226684 070605 stage 4.doc Version 1.30 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!