Care Home: Belle Vue House

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What the care home does well In previous inspections the home has been judged to be a good provider of care. The home is in a tranquil wooded rural area and is a peaceful place to live. The home continues to provide a warm and friendly environment. Personal attention and support is good. Both people living at the home stated they are very pleased to live in there and acknowledged their homely and ordinary surroundings as being a good choice and more satisfactory to them than a large care home. The home has consistently and continuously provided a good quality service where people are respected, are given freedoms and are listened to. There is a total absence of any institutionalisation, or feel that this is other than a family home. Family connections are encouraged by the efforts of the manager who ensures that people are not isolated and that family contact is a regular feature of living at the home. There are frequent visits from relatives. Family involvement is promoted by regular telephone calls to relatives. Family contacts extend to relatives of people no longer living at the home and this is where relatives have maintained contact and have been invited to the home on special occasions. Care plans are appropriately written and well maintained and are kept by service users in their rooms. The quality of meals and food provided and the plan that everybody eats together at the main dining table adds to a normal and ordinary way of living. What has improved since the last inspection? Building work to the side of the house has recently been completed to enlarge the paved area at the side of the house. Railings and a gate now enclose this enlarged paved area. The work has been completed to a high specification. This enlarged area has provided people with easier access and a safer area to sit in the sun, or to wander around in when the grass is too wet, or when it is too cold for people to venture into the extensive garden. One person has moved into the home since the last key inspection and her admission was carefully and sensitively planned. The manager has sought pharmacist advise for maintaining medication administration records, so that all prescribed medication is now in pre-written medication administration sheets. The manager has ensured that medication is provided in sealed containers. The Statement of Purpose has been reviewed. What the care home could do better: The home should consult with the Fire Safety Officer to ensure their place to store fire extinguishers is suitable and that the fire alarm system complies with fire safety standards. CARE HOMES FOR OLDER PEOPLE Belle Vue House Little Heath Gamlingay Bedfordshire SG19 3LL Lead Inspector Don Traylen Unannounced Inspection 11th September 2008 10:00 X10015.doc Version 1.40 Page 1 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 Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 2 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. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belle Vue House Address Little Heath Gamlingay Bedfordshire SG19 3LL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01767 650226 F/P 01767 650226 Mrs Christine Lake Mrs Christine Lake Care Home 3 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (3) of places Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2006 Brief Description of the Service: Bellevue House is a large family residence that stands in an acre of attractive gardens in a quiet, rural setting. The property is situated in the village of Gamlingay, accessible by a single dirt track off the main road. The home has been established for over 12 years and is registered to take three service users over the age of 65 years, who may be people with age-related mental health needs. The registered provider, Mrs Christine Lake and her husband, live in the property. The home is furnished to a high standard. One member of staff is employed for one day each week and the proprietor has an arrangement with a suitably qualified person who can manage the home when holidays are arranged or when other circumstances prevail. Fees charged by the home are from £445 per week to £465 per week. The lower amount is the fee charged and paid by a Local Authority and the later is the fee charged to people who pay privately. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is “ 2 star”. This means the people who use this service experience good quality outcomes The last Key inspection was carried out on 15/12/2006 and an Annual Service Review (ASR) was carried out on 26/10/2007. This inspection lasted 3 hours. The home had completed and Annual Quality Assurance Assessment. The two people living at the home had indicated their views when they had assistance to complete the surveys sent to them. Time was spent talking to these two people, to ensure their views were heard. One person’s written care plan was discussed with her. We looked around the home, including one person’s room, as well as the extensive garden. The manager and one care worker were present throughout the inspection. What the service does well: In previous inspections the home has been judged to be a good provider of care. The home is in a tranquil wooded rural area and is a peaceful place to live. The home continues to provide a warm and friendly environment. Personal attention and support is good. Both people living at the home stated they are very pleased to live in there and acknowledged their homely and ordinary surroundings as being a good choice and more satisfactory to them than a large care home. The home has consistently and continuously provided a good quality service where people are respected, are given freedoms and are listened to. There is a total absence of any institutionalisation, or feel that this is other than a family home. Family connections are encouraged by the efforts of the manager who ensures that people are not isolated and that family contact is a regular feature of living at the home. There are frequent visits from relatives. Family involvement is promoted by regular telephone calls to relatives. Family contacts extend to relatives of people no longer living at the home and this is where relatives have maintained contact and have been invited to the home on special occasions. Care plans are appropriately written and well maintained and are kept by service users in their rooms. The quality of meals and food provided and the plan that everybody eats together at the main dining table adds to a normal and ordinary way of living. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5, Quality in this outcome area is good. People’s needs are always assessed before anyone moves in to the home and relatives have sufficient opportunity to assess if the home is suitable. This judgement has been made using available evidence including a visit to this service. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 9 EVIDENCE: The Statement of Purpose was reviewed and included a section that describes the homes approach to protecting their vulnerable service users. A comprehensive assessment for one person admitted since the last inspection was carried out by the Primary Care Trust (PCT) hospital based social worker. The PCT were funding her care. The manager stated she does also assess any person to ascertain they can be offered the appropriate care. The family of this person had visited the home prior to the admission being arranged. Each of the two people living at the home had been given a contract stating fees to be paid and a copy of the Statement of Purpose. Intermediate care is not provided. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11, Quality in this outcome area is good. The utmost respect and appropriate care has been continuously provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One person’s care plan was read. It contained accurate information and suitable and adequate detail about finances, the daily routines of care, care that had been planned for continence and risks assessments regarding the use of bedrails and handling hot drinks, food preferences and a plan to administer medication. A record of dental visits was kept. Her medication was supplied in a sealed ‘blister pack’, along with printed Medication Administration Records (MAR) sheets, issued by the pharmacist. Sufficient contact with District Nurses and other a physiotherapist to support this for this person’s rehabilitative needs were made. Both people living at the home spoke to us and said they are always treated with respects and good care by the home and are very pleased with the support they receive. Respect was evident in this discussion and in the Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 11 observations made of the personal interaction the manager and her husband conducted with both service users. People have been treated with sensitive care and comfort at the time of their death. This has been confirmed by the continuous contacts with their relatives and by the support provided by Community Nurses and GP. The home has habitually planted a tree, or other, to commemorate people who have passed away whilst in their care. Various families have shown their appreciation of the care provided by the home in their letters and cards sent to the home and by their attendance at ‘party’ recently hosted at Bellevue House. Sufficient contact with District Nurses and other community services are made to ensure the health and welfare of service users is attended to. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Quality in this outcome area is good. People’s lifestyles are in accord with their expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both people living at the home told us that their life was comfortable and was pleasing to them in the circumstances of their age and health. They both agreed that choices were made daily about the preferences and were given as much independence as they wanted. One person said he gets up and goes to bed whenever he wants. Both agreed the food was “very good” and that they always had sufficient to eat and drink. One person has regular visit from his family and the other person has telephone contacts and visits from her family. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Both people living at the home told us they would have no concerns about speaking to the manager should they have reason to complain. The home has a written policy stating their approach to abuse and they adhere to Cambridgeshire County Council’s guidelines and Bedfordshire County Council guidance regarding adult abuse procedures. The manager has arranged refresher adult protection training for herself the two relief staff have received training in Protecting Vulnerable Adults from Abuse provided by Cambridgeshire County Council. Discussion with the manager demonstrated she is aware of how vulnerable people moving into the home are and stated she would report any suspicion of abuse if she felt this was necessary. The manager is aware of the limited social contact people have and how isolated they might feel. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26, Quality in this outcome area is good. People are assured of a well-maintained and clean environment. This judgement has been made using available evidence including a visit to this service. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 15 EVIDENCE: The home is very clean, fresh and comfortable. It is suitably furnished and is spacious. Each person’s room had been individualized with their possessions. Both people said they were satisfied with their rooms. Toilets and bathrooms are situated near to lounges and to each bedroom. The external area to the side of the house has been improved and made safer by the extended and enclosed area that has been paved and surrounded by a wall and railing with an entrance gate. The work has been completed to a good quality finish and standard. This area had seating and tables for sitting in the fresh air and sunshine, in addition to the patio area at the rear of the house. The extended paved area allows people to choose to walk freely and be safe from wandering outside of the home. All of the Standards in this section were met at the last inspection and have again been met at this inspection. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. People are assured they are given care by trained and attentive care staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All Standards were assessed and met at the previous key inspection. The manager and her husband provide the care and support. The home has regular and familiar relief care staff. One care workers is employed one day every. A registered nurse provides relief cover when the manager and her husband take a holiday. The manager had just returned from a holiday the day prior to this inspection. People were seen to be reassured by the relief carer who was working on the day of the inspection. One person said she is a “good girl” and showed they liked her. One care worker has attended a refresher course in ‘Adult Protection’ training. The manager had recently undertaken further/refresher adult protection training and First Aid training. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38, Quality in this outcome area is good. People are assured their best interests are promoted. This judgement has been made using available evidence including a visit to this service. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 18 EVIDENCE: Previous inspections have demonstrated that service users’ best interests are upheld by the management approach and philosophy of this home. People finances are not managed by the home, although the manager is aware to a degree when relatives manage people’s financial interests. The fire alarm was tested during the inspection and the weekly teats are recorded. The fire alarm consists of individual detectors connected to one electrical circuit without a control panel. The manager said she would ask the Fire Safety Officer to revisit and check the equipment and arrangement, to ensure that fire safety standards are complied with. Fire extinguishers and fire equipment were stored in the laundry room and had been appropriately serviced on 06/08/2008. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP38 Good Practice Recommendations The fire safety officer should be consulted regarding the suitable placement of fire extinguishers and the fire alarm system. Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Belle Vue House DS0000015226.V371278.R01.S.doc Version 5.2 Page 22 - 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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