Care Home: Bellefield Residential Home

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What the care home does well A visitor to Bellefield said, "The care here is very good and (name`s) bedroom is lovely." A resident said, "They are doing very well, I am fine." Ten people who told us about their experiences in Bellefield were very satisfied. We received no concerns about the service during the visit. People`s care plans are clear, centred around their individual needs, and have been regularly reviewed. In this way staff have the guidance they need to support the person. By reviewing the care plans and identifying any change in the person`s condition, their independence will be supported, as they will receive the level of support they need. People`s diverse needs are supported in Bellefield by arranging for them to follow their chosen religious beliefs through links with local churches. A range of activities is in place, inside and outside the home, to ensure that people are given plenty of choice about how and where to spend their time. The AQAA informs us that there is a range of disability aids and equipment in Bellefield to support people who need assistance getting round. There is a clear complaints procedure in Bellefield and people said if they had any concerns, they would feel comfortable in talking with the manager or a member of staff. Training in safeguarding has been provided for staff, and in this way they have the knowledge and skills they need to identify and report suspected abuse.There is a training programme in Bellefield and staff performance is monitored to make sure they have the skills they need to support people. Staff who were spoken with during the visit said they received the training they need to support people. There is an ongoing NVQ training programme to give staff qualifications in care and according to training records, over fifty percent of staff have the qualification. What has improved since the last inspection? The AQAA informs us that since the last visit, decoration in Bellefield has been ongoing, giving a more welcoming feel to the home. There is also a wider range of activities on offer to meet people`s needs and preferences. Also there are now two moving and handling facilitators employed who will provide ongoing instruction to staff in supporting people`s mobility. Requirements from the last inspection were checked and have been met. Repairs and decoration have been carried out to the kitchen ceiling and the risks posed previously of food contamination from loose paintwork, have been removed. The televisions were receiving good reception, as the aerials have been checked and digital boxes provided. This has improved entertainment for people living in Bellefield. Staff received training in Patient Handling on 3/8/07 to ensure they have the skills to move people safely. Improvements to the financial systems in Bellefield mean that there is no delay in people receiving their personal allowances, and they may withdraw funds from safekeeping whenever they wish to do so. Action has been taken to include family members in the planning of care in instances where the resident wants this. CARE HOMES FOR OLDER PEOPLE Bellefield Residential Home 42 Aysgarth Avenue Liverpool Merseyside L12 8QT Lead Inspector Trish Thomas Key Unannounced Inspection 11:00 19th June 2008 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 Bellefield Residential Home DS0000025330.V362025.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. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bellefield Residential Home Address 42 Aysgarth Avenue Liverpool Merseyside L12 8QT 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) 0151 259 4397 bellefieldcourt@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited Mrs Paula Gresham Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th June 2007 Brief Description of the Service: Bellefield Residential Home provides accommodation and support for up to thirty-one people over the age of sixty five. This home is owned by Southern Cross, a national organisation operating a number of care services across the country. Staff are available to support residents twenty-four hours a day and meals and laundry services are provided. Bellefield does not provide nursing care for the people who live there. Accommodation is provided over two floors with a lift available to access the first floor. On the ground floor there are two lounges, a dining room and conservatory. Twelve of the twenty-nine bedrooms are en-suite and bathrooms and toilets are available on both floors. There is some on road parking to the front of the home, with a small seating area and car park located at the rear. Bellefield is situated in a residential area of West Derby close to local shops and amenities. There is access to public transport nearby. The fees for the service start at £322 per week with extra charges for en-suite facilities, hairdressing and chiropody. Bellefield Residential Home DS0000025330.V362025.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 two stars. This means that people receive good quality outcomes. The methods we (the commission) used to assess the service in Bellefield against National Minimum Standards are as follows. We carried out an un announced visit and spoke with people who live in Bellefield, three visitors, staff and the manager, Lisa Sutton. We looked at record kept in the home, including those for health & safety and staffing, to make sure the home is safe and that staff are properly vetted. We looked in detail at the care plans of three people to make sure that staff have the guidance they need to support each person. The Annual Quality Assurance Assessment (AQAA) had been filled in and returned to us before the date of the visit. This gave us information about how the home has developed over the past twelve months, plans for future development and any barriers to improvement. What the service does well: A visitor to Bellefield said, “The care here is very good and (name’s) bedroom is lovely.” A resident said, “They are doing very well, I am fine.” Ten people who told us about their experiences in Bellefield were very satisfied. We received no concerns about the service during the visit. People’s care plans are clear, centred around their individual needs, and have been regularly reviewed. In this way staff have the guidance they need to support the person. By reviewing the care plans and identifying any change in the person’s condition, their independence will be supported, as they will receive the level of support they need. People’s diverse needs are supported in Bellefield by arranging for them to follow their chosen religious beliefs through links with local churches. A range of activities is in place, inside and outside the home, to ensure that people are given plenty of choice about how and where to spend their time. The AQAA informs us that there is a range of disability aids and equipment in Bellefield to support people who need assistance getting round. There is a clear complaints procedure in Bellefield and people said if they had any concerns, they would feel comfortable in talking with the manager or a member of staff. Training in safeguarding has been provided for staff, and in this way they have the knowledge and skills they need to identify and report suspected abuse. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 6 There is a training programme in Bellefield and staff performance is monitored to make sure they have the skills they need to support people. Staff who were spoken with during the visit said they received the training they need to support people. There is an ongoing NVQ training programme to give staff qualifications in care and according to training records, over fifty percent of staff have the qualification. 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. Bellefield Residential Home DS0000025330.V362025.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 Bellefield Residential Home DS0000025330.V362025.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have had their needs assessed and have the information they need before making the decision to move in to Bellefield. EVIDENCE: Standard 1,3. Bellefield has a service user guide, which is given to people before they move in. This provides them with plenty of information on which to make a decision as to whether this will make a suitable home for them. The AQAA informs us that the service user guide is available on DVD and audiotape for people who prefer this. The manager told us that people are invited to visit Bellefield to meet residents and staff before moving in. All admissions are subject to a twenty-eight day trial period, and in this way people will have had experience of living in Bellefield before finalising their decision to stay there. Also, staff will be able to make sure the home has the skills and facilities to meet the person’s needs. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 9 People have had their needs assessed before they move in by social workers and staff from Bellefield carry out a further assessment of their health, personal care and social needs. Pre-admission assessments for three people were read and the needs identified had been addressed in their care plans. Bellefield Residential Home DS0000025330.V362025.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs have been set out in their individual care plans, which guide staff as to how their needs are to be met. EVIDENCE: Standards ,7,8,9,10. To look at the guidance given to staff as to how people will be supported, a sample of three care files was read. Each person had a care plan, which had been regularly reviewed to make sure that any change in the person’s condition will be identified. In this way people will maintain their independence and receive the level of support they need. To promote each person’s welfare, care plans have risk assessments in place for areas of support, such as nutrition and mobility with action taken to minimise the risk through focussed action plans. To make sure people who live in Bellefield have the medical support they need, they are registered with local G.P.s and records of medical referrals and outcomes are recorded in their care plans. For a resident who is diabetic, a Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 11 health care plan is in place. In this way, staff have clear guidance as to how to support the person’s medical condition properly for example by administering medication, ensuring a sugar free diet, and referring to the district nurse for professional guidance if needed. It was noted on people’s care plans that they have treatment from paramedical services and local clinics as needed. The AQAA informs us that residents have access to a range of services, including opticians, dentistry and aromatherapy. There is a procedure in place for managing people’s prescribed medication and staff said they have recently received relevant training. Storage and medication records were satisfactory at the time of the visit. There were risk assessments in place for people who self-medicate and these were seen. There is an audit of medication accepted in to the home and records are kept of returns to the pharmacy with signatures, to confirm receipt. In this way all medication will be accounted for. It is recommended that information sheets supplied by the pharmacist about prescribed medication, be held on care plans to inform the people taking the medication and staff about each drug and possible side effects. There is written guidance for staff on promoting the privacy and dignity of people who live in Bellefield in care giving, and in all contact with them and this is confirmed to us in the AQAA. People who were spoken with said they had no concerns about their treatment in this home. A visitor said, “The staff are very good here and (name) is very well looked after.” Visitors were seen being left in private with their relatives, and all records kept in the home were locked away to maintain people’s confidentiality. Bellefield Residential Home DS0000025330.V362025.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents of Bellefield have the lifestyle they choose and their cultural needs and beliefs are supported. EVIDENCE: Standards 12,13,14,15. Some people were enjoying a film show in the dining room at the time of the visit. Others were in the lounges and some were in their bedrooms entertaining visitors. We discussed arrangements for activities with the manager. An activities co-ordinator is employed and there is a range of scheduled activities on offer for residents of Bellefield. Each person has an activities plan to ensure they are able to do the things they like, and an activities calendar is displayed in the hallway. Some residents are becoming involved in charity work and a planning meeting about this was due to take place. A lot of work has been carried out in the garden and residents have been involved. Some people go out without staff being present, others who need support are escorted on shopping trips. There are links with a local school and churches and those who wish to follow their chosen belief are helped to do so. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 13 Residents’ choices and preferences are recorded in their care plans with regards to meals, rising and retiring times and chosen beliefs (if appropriate). In this way their diverse needs are respected and they are supported in following their chosen lifestyle when living in Bellefield. Qualified cooking staff are employed in Bellefield and the menus show a variety of home cooked meals with choices and alternatives available. This was supported by the content of the food stores, which had good stocks of fresh, chilled and frozen foods. A person who lives in Bellefield said, “Yes, the meals are good, nicely presented and hot.” Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents of Bellefield know their complaints will be listened to and they are protected through staff training and the safeguarding procedures in place. EVIDENCE: Standards 16 and 18. Bellefield has a complaints procedure, which is available to residents and their families. People who were spoken with said they would speak to the manager if they had a complaint, but they had not had any cause for concern. There are procedures in place for protection of vulnerable adults and “whistleblowing” and staff and training records confirmed to us that they have received the relevant training. In this way people will be protected because staff have awareness of the indicators of abuse and the procedures to be followed in reporting it. There have been no complaints to CSCI, or safeguarding referrals about Bellefield in the last twelve months. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bellefield is comfortable, clean and well maintained and is a suitable home for the people who live there. EVIDENCE: Standards 19 and 26. Bellefield is a purpose built care home with bedrooms on the ground floor and first floor, which can be reached by passenger lift. The home was in generally good decorative order at the time of the visit and the garden was well maintained. There are two lounges, a dining room and conservatory on the ground floor. There are two assisted bathrooms on the ground and first floors to aid people who have poor mobility, and the AQAA informs us that twelve of the bedrooms have en-suites. We visited one person in her bedroom. She said she is, “Very comfortable, I like to lie down during the afternoon for a rest.” Another person said, “My bedroom is just as I want it and it is a place where I can relax.” On the day of Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 16 the visit, during a tour of the premises, the conservatory was very warm. To make this room more comfortable for people it is recommended that an air conditioning unit be fitted. The home was very clean in all the areas, which were visited and people who live there said, “They work hard and keep the place clean and tidy.” “I have no complaints about the way this place is kept.” A visitor said, “The place is always nice and clean when I call in.” Domestic staff are employed and training schedules inform us they have received training in infection control. For staff guidance, there are procedures in place for the control of substances hazardous to health. These were being followed at the time of the visit by locking away cleaning materials when not in use. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 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 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. This judgement has been made using available evidence including a visit to this service. Residents are protected through the training and recruitment procedures followed in Bellefield. EVIDENCE: Standards 27,28,29,30. The staff rosters were seen and that for the day of the visit gave a true representation of the staff who were on duty. There is a training plan for this home, which shows us that staff have NVQ qualifications and regularly receive mandatory training and updates. This means that staff have the qualifications and skills they need to carry out their duties. Two members of care staff were spoken with, they said they receive plenty of training and good support from management. They were aware of POVA procedures and said they had received training. Bellefield has a recruitment procedure which was in evidence in a sample of staff files which were read. These showed us that prospective job candidates had filled in application forms and been interviewed. Two up to date, written references had been obtained for the person in addition to police and POVA clearances. In the way the employers will only employ people who are suitable to work in the care home. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Bellefield is managed in residents’ best interests and their health and safety is protected. EVIDENCE: Standards 31, 33, 35, 38 The newly appointed manager is Lisa Sutton, who has a management qualification and has applied for registration with CSCI. Ms. Sutton filled in the AQAA and returned it to us before the date of the visit and she provided all the information that was asked for during the visit. Two members of staff who were spoken with said that the manager is approachable and supportive. To ensure that residents’ opinions on the home are obtained, a series of internal audits take place, which are aimed at developing the service in a way, Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 19 which is based on their opinions. The manager said that relatives meetings have not been well attended in the past. To ensure they are able to have their say on behalf of the residents, the manager holds a “surgery” every Monday, when she is available to meet with people. She said there is an “open-door” policy and she is available for discussion with people on a daily basis. We spoke with the administrator, who is responsible for billing and personal allowance records. Staff do not have any involvement in residents’ personal finances or savings accounts. This is either in the control of the resident, their family or power of attorney (if necessary). Personal allowances (for day to day expenses) are held for five people in Bellefield, and we looked at the accounts held in the home. There is an audit trail of each transaction from a person’s account and receipts are retained for all purchases made on behalf of the person. A visitor said, “The staff do not get involved in (name’s) finances. If anything is needed I take care of it for (name).” To make sure the building and equipment in the home are safe for residents and staff, a series pf health and safety checks are carried out, including those for fire safety. The records were seen and these were up to date. A record of accidents is maintained in the home and these were seen and had been well maintained. The accident book is reviewed each month and in this way any trends will be identified and risk assessments carried out accordingly for residents’ protection. The laundry is well equipped and there are systems in place for infection control. The kitchen was well organised and storage of food was satisfactory, all frozen items, being labelled and dated. In this way residents’ health and safety will be promoted. Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 X X X X X X 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 Bellefield Residential Home DS0000025330.V362025.R01.S.doc Version 5.2 Page 21 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. 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 OP9 Good Practice Recommendations Information sheets supplied by the pharmacist about prescribed medication, should be held on care plans to inform the people taking the medication and staff about each drug and possible side effects. An air conditioning unit should be provided in the conservatory to maintain this room at a comfortable temperature for people to enjoy in summer months. 2. 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