Care Home: Belmont Court

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Inspecting for better lives Key inspection report Care homes for older people Name: Address: Belmont Court Basil Street Heaton Norris Stockport Cheshire SK4 1QL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christopher Bond     Date: 1 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Belmont Court Basil Street Heaton Norris Stockport Cheshire SK4 1QL 0161-4771282 01614806887 belmontcourt@boroughcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Borough Care Limited care home 34 Number of places (if applicable): Under 65 Over 65 0 0 34 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 34 34 0 The registered person may provide the following category of service only Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 34 Date of last inspection Brief description of the care home Belmont Court is a residential care home that is registered to provide specialist care for up to 34 service users who have dementia, including four service users with a diagnosed mental illness. Belmont Court provides permanent residential care, respite care and day care facilities for up to eight service users, available Monday to Friday. Day care facilities are located on the first floor with two members of staff being specifically employed for the day care unit. Belmont Court is one of 12 care homes Care Homes for Older People Page 4 of 28 Brief description of the care home owned by Borough Care Limited. Accommodation comprises of thirty single rooms, seven of which are located on the first floor, and two double bedrooms located on the ground floor. There are four lounge areas and one large dining room. The home is suitable for wheelchair users. A visitors kitchen is situated on the ground floor. A full passenger lift is in place. There are pleasant enclosed garden areas. The home is situated in Heaton Norris, close to Stockport town centre and motorway network. Public transport is easily accessible. Information about this home can be obtained through Statement of Purpose and Service User Guide provided by the home. There are also several leaflets avialable to explain the differing levels of service tha the home provides. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: As part of the inspection process an unannounced visit took place over a total of 4 hours on the 17th March 2009.The service users personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication procedures were also examined. We spoke at length to the manager, assistant manager and care supervisor of the service during the inspection. We spoke to one of the care staff. Five residents were also spoken to as part of the inspection process. The Commission for Social Care Inspection also sent out surveys to service users and care staff: the views of those who returned them have been included in this report. Care Homes for Older People Page 6 of 28 Every year the registered person is asked to provide us with written information about the quality of the service they provide. They are also asked to make an assessment of the quality of the service. This information, in part, has been used to focus our inspection activity and is included in this report. The fees for this service are from GBP 355.00 to GBP 430.00 with extra charges for hairdressing and chiropody. What the care home does well: What has improved since the last inspection? What they could do better: The service needs to continue to improve the decoration in communal areas. Parts of the home are looking a little tired, although the service remains homely. People enjoy living in a pleasant environment with nice things around them. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed properly to ensure that they can be cared for properly on admittance. Good information is available for prospective residents to help them to make an informed decision about whether or not the service can meet their specific health and social needs. Evidence: The manager told us how people who wished to use this service were admitted to the home. The service had several brochures produced for the service that explained the aims and philosophy of the home and told people about the services that were provided. This included information about such things as activities, meals, staffing , fees, and information about the rehabilitation and intermediate care services. We spoke to a visitor to the home whos relative had recently been admitted. We were told that good information was given before and during the admittance process, both Care Homes for Older People Page 11 of 28 Evidence: verbal and written. The managers of the service had also taken care to ensure that this person felt at home as much as possible after their admittance and important areas such as medication were sorted out prior as soon as possible to avoid any confusion. All of the files that we looked at for people who lived at this home contained detailed pre-admittance assessments. This information helped to ensure that the carers knew what peoples needs were on their admittance. The assessment also helped to ensure that the people who worked in this service had the skills to deal with specific health needs. The manager confirmed that the service would not admit anyone whos needs were too complex and these people were usually directed towards more specialist services. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service are well cared for and treated with respect. Their health and social needs are addressed properly by a well trained staff team. Evidence: Each of the people who used this service had a care plan that recorded their health and social needs. Each plan also informed the carers of the care that people needed. The information was also recorded on the homes computer system . The plans were comprehensively reviewed on a monthly basis to ensure that the care staff only had current information about health and social needs. We looked at several care plans and each plan held good, current and consistent information, along with daily records and information on such areas as diet, weight, mobility, mental health needs, medication and skin condition. This information helped the care staff to look after the residents properly and ensure that their needs were being met. Some of the people who used this service were taking medication prescribed by their doctor. Most of the residents needed help to take this in the right dose and at the right Care Homes for Older People Page 13 of 28 Evidence: time. This was stored in a lockable trolley and proper safety procedures were followed by the senior carers when administering this. Each trolley was now stored in a lockable room close to the units. We looked at the medication records and these had been completed correctly. There had been training for the senior care staff regarding medication awareness. The service didnt currently hold any medication that was controlled because of its strength or content; the managers of the service demonstrated that they knew what to do if they were to hold this type of medication, and proper records were kept for controlled medication that had been previously prescribed for people who used the service. It was clear that the service had a good relationship with the District Nurse service and those who were in danger of developing pressure sores were closely monitored. The service had a trigger system where concerns could be passed on to the nurses as soon as they were noticed. This helped to make sure that specific areas of care could be dealt with promptly. A district nurse was visiting the home during our inspection. There was specialist equipment available within the service to help prevent the breakdown of skin tissue. Care plans held information to show that pressure area care and wound care was being properly provided. No one who used this service currently had any pressure sores. All of the people who used this service that we spoke too told us that they were pleased with the way that they were being cared for. One resident commented, Its nice here, theres a lot to do and people to talk to, and the girls (carers) are nice. We observed the care staff and how they spoke to people. It was clear that the residents were being treated with respect and were spoken to politely. Everyone we saw looked well cared for and well dressed. We spoke to one of the care staff who said that she enjoyed working at the home and was familiar with using the care plans on a daily basis. This was a service that cared for people who had dementia. There had been specialist training in this specific area of care for the staff at the home to enable them to provide a better and more understanding level of support for people with this condition. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A good selection of regular, planned activities are available to help keep the residents active and stimulated. Catering arrangements are good and people enjoy the meals that are provided. Evidence: All of the care plans that we looked at held important information about the social needs of the residents. Important information was stored about family support, previous occupations, what the person likes and dislikes, food preferences, hobbies and interests, and where they were born. This type of information is good because the carers are able to initiate conversation, arrange specialist activities and contribute to the residents well being. There was also a good programme of regular activities that took place every day. Information was available to all about what activities were available on any given day. There were regular entertainers (singers etc.), ball games, darts, carpet bowls, pamper sessions, and regular trips out. There were also specialist activities, such as reminiscence sessions, for those who had dementia. A good activities programme is vital, as this keeps the people who use the service active and stimulated. When we Care Homes for Older People Page 15 of 28 Evidence: arrived at the home a singer was entertaining the residents in the main lounge, and many people were singing along and joining in. The residents also told us that there were special events when one of them had a birthday and birthday cakes were usually made. Menus were available to show that there was lots of choice at mealtimes. Three of the residents that we spoke to said that there was always a choice available and that mealtimes were very enjoyable. One resident commented, Theres occasionally stuff you dont like but they can put something on special for you. The menu for the day was displayed in the dining area. We spoke to the chef who told us that a good variety of food was offered by the home and that there were regular deliveries of fresh vegetables, meat and fish from local suppliers. There were visitors to the home whilst we were there. The manager confirmed that privacy was offered if required and refreshments were available. It was clear that visitors were encouraged to maintain important contact with families, friends and representatives if this was wished. One visitor told us that she was always welcomed at the home and offered refreshments. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The processes when voicing concerns about this home are clear and easy to follow, meaning that people feel listened to. People are safer because safeguarding issues are promoted and taken seriously. Evidence: The complaints procedure was displayed in the home and was part of the Service User Guide for this service; timescales were given for the handling of complaints and the manager confirmed that all complaints and concerns were handled properly and seriously. The management team were aware of the homes role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the people who use the service. There was a complaints and complements book in the office for people to look at, as part of theinformation provided by the service. We looked at the information that was available in the home that helped to safeguard people from harm. There were policies and procedures to guide the manager and staff in safeguarding issues and a copy of the local authorities code of practice. The manager was aware of what action to take should a safeguarding issue arise within the service. The care staff had also been trained in protecting vulnerable adults and the staff that we spoke to were aware of safeguarding issues and how to report things that they were unsure of, or uncomfortable about. Most of the care staff had also received Care Homes for Older People Page 17 of 28 Evidence: this training via a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). The service also had a whistle blowing policy provided by the organisation for care staff to use should they feel uncomfortable about what they might have seen whilst working at the home. Incidents can be reported and the service has given an assurance that all reported occurrences will be taken seriously and acted upon. There had been no safeguarding incidents within this home since the last key inspection was completed. There was a clear intolerance of poor practice amongst the management team, which made this service a safer place for people to live in. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, homely and pleasant environment. Some of the communal areas are in need of redecoration and enhancement to make the home a nicer place to live. Evidence: This service was divided into separate areas where people with differing needs lived. The people who used the service looked relaxed and content on each area, and there were plenty of staff around to care for people. Each area was well furnished, pleasant and looked quite homely. The people that we spoke to said that they were encouraged to be involved in household tasks within each area to help maintain their skills. The bedrooms that we were looked at were quite large. Some of the rooms had nice views of the garden areas and surrounding grounds. Furniture and beds were of good quality and there was plenty of natural light in most of the rooms. There were also bed-side lamps and reading lamps available, and each room had a call-bell system for staff to be called when assistance was needed. All of the bedrooms that we viewed had personal belongings in them, such as pictures, ornaments and photographs. This was encouraged to help people feel more at home. The carpets and general decoration were of good quality. One of the people who used the service commented, My room is lovely, Im very comfortable here. We also spoke to a visitor to the service who told us, My mums room is a little small but suits her needs. Care Homes for Older People Page 19 of 28 Evidence: Some areas of the building were looking a little tired and were in need of decoration. The management team were fully aware of this and there were plans to redecorate and refurbish certain areas. The service had a maintenance team and there was decoration going on in the home whilst we were there. New lights had been fitted to improve the lighting in some parts of the home. Overall the home was very clean throughout and there were no unpleasant smells. It is important that people live in pleasant surroundings, with nice things around them. This helps to improve their well-being. The management team undertook quality checks throughout the home to help ensure that people lived in a well maintained and nice environment. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at this home are protected from unsuitable staff by robust recruitment procedures. Staff training is good, meaning that the care staff have the necessary skills and knowledge to undertake their duties professionally and successfully. Evidence: Each of the care staff had an individual training file that helped to set out their training needs and documented the courses, training and qualifications that they had undertaken and achieved. We looked at these during our visit. It was confirmed that the service takes the training of its staff seriously; several courses and training events had taken place since the last key inspection. These included training in care practice and mandatory safety training. Most of the carers held a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). A well-trained staff team helps to ensure that they have the knowledge, skills and ability to provide a better standard of care. Staff files were well laid out and information was easy to find. Each file held a photograph and the correct information on each person. This helped to ensure that the people who used this service remained safe and secure. Evidence was available that Criminal Records Bureau disclosures had been obtained, and checks had been Care Homes for Older People Page 21 of 28 Evidence: requested from the Protection of Vulnerable Adult Scheme prior to employment. There were enough care staff on duty to help ensure that the assessed needs of the residents were addressed properly. We looked at the staffing rota for the service and each duty was covered well. The care supervisor told us about the ammount of care staff that were employed on each shift, and what action would be taken should a carer ring in sick. Two residents were able to tell us that they were pleased with the amount of care staff that were available and that they felt well cared for. Staff surveys told us that there were always or usually enough carers on duty to meet the individual needs of all the people who use the service. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being run in the best interests of the residents and their welfare is promoted and protected. Good quality control systems help ensure the service runs well. The manager is well respected and runs the service well. Evidence: The manager of the home has a recognised qualification in management and NVQ level 4 in Care, which is also nationally recognised. These qualifications mean that the manager is trained, prepared and qualified to manage the home properly, which helps to ensure that the people who live there receive a good service. The manager had an excellent working relationship with the care staff of the service and was well respected. We also observed how the management team interacted with the people who used the service, they were very respectful and had clear values regarding how good care should be delivered, and set a good example for the care staff who worked at Belmont Court. Care Homes for Older People Page 23 of 28 Evidence: Reguar quality checks were made throughout the home by the management team and the results of these were recorded. A regular monthly check was also done by a representitive of the owners of the service: we looked at the results of these checks. The outcome of these checks were used to improve the service and maintain standards. The care staff received regular training in areas of safety around the home: this included fire safety, food hygiene, first aid, infection control, and moving and handling training. There was equipment available to help ensure that the residents of the home were helped to move around the home safely and comfortably. The staff had received training in using this. There were records to show that major appliances within the home had been serviced properly and that safety equipment had been examined by suitably qualified persons to ensure that the health, safety and welfare of the people who use the service was being properly addressed. The gas system, electrical installation and lift had been serviced on a regular basis and there were certificates to show that this had taken place. The home was also properly insured to help protect the people who use the service. Risk assessments had been completed for areas where the residents might need extra protection. The care staff told us that individual supervision had taken place and there were records available to show this. Supervision is important because it provides support for the care staff to review their performance and training needs. All of the surveys that were returned to us said that regular support was available. We also looked at supervision records and spoke to the management team about their supervision practice. The manager told us that there were regular staff meetings for both day and night care staff and there were minutes available to confirm this. There were also minutes held for residents meetings where people were encouraged to talk about the service that they received and what changes could be made to improve their lives. Some of the people who use the service had small amounts of personal money that was held by the home. This was monitored by the management team and checked on a regular basis. The caring organisation regularly audited the financial aspects of the service. As part of the inspection process the manager provided the commission with an Annual Quality Assurance Assessment that told us about the home and how it was progressing. This was completed well and outlined in detail how the service was Care Homes for Older People Page 24 of 28 Evidence: improving outcomes for the people who use the service and meeting their specific needs. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 26 The owners of the service should continue to ensure that the property is well maintained and decorated for the benefit of the people who live in this home. Some of the communal areas are in need of attention. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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