Care Home: Belper Views

Similar services:

• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge
• London Road Neurological and Specialist Care Unit
• Carlton Care Home

What the care home does well Belper Views provides a homely and relaxed environment for the people that live there. The majority of staff that work at Belper Views have been there for many years and this ensures that continuity of care is maintained and enables the staff team to build positive relationships with the people living at the home. Comments from the people living at the home confirmed that they were happy with the care and support they received. These comments included, "The strengths here are the caring facilities. The staff are very good and caring. They care for individual needs." and "Food is good. Accommodation is comfortable. Care is good. There are no restrictions on visitors. Staff are very nice indeed." And "It is fine being here. I am happy and comfortable". Staff working at the home confirmed that they enjoyed their work and said that they all worked well as a team. Comments included, "It is friendly. There is a good atmosphere. We chat and laugh with residents. It is homely." "It is home from home." And " It`s a nice environment, good team work, I enjoy the job". What has improved since the last inspection? All of the outstanding requirements made at previous inspections and the requirements made at the last inspection have now been met. The provider, registered manager and deputy manager demonstrated to us that they have worked very hard to ensure the service is managed effectively and within the legislative requirements. What the care home could do better: There was evidence in place to demonstrate that people living at the home had been consulted about the activities provided to them. The information seen showed us that there is a clear action plan in place to develop community activities to enable people to access their immediate community more. However this action plan now needs to be put in place. There was evidence in place to demonstrate that people living at the home had been consulted about the variety of meals available to them and that an action plan was in place to develop the variety of meals. Again this action plan now needs to be put in place. Key inspection report Care homes for older people Name: Address: Belper Views 50/52 Holbrook Road Belper Derbyshire DE56 1PB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Angela Kennedy     Date: 2 6 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 33 Information about the care home Name of care home: Address: Belper Views 50/52 Holbrook Road Belper Derbyshire DE56 1PB (01773)829733 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Alan Kilkenny care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 25 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: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home The home is a large detached brick building with its own large garden and patio area, set on a hill on the outskirts of Belper. The area offers access to a good range of community and leisure facilities, although there are limited shopping facilities in the immediate area. The home offers accommodation for 25 older people in single rooms, some with en-suite facilities available, and has a good range of communal areas, offering a variety of spaces for people and their visitors to use. People at the home are registered with one of the two local Doctors practices and there is a small community hospital in the town. The current range of fees for the home is 353.92 to 373.17 GBP per week with no top ups. Day care is charged at 28.00 GBP per day. Hairdressing is Care Homes for Older People Page 4 of 33 Over 65 25 0 2 9 0 9 2 0 0 9 Brief description of the care home charged at 1.00 GBP. The last Inspection report was kept in the office. further copies of this report on www.cqc.org. You can obtain Care Homes for Older People Page 5 of 33 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: This key unannounced inspection took place over one day. An expert by experience came with us for part of the inspection. An expert by experience is a person who because of their shared experience of using services or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Information from the findings of the expert by experience has been included in this report. Key inspections take into account a wide range of information and commence before the site visit by examining previous reports and information such as any reported incidents. The site visit is used to see how the service is performing in practice and to meet with the people using the service. The focus of inspections undertaken is upon outcomes for service users and their views on the service provided. This process considers the providers capacity to meet Care Homes for Older People Page 6 of 33 regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. An Annual Quality Assurance Assessment had been completed by the service. This is a self assessment for providers, which is a legal requirement. This assessment gives the provider an opportunity to let us know about their service and how well they think they are performing. The information provided in the AQAA is reflected within this report. At this inspection we looked at the files of two of the people living at the home to see if the information about them told the staff how they liked to be supported and what kind of support they needed. This is called case tracking and is referred to within this report. We looked at other records to make sure that the people living at the home were kept safe and were supported to do the things they liked. We talked to some of the people that lived at the home. Their views of the service and the care and support provided are include within this report. The comments provided within six surveys received from the people living at the home are also reflected throughout this report. We also talked to some of the staff working at the home. Their views and opinions of the care provided, the support and training given to them is included within this report. Care Homes for Older People Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 33 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 9 of 33 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. People had all the information they need to make informed choice about the home and they can be confident that the home can support them as accurate assessments are undertaken before admission is agreed. Evidence: The providers self assessment told us that each person is provided with a resident guide and booklet for information about the home. In the six surveys we received from people living at the home four confirmed that they received enough information about the home prior to their admission this enabled them to make an informed choice. The other two surveys said they didnt know if they had received enough information about the home. All six surveys confirmed that they had received Terms and Conditions of residency. A revised statement of purpose has been provided. This was seen and ensured that those considering the service and those already using the service will have up to date Care Homes for Older People Page 10 of 33 Evidence: information which includes the required information. The providers self assessment told us that people that are admitted to Belper Views come for a visit in the day or come around with there family to ensure that the home environment is suitable for them. It told us that during this time information is gathered with the person and their family on the homes pre assessment form which covers all areas of their immediate care. From this information the home can assess that all their care needs can be met. One person that spoke to the expert by experience said, I chose to live here as I had spent short periods here while my relative was on holiday. I knew I could settle here. I am very happy. It is like being at home. Needs assessments were in place in the files of both people that were case tracked. These assessments were detailed and were used to formulate the care plans. The needs assessments looked at all areas of personal and health care needs and history. Personal information was also in place. This ensured the staff had all of the relevant information required regarding each person. Such as prescribed medication, confirmation of the G.P practice the person was registered with and the persons next of kin details and other family contacts. From the information gathered risk assessments were undertaken to determine the level of risk and the support required to minimise the risk. Evidence was also in place to demonstrate that reviews of care had been undertaken in one persons file. The other person had recently been admitted to the home and therefore a review of their care had not yet taken place. Care Homes for Older People Page 11 of 33 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. Peoples health and personal needs are met by the service and the service supports people to take their medicines in a safe way. Evidence: The providers self assessment told us that they had introduced a new care planning system that included all physical, mental and emotional needs, risk assessments and day to day information. It said that the care plans are used by all the staff to ensure consistent care is given daily and they are also updated daily by the management or senior care to document any changes. Care plans were in place and had been regularly reviewed and the records seen supported that people were being involved in the planning of their care. They gave staff clear directions about what the persons care needs were, and how their needs were to be met. Care plans had been updated as peoples needs changed. Personal details about the individual were completed, including their the marital status. One person case tracked did not have a care plan in place regarding pressure area Care Homes for Older People Page 12 of 33 Evidence: care. They did have a risk assessment regarding pressure ulcers and this showed that they did not have any pressure ulcers. This person spent long periods of time sitting in their wheelchair, this was their choice and was clearly recorded. Discussions took place with the registered manager regarding the need for a care plan to be in place regarding pressure area care, to ensure that this persons pressure areas were monitored. There were risk assessments in place that linked with care plans. The risk assessments identified areas of risk clearly and instructed the staff on the actions that were to be taken to minimise the risks. The providers self assessment told us that life stories were now included within the information regarding each person. This was seen in the records of one person that was case tracked. However there was no information in the other persons file regarding their life history. The registered manager told us that this information had not been provided by this persons family. This was further discussed and agreed that this could be addressed at this persons next care review. Information was also seen in the files of the two people case tracked regarding financial matters and any appointees that were in place for them. The providers self assessment told us that the people living at Belper Views have the correct medical care that they need from professionals such as GPs, district nurses, chiropodist, dieticians, speech and physical therapists. The information seen in the files of the two people case tracked supported this. The expert by experience spoke to ten people that were living at the home. The comments they made regarding the care and support they received at the home were positive. Comments included, The strengths here are the caring facilities. The staff are very good and caring. They care for individual needs. When I had been in hospital for an operation, I got all the care I needed for a full recovery and The staff are brilliant. Who could ask for more and I feel a lot safer here than on my own. Best move I ever made. The providers self assessment told us that people living at the home are treated with privacy, dignity and respect at all times . They gave us examples of this by saying, staff ensure they always knock before they open a door and they always explain and ask permission before doing any personal care and people have the use of the telephone at any time in privacy and staff will always assist when needed. Comments we received on the day of this inspection and in the surveys received regarding Care Homes for Older People Page 13 of 33 Evidence: privacy and dignity confirmed this. The providers self assessment told us that they had an excellent relationship with the pharmacy who deal with all of their medication needs and questions. They said that all medication is documented on medication administration records sheets which are signed every time medication is administered. They said a receipt book was kept for any returns and that medication audits were undertaken. The records seen confirmed that medications returned were recorded. Staff that were responsible for administering medication had received the appropriate training in June 2008. The registered manager told us that they were planning to rebook staff onto refresher training with the Local Authority and that this training was available in February 2010. The medication records of the two people case tracked were looked at and no errors were noted. Records had been completed accurately. Medications were stored correctly and all records seen were clear and accurate. A fridge was in place for storing medicines that required cold storage. This fridge was situated in the duty office and at the time of this inspection visit did not hold any medication. There was no lock for this fridge and no thermometer in place to record the fridge temperature. The providers self assessment told us that controlled drugs are only administered by the district nurse team but said that the home had a controlled drugs cupboard as good practice. There was a cupboard in place for storing controlled drugs, however the registered manager did not have any documentation in place to confirm that this cupboard met with the legal requirements of a controlled drugs cupboard. At the time of the inspection visit there was a controlled drug that was stored in the homes controlled drugs cupboard. This drug was not legally required to be stored in a controlled drugs cupboard or recorded in a controlled drugs register. The manager confirmed that the home did not have a controlled drugs register, however a register must be in place to ensure it is available if needed. Care Homes for Older People Page 14 of 33 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. People were supported to follow their personal interests and routines and were able to keep in touch with their family, friends and representatives. Meals were of a good quality but lacked variety. Evidence: The providers self assessment told us that they had recently spoken to everyone living at the home to get their opinions and choice on the range of activities and entertainment at Belper views. They said that with this feed back they had developed a new activities rota with a varied choice. This was also confirmed in the providers monthly audit reports known as Regulation 26 visits. Discussions with the registered manager confirmed that the deputy manager was responsible for coordinating the activities that were undertaken at the home and that the staff on duty were responsible for carrying out those activities. Clear information was recorded within the care plans seen about the individuals interests and social preferences, such as if the person preferred their own company or if they enjoyed participating in group activities. Care Homes for Older People Page 15 of 33 Evidence: A programme of activities was in place from Monday to Friday that included music, dominoes, exercises and one to one chats. No obvious group activities were seen being undertaken on the day of this visit. Staff were observed chatting with people that lived at the home and one person was seen with a talking book, from the library. The expert by experience stated, the owners dog was present during my visit and the residents were pleased to see it and stroke it.It was very well behaved. One of the people living at the home told the expert by experience, They have a nice cat here. It is like the one I had. The surveys we received from people living at the home indicated that there are usually activities available for them to participate in if they want to. The expert by experience saw photographs of people living at the home having birthdays and cooking. Comments made to the expert by experience regarding activities at the home included, We play bingo and do chair exercises when staff have time. People from a church and a chapel visit. We sing and they bring Easter eggs and presents. and We play games. I knit and read books and magazines. and I join in when we play dominoes. They give you the choice, what to join in. Other people said, there have been no outings since I arrived 9 months ago and we used to do activities when I first came here but not recently. The registered manager and deputy manager talked about plans they had regarding hiring transport to enable outings to take place. It was also confirmed that some people went out with staff support on a one to one basis, such as to the local shops. This was recorded in the activities book and in peoples daily logs. The providers self assessment told us that all religious choices are covered by in house communions,varied Churchs visit the home to provide services and all of the people living at the home are asked by staff if they wish to participate. Staff take those who wish to the local church on Sundays. Discussions with the registered manager on the day of this inspection visit confirmed that one person received holy communion in the home each week and that one person visited their local church each week. The providers self assessment told us that at Belper Views all staff work to the same routine that suits each individual person living at the home. It said that this was done by regular updates in care plans,knowledge, communication and observations. People told us that their daily routines were flexible. Comments made included, I go to bed and get up when I choose. And I get up for breakfast. I go to bed when I am ready. The staff ask if they can take you up, but you decide. And I go to bed early by Care Homes for Older People Page 16 of 33 Evidence: choice, because I want to stretch out in bed by then. And I have some meals in my room which I appreciate very much. I go out shopping and buy myself little tit bits which they cook for me. Information regarding independent advocacy services was seen on display in the entrance area of the home. This means that the people living at the home and their relatives have information about this service and how to access it, should they wish to. The providers self assessment told us that all visitors may come and go as they wish and all family members, friends etc can visit people in the privacy of their own room if they wish. Comments made to the expert by experience regarding visitors included, Visitors can come at any time, but there is no private area to talk to them. There is not suitable seating area in my room. And There are no restrictions on visitors. And Visitors can come any time. The providers self assessment told us that a wide range of daily meal choices are available and fresh food is cooked from the local fresh food suppliers and the cook goes around daily asking people their choice of meals for tea which includes hot or cold dishes. The cook confirmed this and said that the menus were in the process of being slightly altered following consultation with people living at the home. The expert by experience observed the cook asking people about their lunch. They were offered gammon and given a choice of type of potatoes and vegetables. They were offered a dessert or yogurt. The cook told the expert by experience that she was also catering for one person who required vegetarian dish and one person who required a coeliac diet. The expert by experience observed that the dining areas made use of the shape of the room so that there were several discreet areas. The tables had cloths on, cruet and flowers. The lunches served looked attractive. Staff were seen supporting people that required some assistance in an appropriate and respectful way. The expert by experience received positive comments about the quality of meals provided, but some people said there was no choice. People said, The food here is good but there is no choice. I wish they would tell me today what the meals are going to be tomorrow. Food is good. It is nice here. Food is nice but there is no choice There is something nice to eat and I dont have to cook it. The food is good. Meals are usually good The meals are always satisfactory. There is plenty to eat. Food is good. I like it very much.Comments within the surveys regarding food indicated that Care Homes for Older People Page 17 of 33 Evidence: people liked the meals that were provided. The providers monthly audit reports were looked at and demonstrated that people living at the home were asked for their opinion about the meals provided.Information seen within the providers monthly audit report for November 2009 indicated that people living at the home were happy with the quality of the meals but felt the choices were limited. In the providers December 2009 report it stated that the people living at the home were happy with the food and when asked about the variety they all said they were happy with what was offered. This report stated that a new menu system had been devised to offer three varieties on a daily basis. Although in this report it said that this new menu system had not yet been implemented. The providers self assessment told us that they also supplied a full and varied range of food supplements for the people who needed them. It said the cook has recently attended a nutrition course and has produced her menus by asking all people about their own personal food choices. It said that she often adds something different to her menu and monitors peoples interest in this and staff also tell her if the meal has been enjoyed. The cook confirmed that she was given information regarding any special diets that were required and discussed the alternative dishes that were prepared for people requiring a gluten free or diabetic diet. Care Homes for Older People Page 18 of 33 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. People are confident that their concerns will be listened to and taken seriously and the practices in place safeguard people from abuse and neglect. Evidence: The providers self assessment told us the complaints procedures are in place and on display in the entrance for all to see, all documentation is kept up to date and used, procedures are in place in the residents guide and staff policies and procedures and all complaints we receive are dealt with by procedure. The providers self assessment confirmed they had received no complaints . The complaints procedure was on display in the entrance hall and included contact details of the Care Quality Commission. The registered manager confirmed on the day of this inspection visit that no complaints have been received by the home since the last inspection. We have not received any complaints regarding the service since the last inspection visit. Information within the six surveys returned told us that four people knew how to make a formal complaint and that all six people had someone they could talk to informally if they had any concerns. Comments within one survey included, the staff would deal with any problems I had Care Homes for Older People Page 19 of 33 Evidence: People that spoke to the expert by experience said that they did not have any reason to complain but confirmed that they would speak to the manager or deputy if they did. Comments included, If I had a complaint, I would talk to Margaret. I would not need to make a fuss. We would discuss it rationally, as 2 adults and I would tell Margaret or Helen. The providers self assessment told us that there are full staff policies and procedures in place to ensure the protection of any abuse for the people living at the home and the staff team. It said that all staff are up to date with their training to deal with any issues or problems. There was evidence in the staff files seen that training had been undertaken regarding safeguarding adults, the mental capacity act and the deprivation of liberty safeguards. The manager was also able to provide confirmation of Safeguarding training updates that were booked for all staff to attend over a two day period in February 2010 with the Local Authority. Staff that were spoken to demonstrated a good understanding of the safeguarding procedure and were able to confirm the location of the Safeguarding Policy within the home.This was looked at and included the contact details of the Local Authority for safeguarding referrals. People that were spoken with during this inspection visit indicated that they were happy with the standard of care they received and felt safe at the home.Comments included, It is fine being here.I am happy and comfortable. They look after my husband and me. They look after him splendidly. I would not have come here if I did not like it. They are good to us both. We are well taken care of. Staff are very nice indeed. The Manager is lucky to have such good staff. And I feel a lot safer here than on my own. Best move I ever made Care Homes for Older People Page 20 of 33 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. The home provides sufficient space and facilities to meet needs and preferences and is kept to a good standard to ensure peoples safety and well-being is maintained. Evidence: The providers self assessment told us that Belper Views was homely with a wonderful view from the rear of the property which the the people living there enjoyed. There were two pleasant lounges and a conservatory lounge. Each had a television. There was a music centre in the conservatory. After lunch there was music playing in this area. Redecoration had taken place in the lounges and upstairs corridors. At the last inspection visit it was found that there was only one staff call point in the conservatory area. This was still the case at this inspection visit. We were told that people that sat in the conservatory area were fully mobile and independent. The expert by experience spoke to one person who was sitting in the conservatory and asked them what they would do if they needed something. They said I would shout for help. There were a variety of chairs and settees in the lounges. Some of the chairs belonged to the people living at the home. The variety of furniture made the environment homely. There were plenty of coffee tables around. All areas had good levels of Care Homes for Older People Page 21 of 33 Evidence: natural light. There were lots of magazines on a coffee table. There was a terraced area at the back of the home that had decking, seats, tables and umbrellas. The bedroom doors were numbered and many had the persons photographs on,which assisted them in identifying their own room. Three bedrooms were seen. The bedrooms seen were clean and had been personalised with peoples own furniture and belongings and call buttons were in place, to ensure people could call for staff assistance if needed. The deputy manager told the expert by experience that there was a planned programme of redecoration and new carpets for some bedrooms and that others were to have new soft furnishings. The expert by experience spoke to people living at the home regarding their bedrooms, they said. My room is nice and comfortable. It is cleaned every day. It is always cleaned thoroughly. I have a nice big room with my own things. Accommodation is comfortable. My room is very nice. Comfortable with my own things. My room is very comfortable. I spend a lot of time there. I have my own TV and some personal items. Julie is going to have my room decorated to the style that I have chosen (Japanese). I have a toilet and washbasin in my room. At the last inspection visit one bedroom had a damaged ceiling and work was being undertaken on this ceiling at the time of this inspection visit. One bathroom was seen by the expert by experience who said that it was very clean and looked as if it had been recently refurbished. It contained a specialist bath. Another bathroom was seen that contained a bath, shower and hoist. One person said, It is lovely to have a bath. They have the equipment here. I did not feel safe taking a bath at home. A coin operated telephone was available in the hall for people living at the home to use. The laundry area was seen and housed sufficient equipment to meet disinfection standards and maintain individuals laundry requirements. The expert by experience spoke to people living at the home regarding the laundry services provided. The comments made indicated that people were happy with the way their clothes were laundered but there appeared to be some issues regarding clothing that wasnt named. Such as All my clothes are washed. The slight problem is when I have new items, which do not have name tags on, so socks, etc. get mixed up. I am not able to Care Homes for Older People Page 22 of 33 Evidence: put the tags on. They get done eventually. And Laundry is done very regularly. About before you have taken the clothes off. Any clothes not marked with name get mixed up, but they get sorted eventually. And My clothes are washed for me. They got mixed up once or twice when I first came here because I did not have my name on them. It is ok now. My daughter-in-law put my name on them. The expert by experience felt that it would help if a system were introduced for the name tags, especially for people who have no relatives to put them on for them and suggested involving the individual in doing this as an activity with staff support. The providers self assessment told us that the housekeepers are very proud of their abilities in keeping the home dust free and clean.It said that all the staff including cleaners have done their infection control so they all know how to deal with cross contamination and good hygiene practices. All the staff do their fare share of cleaning and tidying and so do some of the people that live at the home, who enjoy going round with a duster. They told us that the toilet facilities are checked on a regular basis to ensure their cleanliness and deep cleaned every night, table linens are changed regularly, all staff are trained in correct washing programmes in the laundry, such as sluicing, washing temperatures for clothing and soiled items and the laundry is deep cleaned and mopped every night. In the six surveys we received from people living at the home we were told that the home is always kept fresh and clean. Care Homes for Older People Page 23 of 33 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. People have safe and appropriate support as there are enough competent staff on duty at all times. Appropriate staff checks ensure individuals safety is maintained. Evidence: The providers self assessment told us that there is a four week rota for all staff to see. This is kept on the office notice board to ensure that staff know what shift pattern they will be working. There are three to four staff members on in a morning this includes a senior at all times three staff members in the afternoon and two waking night staff. The management on call rota is in place for emergencies. It told us that all staff employed are over the age of 18 and that no member of staff under the age of 21 is left in charge of the home. The rotas were looked at including the current rota in use and confirmed that a satisfactory skill mix and numbers of staff were in place. People living at the home indicated that there was enough staff on duty to meet their needs. They said,The staff are excellent. There are always enough staff around. The staff are very kind. I rely on them to take me to the toilet. There are plenty of staff around. They are very good. The staff are happy together and work well together. There are enough staff. There is always someone here. The providers self assessment told us that two housekeepers were on duty during the day, who ensure all bedroom and living areas are kept clean and staff also do extra Care Homes for Older People Page 24 of 33 Evidence: cleaning and tidying jobs where applicable . There is a trained full time cook who takes care of all the kitchen needs such as, cleaning, ordering and cooking. Information was provided on the rotas seen to confirm this. Information within the providers self assessment stated the correct recruitment checks were undertaken. This was confirmed in the staff files that were looked at. All of the information required by law was in place within the documents seen and this ensured the safety of the people living at the home was maintained. This included full employment histories. This ensures that any gaps in employment can be identified and investigated to ensure they are accounted for. The providers self assessment told us that all training for staff is undertaken with Derbyshire County Council and that they had entered the Babington Care Support Team programme who will be assisting them during 2010 with all their training and support needs. Records were seen to demonstrate that the training requirements from the last inspection have been met. The records showed that staff were up to date in mandatory training. At the last inspection visit it was identified that there was some paperwork to provide new staff with an induction but this needed further development. The providers self assessment told us that they have reviewed and up dated all areas of induction, supervisions and appraisals. However on looking at the induction paperwork at this inspection visit, it was agreed that this needs to be further developed into a formal induction training programme. Discussions took place with the registered manager on how this could be achieved. The providers self assessment told us that out of 15 care staff 11 have their NVQ level 2 or above. This was confirmed at this inspection visit. Care staff spoken with confirmed that the training provided was regular and useful in developing their skills and knowledge. This enabled them to provide a good standard of care to the people living at the home.Staff told us that they enjoyed their work. One said Its a nice environment, theres good team work here. Another member of staff said, It is homely. We all get on. Two housekeepers told the expert by experience that they had both worked at the home for eleven years. They confirmed that they work a rota system for cleaning all the areas of the home. They said they had done training for Care Of Substances Hazardous to Health, infection control, food hygiene, fire safety and Health & Safety. They told the expert by experience that they liked being able to talk to the people Care Homes for Older People Page 25 of 33 Evidence: living at the home and help, for example. by making them drinks.They said, It is lovely here. I would not leave. It is friendly. There is a good atmosphere. We chat and laugh with residents. It is homely. It is home from home. They confirmed that if they were not happy about something, they would talk to the registered manager or the owner of the home. Care Homes for Older People Page 26 of 33 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. People have confidence in the service provided because the home is led and managed appropriately, with peoples health and safety maintained and finances safeguarded. Evidence: The providers self assessment told us that the registered manger and deputy manager have both completed and passed their Registered Managers Award and attended all other work related training courses. Training records seen demonstrated this. The providers self assessment told us that the owner of the home and the registered manager have a good working relationship and they endeavor to aid each other in any part of the running of the home to their best ability to ensure a good outcome for the people living there and the staff team. As stated throughout this report we received positive comments from the people that live at the home and the staff that work at the home, regarding the care provided and the homely and friendly atmosphere of the home. Care Homes for Older People Page 27 of 33 Evidence: The overall observations made by the expert by experience was that Belper Views is a pleasant, spacious home. The staff appeared relaxed and worked as an effective team, which the expert by experience felt resulted in the most common description being homely. The owners dog was present during the visit and the people living at the home were pleased to see it and stroke it. It was very well behaved. The bedrooms were personalised and people living at the home confirmed they were happy with them. The people living at the home were complimentary about the food and staff and said that the registered manager was very approachable. Staff were caring towards the people living at the home and treated them with dignity and respect. The providers self assessment gave us examples of how they ensured that the views of people who lived at the home were gathered and used to develop the service provided. This included, regular quality assurance surveys, care reviews and one to one discussions with people. We looked at surveys that had been sent out to people living at the home in November 2009. Out of twenty two surveys that were sent out ten were completed. Some of these were completed independently and some people were assisted by their family or friends. The audit of these surveys showed the feedback received was positive. The people living at the home were very satisfied with the overall care and support provided to them. The outcome of this audit was recorded and showed the actions that were to be undertaken. This consisted of improvements to the entertainment and activities programme. These actions linked with the feedback that was provided from the staff surveys that were sent out. The audit information here showed that the staff were consulted, their views were gathered and used to develop the service. For example, following this audit it was agreed that the service would look at purchasing or hiring a vehicle to enable people living at the home to access the community on a regular basis. Family members satisfaction surveys had also been sent out and out of twenty two, fourteen people had returned these. The audit showed that families and representatives of people living at the home were very satisfied with the overall care and support provided. From the copies of the providers monthly audit reports known as regulation 26 visits, we could see that people living at the home and staff working at the home were asked for their views of the service and any improvements they felt would benefit the service. Information within this report also showed us that these visits included details of the homes improvement plan, records of events and complaints and any actions that were required as a result of these monthly visits. Care Homes for Older People Page 28 of 33 Evidence: The financial transaction records and monies held by the home for one of the people case tracked was checked. The other person case tracked did not have any monies held in safe keeping for them. Therefore the monies of two other people were picked at random. Their financial transaction records were checked against the monies held for them and showed us that the accounting procedures for their personal finances was managed in a safe way. This demonstrated that individuals monies were managed in their best interests. Staff that were spoken with confirmed that they received formal supervision sessions. The registered manager confirmed that supervision had taken place and there were records available to demonstrate this. These showed that staff supervision sessions had taken place, some in October 2009, some in November 2009 and the remainder in January 2010. The manager stated that the aim was to provide all staff with formal supervision sessions six times a year. A sample of health and safety certificates were examined this included maintenance checks on equipment and fire safety procedures. The records seen showed us that the environment is safe for people because the appropriate health and safety checks are carried out. Care Homes for Older People Page 29 of 33 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 30 of 33 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 1 9 13 A controlled drugs register must be available within the home for any controlled drugs that have to be recorded within a controlled drugs register. This is for security reasons and to meet legal requirements. 26/04/2010 2 9 13 Written documentation must 26/04/2010 be in place to demonstrate that the Controlled drugs cupboard complies with the Misuse of Drugs (Safe Custody) regulations. This is for security reasons and to meet legal requirements. 3 30 18 New staff should receive formal induction training This is to ensure they have the knowledge that they need to know about before they can work unsupervised. 26/04/2010 Care Homes for Older People Page 31 of 33 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 7 A care plan regarding pressure area care should be undertaken, in relation to one of the people case tracked that is referred to in the Health and Personal Care section of this report . This will ensure their pressure areas are monitored. The medicine refrigerator should be locked and the temperature should be monitored over a 24 hour period by a minimum, maximum thermometer. A daily temperature record should be kept. All of the people living at the home should be offered regular access to their local community both as organised trips out and on a one to basis, with staff support as required.This will ensure people are given an opportunity to be part of their local community and ensure they do not become socially isolated. A wider variety of meals should be made available to the people living at the home and information should be made available of the weekly menu plan for those people who prefer to know the meal choices that are available to them in advance. A risk assessment should be undertaken regarding the accessibility of a call system within the conservatory to ensure that anyone that chooses to sit in the conservatory is able to call staff when needed. A system should be put in place to ensure that all new clothing is labeled with names prior to washing.This will reduce the possibility of items of clothing being misplaced. 2 9 3 12 4 15 5 22 6 26 Care Homes for Older People Page 32 of 33 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 33 of 33 - 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!