Care Home: Five Bells Residential Care Home

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What the care home does well The home provides a comfortable, safe and homely environment for people to live in. It is very well managed and organised. Five Bells is very much a part of the village community, with many of the carers being local. The bungalows and terraced houses offer people the opportunity to have support and care while retaining as much independence as they can. . Residents are very positive about the care they receive; one said `It`s very good and another said `I`m very happy to be here`. Survey forms we received were complimentary. Staff members are well trained and feel supported by the management. They have a sound knowledge of residents needs and work well together. What has improved since the last inspection? Improvements have included new pre-admission assessments. Recent environmental improvements have included improved wheelchair access throughout the ground floor and gardens, redecoration of the dining room, reception area and conservatory and new carpets laid and a new boiler installed. Systems for keeping and maintaining office documents and records have been improved. What the care home could do better: CRB documents should be destroyed once information has been recorded. CARE HOMES FOR OLDER PEOPLE Five Bells Residential Care Home 28 Market Place Folkingham Lincs NG34 0SF Lead Inspector Julie Western Unannounced Inspection 23rd July 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Five Bells Residential Care Home Address 28 Market Place Folkingham Lincs NG34 0SF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01529 497412 darrontalton@compleatcare.co.uk Compleat Care (UK) Ltd Care Home 25 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (25), of places Physical disability (1) Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC To people 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 Dementia, over the age of 65 years - Code DE(E) - maximum number of places: 2 Physical Disability - Code PD - maximum number of places: 1 The maximum number of people who can be accommodated is: 25. 2. Date of last inspection 25th July 2006 Brief Description of the Service: The Five Bells is a Grade II Listed former coaching inn, originally built in 1629 and located in the centre of the village of Folkingham, which is a conservation area. Folkingham is of equal distance from the towns of Grantham and Sleaford and has a shop, restaurant, pub and post office. The home is registered as a care home and mainly provides care for older service users; it is also registered to provide care for service users with those needs associated with dementia and for one service user who falls within the category of physical disability. On the day of the inspection 14 service users were being accommodated. The home comprises a main home, the coaching inn, which was extended in 2001, four modern terraced properties in Tannery Lane, which is adjacent to the main building and three bungalows within the grounds of the home. These have been built in keeping with the village setting and provide self-contained accommodation for less dependent service users. Across the road from the main home there are offices from which a domiciliary care service is operated, the whole group being called Compleat Care [UK] Ltd. and being owned by Mr and Mrs Sisodiya. The group manager is Darron Talton, who maintains an oversight of the care home. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 5 Accommodation in the main home is provided on ground and first floors, which are accessible via stairs or a stair lift. Access to the first floor flat of one of the self-contained houses in Tannery Lane is via an external staircase. The home and bungalows share a series of courtyard gardens where residents can sit out in good weather. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was carried out over three hours and took into account any previous information held by CSCI including the home’s previous inspection reports, its service history, any pre-inspection questionnaires completed by the Manager including the Annual quality assurance assessment [AQAA] and any residents’ questionnaires sent to the home by the Commission prior to the inspection. The site inspection was unannounced and consisted of tracking a sample of residents’ care records and assessing the care given. Some policies and procedures were examined and some records concerning the safety of the home were also seen. Three residents, three care and ancillary staff and two visitors were spoken with. The Manager was present throughout the inspection. What the service does well: The home provides a comfortable, safe and homely environment for people to live in. It is very well managed and organised. Five Bells is very much a part of the village community, with many of the carers being local. The bungalows and terraced houses offer people the opportunity to have support and care while retaining as much independence as they can. . Residents are very positive about the care they receive; one said ‘It’s very good and another said ‘I’m very happy to be here’. Survey forms we received were complimentary. Staff members are well trained and feel supported by the management. They have a sound knowledge of residents needs and work well together. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information provided is freely available to residents. A comprehensive initial assessment ensures that the needs of residents can be met. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The group manager confirmed that the assistant manager, accompanied by a senior carer, always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records confirmed this. Written admission documentation was comprehensive and clear, giving staff the information they needed to meet the residents’ needs. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 10 The statement of purpose and the service user guide contained all of the information that they should in order to enable residents to make informed choices. A resident described how he had visited for the day before he was sure he wanted to move in permanently. A staff member described the admission process and the importance of making new residents and their families welcomed. The home does not provide intermediate care. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in sufficient depth and detail to ensure that residents’ care needs can be met. EVIDENCE: The care plans looked at contained information about the residents’ health and personal care needs. They were reviewed regularly and signed where possible by the service user or relatives/advocates. They contained clear risk assessments. The home has a key worker system to enable residents to get information more quickly. Following discussions with the local dispensing surgery, the service now uses a monitored dosage system, which all staff said was much easier to use. There was a clear, recently updated medication policy. Pharmacy training and inspection is provided by the owners. The group manager said that only senior staff members administered medication, although all staff received medication training. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 12 Residents received regular visits from district nurses and other agencies involved with their care. Residents spoken with said that they were happy with the way they were looked after; one said ‘the staff are very kind and make sure I get the help I need’. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities are regular and are tailored to suit individual residents’ needs. Residents have a choice of meals from a balanced and varied menu. EVIDENCE: The home has a new activities co-ordinator who works 6 hours weekly; the group manager said that he was looking to develop this role more in time. Care plans seen included a list of all residents’ likes and dislikes. The service actively promotes independence, choice and privacy by listening to residents and relatives/representatives. Equality and diversity are promoted through the policies and procedures and through the staff induction procedures, ensuring that residents’ individual needs can be met. There is a programme of regular activities, including entertainers, bingo, church services and various board and card games. Two residents said they preferred to stay in the home and relax. The home has a library with an extensive range of books. Others said they went to the village pop-in club and lunch club, or to the local pub. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 14 Residents spoken with all said they had a choice of whether or not to take part. Two residents were sitting outside in the courtyard garden, reading newspapers and enjoying the sunshine. Residents were observed eating breakfast. All residents said they enjoyed the meals served; one said ‘It’s marvellous – they always use an alternative if we don’t want what’s on offer’. The day’s menu was displayed in the corridor near the kitchen. It was balanced and the group manager said that fresh, local meat and vegetables were used. The cook said she knew all the residents’ likes and dislikes, which were displayed on the kitchen wall; if residents didn’t like any of these choices, she would make them an alternative. The cook was knowledgeable about the nutritional needs of service users and described liquidised meals and cooking for diabetics. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s procedures for addressing complaints and for protection from abuse are clear. Residents and their families are confident that their comments and concerns will be listened to EVIDENCE: Residents spoken with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures; staff members said they had read it. The group manager said that residents and their families were regularly asked for their views regarding the running of the home. Since the last inspection there had been no complaints. Staff spoken with confirmed that they had received training in safeguarding adults. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents live in a safe, comfortable and pleasant environment that is suitable for their needs. Thought has been given to enhancing the lives of residents and enabling them to live independently for as long as possible. EVIDENCE: Overall, the standard of decoration internally was high and afforded residents a great degree of comfort. The terraced properties and bungalows were very well appointed and residents spoken with said they enjoyed the privacy and independence, while enjoying the facilities of the main house, such as medication and meals. Residents living in these properties could choose whether they came to the main house for meals or had them delivered. The courtyard gardens were very well Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 17 maintained with raised herb and flower beds and patio tubs and offered attractive, pleasant places for residents to sit out in good weather. Staff members described how the maintenance worker carried out any repairs needing attention. He confirmed that he had a book listing outstanding repairs and any issues needing addressing were actioned. Recent improvements included improved wheelchair access throughout the ground floor and gardens, redecoration of the dining room, reception area and conservatory and new carpets laid and a new boiler installed. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. A risk assessment of the building had recently been carried out. The Environmental Health Officer visited in September 2007 and awarded the service four stars in their award scheme for food hygiene. The buildings smelled clean and fresh throughout. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent to meet the needs of residents. EVIDENCE: The group manager said that usual staffing consisted of a senior plus two carers, plus a housekeeper, cook and handyman. Records confirmed this. In addition, the manager was usually present. The group manager said that most staff members were either commencing the National Vocational Qualification [a nationally recognised qualification] at Level 2, had achieved it or were currently working towards it. The core staff group has been stable for some years. Several staff members are ex-nurses working as carers and it was suggested that they also undertook the NVQ at Level 2 to keep themselves up to date with current legislation and practice. The most recent staff member confirmed that she had an interview, given three references and undergone an induction and CRB/POVA checks. Staff records confirmed this. Staff folders were not as well organised as the home’s other records and the group manager said that this would be carried out as soon as the assistant Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 19 manager was able. Completed CRB check forms should be destroyed once the number has been put on staff records. . Staff training records demonstrated that statutory training has been undertaken and that staff received regular supervision. The group manager said that the aim was to build up in house training with the home care agency. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of the residents are listened to and they are involved in decisions affecting them. EVIDENCE: The assistant manager is currently managing the service, overseen by the group manager. He has worked for the group for two years, nine months of these as a senior carer. On completion of NVQ Level 3, he will undertake the Registered Manager’s Award and Level 4. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 21 Staff members spoken with said the management team were very approachable and accessible. Health and safety policies are well documented and demonstrate a clear commitment to ensuring the wellbeing of residents. There is a quality assurance system in place; this consists of sending questionnaires to residents and their families/advocates. On return, these are analysed and any issues are addressed. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP37 Good Practice Recommendations CRB check documents should be destroyed once they have been recorded on staff files. Five Bells Residential Care Home DS0000002440.V368851.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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