Bellfield Home Care Home Service Adults Banchory

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1 Bellfield Home Care Home Service Adults Banchory Inspected by: Carole Kennedy Type of inspection: Unannounced Inspection completed on: 6 March 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 11 4 Other information 24 5 Summary of grades 25 6 Inspection and grading history 25 Service provided by: Church of Scotland Trading as Crossreach Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Carole Kennedy Telephone enquiries@careinspectorate.com Bellfield Home, page 2 of 27

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 5 Very Good Quality of Environment 5 Very Good Quality of Staffing 5 Very Good Quality of Management and Leadership 5 Very Good What the service does well The staff group were friendly and treated people with respect at all times. They appeared to work well as a team, to the benefit of residents and their families. The environment was clean, well maintained and odour free. What the service could do better The service management team gave commitment to take forward the areas for improvement identified in this report. The service was undertaking a recruitment drive to fill vacancies and increase the overall number of staff. Staff should be vigilant in recordkeeping and ensure old or superceded records are removed from personal plans and archived. What the service has done since the last inspection The service had temporarily relocated to Aberdeen while Bellfield Care Home in Banchory was upgraded and refurbished. The temporary relocation appears to have been well managed. The service had kept residents and their families up to date with how the project had been progressing. There had also been consultation regarding choice of rooms and decor etc. The service hopes to return to Banchory in late April Bellfield Home, page 3 of 27

4 Conclusion Inspection report continued From our observations and feedback from residents and their relatives, we identified that Bellfield provided a very good standard of care and residents enjoyed good quality of life. Who did this inspection Carole Kennedy Lay assessor: Mr Bill Stalker Bellfield Home, page 4 of 27

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Prior to 1 April 2011 this function was carried out by the Care Commission. Information in relation to all care services is available on our website at inspectorate.com. This service was previously registered with the Care Commission and transferred its registration to the Care Inspectorate on 1 April Requirements and Recommendations If we are concerned about some aspect of a service, or think it could do more to improve its service, we may make a Recommendation or Requirement. * A Recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service, but where failure to do so will not directly result in enforcement. * A Requirement is a statement which sets out what is required of a care service to comply with the Public Services Reforms (Scotland) Act 2010 and Regulations or Orders made under the Act, or a condition of registration. Where there are breaches of the Regulations, Orders or conditions, a Requirement must be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. This service is owned and managed by Crossreach, to provide residential accommodation and support to a maximum of 27 older people. Bellfield Home is a traditionally built home set in its own grounds in rural Aberdeenshire. The building is in the process of being upgraded and refurbished. The service is temporarily located in Rubislaw Care Home, Aberdeen. Bellfield Home's aims and objectives state that the service will provide "...care services...in a safe and comfortable environment, with respect for independence, and privacy". The service employs a team of care, domestic and catering staff with a range of skills, expertise and qualifications. There were 20 people resident in the home at this inspection. The people who live in Bellfield prefer to be known as residents, therefore this term has been used throughout the report. The inspector and inspection volunteer would like to thank the residents, manager and staff for making us feel welcome, providing us with hospitality, and residents and their relatives for giving up their time to speak to us. Based on the findings of this inspection this service has been awarded the following grades: Bellfield Home, page 5 of 27

6 Quality of Care and Support - Grade Quality of Environment - Grade Quality of Staffing - Grade Quality of Management and Leadership - Grade This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. Bellfield Home, page 6 of 27

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection The inspection of Bellfield Home took place on 27 February and 6 March The service submitted a completed annual return and a self assessment form as requested by us, and this information was used in preparation and during the visit. The inspection was unannounced and carried out by inspector Carole Kennedy and inspection volunteer Bill Stalker An inspection volunteer is a member of the public who volunteers to work alongside Care Inspectorate inspectors during the inspection process. Inspection volunteers have a unique experience of either being a service user themselves or being a carer for someone who uses or has used services. The inspection volunteer's role is to speak with people using the service being inspected (and potentially their family carers, friends or representatives) and gather their views. In addition, where the inspection volunteer makes their own observations from their perspective as a recipient or a carer, these may also be recorded. The inspection volunteer spoke with 18 residents and three relative at this inspection. The comments and observations of the inspection volunteer have been incorporated in this report. Feedback was given at the end of the inspection to the deputy manager and the manager of Bellfield. During the inspection, evidence was gathered from a number of sources including: Talking to 18 residents Telephone discussion with 5 relatives Discussion with the manager, deputy, senior and 3 staff. Examination of a sample of the policies, procedures and health and safety records which the service is required to maintain, including: *Certificate of registration *Self assessment *Staffing schedule *Insurance certificate Bellfield Home, page 7 of 27

8 *Duty rotas for period 1/12/13-4/1/14 *Accident/Incident records *Medication management *Complaints records *4 personal plans, including risk assessments, care plans, reviews and daily progress notes *Minutes of residents, relatives and staff meetings *Quality assurance processes and audits *Staff training records *Risk assessments *4 Care Inspectorate questionnaires submitted by relatives *6 Care Inspectorate questionnaires submitted by residents *2 Care Inspectorate questionnaires submitted by staff. Verbal feedback on the outcome of the inspection was provided to the manager and deputy manager on 6 March Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at Bellfield Home, page 8 of 27

9 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The Care Inspectorate received a fully completed self assessment document from the provider. We were satisfied with the way the provider completed this, and with the relevant information included for each heading that we grade services under. The provider identified what they thought the service did well, some areas for development and any changes they had planned. The provider told us how the people who used the care service had taken part in the self assessment process. Taking the views of people using the care service into account We received 6 completed questionnaires from residents. We also spoke with 18 residents during the inspection. They told us they were very comfortable living in Bellfield and received good support from a friendly and caring staff group. Some comments are noted below and others have been included in the body of the report. "Very good" "I've no complaints at all" "The staff are very nice". Taking carers' views into account Four completed questionnaires were returned by relatives. We also contacted 5 relatives by telephone at this inspection. All expressed themselves to be very satisfied with the quality of the service provided to their relatives and themselves by the staff of Bellfield. Some comments are noted below and others have been included in the body of the report. Bellfield Home, page 9 of 27

10 "We are absolutely delighted " "Everything is perfect " "I have no concerns " "I can't praise them highly enough". Bellfield Home, page 10 of 27

11 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths From the range of evidence sampled we found the performance of the service continued to be very good. The self assessment completed by the service gave detail on the policies, procedures and work practice that enable residents and their relatives to be involved in all aspects of assessment and improvement. The service provider has a user involvement policy and a wide range of methods was used to encourage and support residents' and their relatives' involvement in the development and ongoing improvement of the service. This included 6-monthly care review meetings, regular residents' group meetings, keyworker meetings, relatives and 'Friends' meetings, daily informal individual discussions, social get togethers, comments book, annual quality survey and the service complaints procedure. Residents were provided with opportunity to take part in daily devotions and were reminded that staff were happy to address any suggestions or concerns raised with them. Residents were involved in developing and agreeing their personal support plans. They also confirmed that they had opportunity to participate in the regular group meetings to discuss day to day events in the service. A minute was kept of each meeting and copies of these were distributed to all. We saw that residents and their relatives, where appropriate, were also involved in their individual 6-monthly care review meetings. The record of the review was signed by the resident or their relative to confirm their agreement with the content and outcome and a copy was kept in the personal plan. We saw that residents, relatives and staff had been consulted and kept up to date on the refurbishment of Bellfield Home in Banchory. Residents had been involved in choosing decor etc, and said they were looking forward to returning to Bellfield Home, page 11 of 27

12 Banchory sometime soon. People told us they were very happy with the quality of care and support provided to them, and were comfortable to raise any issues about care and daily life in the home, either individually or as a group. Observations of Inspection Volunteer; The residents I spoke to appeared to be generally happy with the care provided to them. All of them looked well dressed and well nourished, and attention had been paid to their personal appearance. The group of residents I spoke to would have appreciated more outings, especially to the Johnston Gardens, which are very close but are quite difficult to access. Residents said:- "I've no complaints at all" "The food is good" "The breakfasts are fantastic!" "I am very well looked after but would prefer to live in my own home" "I would like more green vegetables". Relatives commented:- "We're kept up to date, invited to meetings and information is sent out" "Always plenty of opportunity to give our views in meetings etc, always asked for views and if anything could be improved on" "We know the keyworker and the staff put off time to speak to you" "We're kept informed about X's health and they get the GP involved" "Feel X is very safe in the home". Areas for improvement Inspection report continued The normally informative newsletter had not been produced since the service had temporarily transferred to Rubislaw in Aberdeen. We were told that it was planned to restart the newsletter when the service returns to Banchory. This will help keep people up to date with activities, social events and other items of interest. The 'You Said - We Did' information board was also going to be reinstated. We were advised that use of the communication tool 'Talking Mats' was going to be further developed. This would improve the lives of people with communication difficulties, by increasing their capacity to communicate effectively about things that matter to them. Progress in this will be reviewed at the next inspection. The service should continue to develop its engagement with residents, families and other stakeholders and formalise residents involvement in staff recruitment and selection. Bellfield Home, page 12 of 27

13 Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths A range of policies and procedures were in place that were known and understood by staff. This helped ensure they were vigilant in their duty to promote and protect residents' health and wellbeing. Staff were friendly and knew residents very well, including their likes, dislikes, life history, daily habits and health needs. Each resident had a person centred personal plan which detailed their support needs and how these were to be met by the staff. We examined a sample of four personal plans. We found them to be informative and each contained a range of social and healthcare history, risk assessments and care plans. There was evidence of regular review and updating of risk assessments and care plans. We saw that where a decision had been made by the resident, or their legal proxy, and their doctor that CPR was not to be tried, this was recorded on a 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) form. This helps ensure staff are aware of and respect the individual's wishes. Some residents had been assessed as not having capacity to give informed consent to medical treatment. Valid certificates of incapacity under section 47 of the Adults with Incapacity (Scotland) Act 2000 were in place for them. This is good practice. Healthy eating was promoted and the service used the Malnutrition Universal Screeniong Tool (MUST) to assess and monitor residents' nutritional status. Weights were monitored and recorded monthly. There was evidence in the personal plans of appropriate referral and involvement of GPs, nurse practitioner, and other health professionals and agencies. A record was maintained of all visits and communication with GPs and other professionals. We saw that residents health was routinely monitored and healthcare needs were met in a timely manner. Residents told us they received their medicines as prescribed. We checked the system for storage, handling and administration of medication and found it to be satisfactory. Areas for improvement While overall we found the quality of care recording to be of a good standard, there were some aspects which could be further improved. For example, staff need to be vigilant to regularly remove and archive old information from the personal plans. One Bellfield Home, page 13 of 27

14 person's assessments had not been updated monthly as per the service's policy. We were advised that the frequency of the person's assessments had been reviewed and a decision made that monthly evaluation was not appropriate. The relevant parts of the resident's care file were amended to clearly instruct staff as to how often the assessments were to reviewed and updated. Communication care plans had limited information. We saw that ABC (Antecedent Behaviour Consequence) charts were used to record inappropriate, challenging or problematic behaviours. These were in use for 3 residents but this was not clearly evident in the care plans. One person's plan identified that they could on occasion be quite aggressive verbally, but there was no guidance on how staff could manage any incidents. Following discussion, the service took action to address these issues in the course of the inspection. An individualised and informative summary of behaviours and management plan was introduced for specific residents. We found these to be good tools to inform and guide daily practice. Sensor/pressure mats were in place for some people who were at risk of falls when mobilising. The use of sensor mats is potential restraint, and needs to be discussed and agreed with the resident or their relative/representative. (See Requirement 1). This was discussed with the manager, and signed consent to the use of sensor/ pressure mats was introduced to the relevant personal plans in the course of the inspection. The AWI (Adults With Incapacity) section 47 certificates viewed did not have treatment plans in place. Treatment plans are good practice, and the manager will raise this with the GPs and discuss how this matter can be taken forward. Grade awarded for this statement: Number of requirements: 1 Number of recommendations: 0 Requirements 1. The provider must make proper provision for the health, welfare and safety of service users. In order to achieve this the provider must recognise that; the use of sensor mats/pressure mats is a form of restraint. Their use must be supported by evidence of discussion and agreement with the service user and/or their representative. This is in order to comply with: Inspection report continued SSI 2011/210 Regulation 4(1)(a) - a requirement to make proper provision for the health and welfare of people. Bellfield Home, page 14 of 27

15 Timescale: 1 month from receipt of this report. Inspection report continued Bellfield Home, page 15 of 27

16 Quality Theme 2: Quality of Environment Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths We found the service demonstrated very good practice in involving people in assessing the quality of the environment within the service. Information in Quality Theme 1, Quality Statement 1 is also relevant in this Quality Statement. Bellfield Care Home in Banchory is currently being improved and refurbished. The service was relocated to Rubislaw from Banchory in June 2013 and it is planned that residents will return to their refurbished care home in April this year. The relocation appears to have gone smoothly. The inspection volunteer commented: "The care home is only 6 years old and is situated in a quiet residential part of Aberdeen. The facilities are modern and in good condition. All the rooms are en-suite and there were no odours in the rooms or corridors." People living in the home and their relatives confirmed that they can have their own personal belongings and items of furniture in their room if they want. Bedrooms were observed to be individualised with decor, fabrics, items of furniture, photographs and ornaments which reflected the resident's personal choice and interests. Residents and relatives told us they had been consulted and kept up to date with all aspects of the refurbishment of the care home building in Banchory. Plans are in hand to offer residents and relatives an opportunity to view the upgraded accommodation once the works are complete and it is safe to do so. A relative said "X has chosen the colour of carpets etc" Bellfield Home, page 16 of 27

17 Areas for improvement The areas for development for this Statement are included in Quality Theme 1, Statement 1, Areas for Improvement. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Statement 2 We make sure that the environment is safe and service users are protected. Service strengths Based on the evidence found during the inspection we graded this quality statement as very good. We decided this after we looked at the environment and records of checks undertaken, and spoke with staff, residents and relatives. The service is currently decanted temporarily to an area of another care home while Bellfield's building in Banchory is undergoing extensive building works and refurbishment. The service is currently located in a self contained first floor area. The main door of the care home building is secure and visitors are required to ring the doorbell for a member of staff to attend. A visitors' book was placed at the entrance area and visitors were required to sign on arrival and departure. Staff ensured they checked the ID of visiting professionals. Entry into and out of the first floor area used by Bellfield was restricted by electronic keypad. These measures helped ensure staff were aware of who was in the building. Staff had ready access to hoists and other moving and handling equipment to support and transfer residents safely and with dignity. Personal protective equipment (PPE) such as disposable gloves, wipes, aprons, soap and hand towels were readily available, and used appropriately by staff to reduce risk of infection. Staff spoken with had good awareness of adult support and protection. This meant they were aware of their responsibilities and actions to be taken to safeguard residents. The Bellfield staff had introduced signage, photographs and other items to personalise the space and help people find their way to the communal areas and their own rooms. We saw that staff carried out regular checks of the environment and all areas were found to be very clean, well maintained and odour free. Residents told us they were very comfortable in the home and felt safe. Bellfield Home, page 17 of 27

18 Areas for improvement The service had recorded an increased number of falls by residents since the transfer to the temporary accommodation. Staff advised that a number of residents, when getting up to the bathroom during the night, had been confused by the change in bedroom layouts and the addition of en-suites. The service had introduced the multifactorial falls risk assessment, which will help identify individuals' risks and actions that can reduce risk. Given that the service will shortly be relocating back to the original building in Banchory, staff must be vigilant to the potential of further disruption and confusion, and take appropriate safety precautions to reduce risk and safeguard residents. The manager advised that additional staff would be deployed for the first 2-3 days following the transfer back and members of 'The Friends' group had also volunteered to help support residents and staff. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Bellfield Home, page 18 of 27

19 Quality Theme 3: Quality of Staffing Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths The evidence for the grade awarded in this Statement is included in Quality Theme 1, Statement 1, Service Strengths. Residents and relatives were complimentary about the quality of staffing. Comments included:- "The staff are very good ' ''I'm very happy with the staff" "The staff are very nice" "They look after us and do everything under the sun" "I think it's excellent, all caring, nothings too much bother" "I can't praise them highly enough". Areas for improvement The areas for development for this Statement are included in Quality Theme 1, Statement 1, Areas for Improvement. The service was reviewing ways to involve residents and families in the selection of staff. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Residents and their relatives spoke positively about the qualities of the staff employed in Bellfield. The inspection volunteer noted: Bellfield Home, page 19 of 27

20 "The staff I observed appeared to be familiar with their charges and were attentive to their needs". In observation and discussion, staff were confident in their practice and spoke freely to us about the key underpinning values of what they do. They demonstrated knowledge of key themes like 'respect, enablement and meaningful activity'. During our inspection we observed that staff encouraged and supported a small group of residents to access the enclosed garden patio area. The residents told us they had enjoyed the fresh air. A resident said 'It's brought the colour to my cheeks'. The service had a wide range of policies and procedures to guide and inform staff practice. We saw that these were displayed and easily accessed. Staff were required to sign to confirm they had read and understood the policies. Individual policies were also discussed during one to one supervision meetings. Supervision took place 3-monthly. The management provided staff with copies of the SSSC (Scottish Social Services Council) Code of Practice and National Care Standards. Management confirmed they monitored staff understanding of policies and standards during supervision sessions. There were regular staff meetings. Review of minutes and discussion with staff indicated that the service was proactive in sharing information and addressing any issues identified. Staff confirmed that new employees were provided with induction training and there were ongoing training opportunities, including a programme to attain Scottish Vocational Qualifications (SVQ). We evidenced that the provider, Crossreach, issued an annual training schedule which covered a wide range of topics. All staff had received fire awareness training since the transfer to Rubislaw. A senior care officer was in the process of completing training to become a dementia ambassador. She advised that,,once trained, it was planned that she would be the in-house dementia lead responsible for guiding and training the staff team in dementia care issues. Areas for improvement The service had approximately 7 care staff vacancies. The vacancies were being covered by use of agency staff. The agency tried whenever possible to provide the same members of staff. This helped ensure residents knew the staff supporting them and there was consistency of care and support. An agency member of staff confirmed they regularly worked in Bellfield and felt well supported by the staff team. The service was in process of a recruitment drive to fill vacancies and increase the staff group. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Bellfield Home, page 20 of 27

21 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths The evidence for the grade awarded in this Statement is included in Quality Theme 1, Statement 1, Service Strengths. The Inspection volunteer commented: "The manager was unavailable but the senior carer in charge was very welcoming and helpful." A resident described the manager as a "well known and likeable woman". Areas for improvement The areas for development for this Statement are included in Quality Theme 1, Statement 1, Areas for Improvement. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths The service had completed the Care Inspectorate self evaluation prior to the inspection, which included what the service thought it was doing well and how it could improve. The provider had a detailed quality assurance (QA) programme in place to support provision of a good quality service. The service had been awarded the Customer Excellence Award which recognises the service is customer service focused and promotes continuous improvement. We evidenced a range of methods used to assess the quality of the service provided and identify areas where improvement can be Bellfield Home, page 21 of 27

22 made. The management carried out regular quality assurance audits in the home, including medication management, care files, meals and health and safety. We evidenced that regular environmental safety checks were undertaken, and accident and incident reports were maintained and monitored by the management. The service's QA programme included seeking the views of residents and relatives to provide feedback on the quality of the service provided. This is detailed in Quality Theme 1, Statement 1 of this inspection report. There was evidence that the manager and staff team responded effectively to suggestions and comments from people who used the service. The care service has a complaints procedure, and details of this were prominently displayed in each person's room. Residents and their families were also reminded of how to raise concerns at each care review meeting. Residents and relatives we spoke with confirmed that they knew how to raise a complaint if they were unhappy with any aspect of the care service but had no need to do so. Review of the complaints register and discussion with the deputy manager and senior carer identified that there had been no complaints since the last inspection. We saw that the provider also seeks the views of staff via an annual employee survey. The latest survey was commenced in February The outcome of this survey will be reviewed at the next inspection. The manager and staff team were appropriately registered with Scottish Social Services Council (SSSC). The deputy manager was a registered nurse and maintained her professional registration with the Nursing and Midwifery Council (NMC). The provider's HR department carried out routine checks with the registration bodies to ensure staff registration status was current. Bellfield Home, page 22 of 27

23 Areas for improvement The service should consider expanding their surveys and questionnaires to include formal feedback from visiting professionals. We were told that this had been done in the past but had not been done for some time. Power of Attorney (POA) had been granted in regard to some residents. The manager and deputy were in process of contacting families and asking for clarification around the powers they may hold and requesting a copy of the relevant documentation. This information would then be placed in individual personal plans to ensure that staff were aware of all residents' legal status and had clear understanding of the legal powers granted. Ensure action plans are developed and implemented to evidence further improvement to the service. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued Bellfield Home, page 23 of 27

24 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). Bellfield Home, page 24 of 27

25 5 Summary of grades Quality of Care and Support - Statement 1 Statement 3 Quality of Environment - Statement 1 Statement 2 Quality of Staffing - Statement 1 Statement 3 Quality of Management and Leadership - Statement 1 Statement 4 6 Inspection and grading history Date Type Gradings 14 Feb 2013 Unannounced Care and support Environment Staffing Management and Leadership 17 Aug 2012 Unannounced Care and support Environment Staffing 4 - Good Management and Leadership 4 - Good 4 Nov 2010 Unannounced Care and support 4 - Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed Bellfield Home, page 25 of 27

26 23 Jun 2010 Announced Care and support 4 - Good Environment Not Assessed Staffing Management and Leadership Not Assessed 7 Dec 2009 Unannounced Care and support Environment Staffing Management and Leadership 23 Jun 2009 Announced Care and support Environment Staffing Management and Leadership 4 Mar 2009 Unannounced Care and support 4 - Good Environment 3 - Adequate Staffing Not Assessed Management and Leadership Not Assessed 24 Sep 2008 Announced Care and support 4 - Good Environment 3 - Adequate Staffing 4 - Good Management and Leadership 4 - Good All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. Bellfield Home, page 26 of 27

27 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: Bellfield Home, page 27 of 27

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