Inspection on 29/07/08 for Blackhurst Care Home

This is the latest available inspection report for this service, carried out on 29th July 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

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Polesworth Group 70 Long Street

Breme

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Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 Blackhurst Care Home Blackhurst House The Lawley Longnor Shrewsbury Shropshire SY5 7QJ Lead Inspector Rebecca Harrison Key Unannounced Inspection 29th July 2008 10:00 Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 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 Blackhurst Care Home DS0000069037.V369060.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 Adults 18-65. 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. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackhurst Care Home Address 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) Blackhurst House The Lawley Longnor Shrewsbury Shropshire SY5 7QJ 01694 771318 01694 771318 jvealuk@aol.com Blackhurst Care Home Limited Mrs Jane Veal Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Blackhurst Care Home DS0000069037.V369060.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 service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD) 6 The maximum number of service users who can be accommodated is: 6 2nd August 2007 Date of last inspection Brief Description of the Service: Blackhurst Care Home Limited is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for six adults with a learning disability. The home is situated in an isolated rural community in a valley to the northeast of Church Stretton. The building is of a country cottage style and domestic in nature. Accommodation is provided over two floors comprising a lounge, kitchen/diner, two single and two double bedrooms. A workshop and activity room is available within the grounds. Prospective service users and their representatives are able to gain information about this service from the Statement of Purpose and Service User Guide. Inspection reports produced by CSCI are available direct from the provider or are available from our website at www.csci.org.uk The fees charged were not available in the Service User Guide as required; therefore the reader may wish to obtain this information direct from the service provider. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We contacted the manager the day before the inspection to let her know that we would be inspecting the home; this was because most people who live at the home are out during the day. One inspector carried out the inspection over seven hours. An ‘expert by experience’ and his support worker also visited the home during the inspection. An expert by experience is a person who, because of their shared experience of using services and ways of communicating, visits a service to help us get a picture of what it is like to live in or use the service. During the visit they met with five of the six people who live at the home, talked with two staff, looked at some records and toured the home. A range of evidence was used to make judgements about Blackhurst to include discussions with five service users, two staff on duty and the manager. We also did a tour of the home, reviewed the homes quality assurance processes and observed the care experienced by people using the service. We received one survey from a professional and six surveys from all of the people who use the service. A number of records were reviewed to include care records held on behalf of two people, complaints and protection, staff training, recruitment and health and safety records. Two people who live in the home were ‘case tracked this involves establishing individuals experience of living in the care home by meeting them, discussing their care with staff, looking at care files and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the manager for completion. The AQAA is a selfassessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. The inspection reviewed all twenty two of the key standards for care homes for younger adults and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 6 users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. What the service does well: What has improved since the last inspection? What they could do better: People we spoke with did not think how the service could improve and they were happy with living or working at the home. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 7 It would be better if people living at the home had more involvement in their support plans and that these were reviewed and updated more regularly to reflect their changing needs. This would help the staff meet their needs more effectively. One person said ‘As with most services at the moment I think resources are limited and more staffing hours would benefit the service’ The management of people’s money is better recorded ensuring greater protection, however the manager was advised to ensure peoples benefits are paid directly into their own bank accounts. People would benefit from being provided with greater opportunities to develop their daily living skills to promote their independence within the home, for example cooking and laundering. The provider reported that service users are involved in daily living tasks as much as their abilities permit. Staff do receive training in safety procedures but may benefit from attending training in areas to include the mental capacity act, deprivation of liberty, equality and diversity, person centred planning, learning disability and management of actual and potential aggression to enable them to be more knowledgeable offering better support. The expert by experience said ‘Overall I found the home to be very friendly and people did say they liked living here…but I don’t feel there is enough staff, especially in the location. I do feel the home needs to be brought up to date, with the decoration, furnishings, people being supported and not cared for, staff having training on values and Valuing People, people understanding what choice is and having choices everyday like I do’. 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. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is adequate People looking for a care home can be confident that Blackhurst can support them. This is because information about the service is made available to help them make an informed choice about whether the home is able to meet their individual needs. A complete assessment of their needs is undertaken with them and others close to them, and people are given the opportunity to visit the home and “test drive” it to ensure the service is right for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about the service is available in the Statement of Purpose and Service User Guide. Both documents provide people with information to help them understand the services that the home provides, however these documents require updating which the manager agreed to do. There have been no new admissions to the service for a number of years however the home has an admissions procedure which indicates that a needs assessment would be obtained for any prospective service user and trial visits offered to ensure the home is suitable for meeting peoples needs. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 10 The expert by experience spoke to the people who live at Blackhurst to gain their views about what it’s like to live there. He said ‘From what people said, the people in the home do not always get on with each other…I don’t think people that don’t get on with each other should live together in such a small home’. The provider stated ‘People have been living together for the past 18 years and on the whole get on very well together, they do fall out occasionally which is normal behaviour for people who live together…they may argue with one another at times but will always defend one another and look out for each other’. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, and 9 Quality in this outcome area is adequate People living at Blackhurst have a support plan in place, which provides staff with information about their individual needs and how they prefer these to be met. It would be better if people were more involved with their plans and that these are updated more regularly to reflect their changing needs. Strategies should be developed to evidence that people who use the service are supported to make choices and decisions about their lives on a day to day basis with support if they need it. People are supported to take some risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 12 People living at Blackhurst have an individual plan and those case tracked have been formally reviewed by their placing authority. It would be better if people living at the home had more involvement in their plans and that these were reviewed and updated more regularly to reflect their changing needs. This would help the staff meet their needs more effectively. The expert by experience said ‘I asked what type of plans people had but people were not sure. Staff said they all have personal plans and shared one with me. The plan said lots about the person but it didn’t appear to have been updated since 2006’. The provider has since stated ‘Care plans and residents files had all been reorganised in 2008, and reviewed six monthly’. The homes Statement of Purpose states Blackhurst promises residents that staff will listen and value their views and comments, and will communicate openly and honestly, will be fair and reasonable in decision making and invest time and money in each individuals development…weekly service user meetings are held and residents encouraged and supported to make their views known and make decisions.’ People spoken with told us about the weekly meetings held and the things they discuss to include meals for the week, jobs and activities however more could be done to evidence that people are supported to make decisions on an individual basis and in their best interests. People living at Blackhurst are supported to take some responsible risks to maintain and develop their independence. Assessment of risks were available on the files sampled and include gardening tasks, using public transport, cycling, shopping, work experience, tasks in the workshop ensuring risks are minimised. The Statement of Purpose states ‘Residents are encouraged to take calculated risks to ensure they reach their full potential’ Discussions held and observations made indicate more could be done to promote people’s independence and skill mix for example cooking meals. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17 Quality in this outcome area is good The people who use the service are provided with good opportunities to develop their social, educational and recreational activities but could be better supported to develop their independent living skills with the support of staff. People are enabled to keep in contact with family and friends and receive a diet that is varied but lacks choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The self-assessment completed by the manager states ‘Residents lead full and active lives. We do not feel it can improve this area any more, only to keep listening to residents and try wherever possible to carry out their wishes for their own chosen lifestyle…’ Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 14 People told us about what they do during the week and it is clear that people are provided with good opportunities to access the community and partake in work experience, college courses, clubs and lots of different activities. The expert by experience spoke to five people who live at the home and told us ‘When people started to arrive home they were quite happy to talk to me and were very welcoming which was nice. I talked to people about what they did during the week and people said they do different things like working on local farms, accessing day centres and colleges. I felt people seem to have a busy week and was happy, this was great to hear. I also asked about local pubs and people said they would often go to the local pub and they really enjoy it. Staff said the people had lived here for a long time and knew lots of local people. I was really pleased to hear people being part of the local community. I asked about holidays and people said they all go together. I think people should be choosing their own holidays with support and having the choice not to go on group holidays. I asked if transport is a problem as it is such a rural area. People said they have their own minibus and it’s never a problem. I noticed the weekly planner on the board, which looked like people were quite active apart from on a Sunday where they only seem to go to church once a month’. The provider reported that people chose to go on holiday to Butlins as a group and that all service users have additional holidays independent of one another. Four people go home to their families on a regular basis, one person attends an activity holiday, another person attends a holiday with their day service and two people attend the Shropshire Sharks Olympics for one week’s holiday. The provider stated that people do not go to church every week as there is a family service once a month only. One service user plays the organ in church and four of the six people attend church, two choose not to attend. One survey we received stated ‘There are issues around being based in such a rural county which are beyond Blackhurst’s control. Lack of regular public transport and isolation can influence personal choices etc. Also it can be difficult to educate service users on a variety of choice available to them without further complicating life. To my knowledge the people I have contact with are happy with the support they receive’ People are supported to maintain contact with their friends and families if they desire and all contact is recorded. Friendships have also been developed through work experience, college, clubs and events held in the community. People told us that they help keep their rooms clean and can make drinks for themselves when they want but do not help with preparing or cooking meals, as observed during the inspection. The expert by experience told us ‘As I could smell the dinner cooking I asked who generally does the cooking. People said that staff do the cooking and all people eat the same food and are happy with it. This frustrated me, as I strongly believe people should be supported to cook their own meals. As people have lived here for such a long time it worries me that people just accept what meals they are given, and are not given choices. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 15 I asked who does the shopping and writes the shopping list. People said they write the shopping list on a Monday and then some people go shopping on a Thursday. I asked what people were having that evening for dinner but people said they didn’t know. People said they do take it in turns to do the washing up. I was then shown around the home and went outside to where the laundry was done. I asked who does the laundry and people said staff do. Again this frustrated me, as I felt that people were being cared for here and not being supported to be as independent as possible’. The provider has since reported that service users are involved in daily living skills as much as service users abilities allow. People told us that they like the food. Fresh produce was purchased from a local farm shop during the inspection. Records seen on one persons file evidence that concerns have been raised about the persons weight although there was no clear evidence available of how this is being monitored or that the meals provided take into account the persons dietary needs. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because there is good evidence of multi agency working in the best interests of the people living at the home. Staff effectively support people with the management of their medication safeguarding their health. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People’s preferences in relation to their personal care are recorded in people’s support plans and individuals spoken with said they are happy with the support they receive from staff. Observations made and discussions held evidence that the home could do more to promote people’s privacy and dignity for example by ensuring faulty privacy locks on the toilet and bathroom are replaced and provide privacy screening in shared rooms, if desired. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 17 People’s health needs are monitored and individuals are supported to access health appointments as and when required and outcomes are recorded. Everyone living at Blackhurst has a detailed Health Action Plan, which is a plan that states what an individual needs to do in order to stay healthy. Records seen on one file evidence that the home has sought professional input for one person’s condition and everyone’s health is monitored through an annual health check. ‘All About Me’ information packs have been developed in the event of admission to hospital. These packs are detailed and would provide hospital staff with vital information about the health and personal care needs of each individual. We received positive feedback from a professional who stated ‘We have no concerns at all about the management of health care needs. There are some ongoing issues but the service is open to working with us about them’. People who are on prescribed medication can be confident that the home is able to support them manage their medication safely as staff have a clear understanding of procedures to follow. Staff spoken with confirmed they have received training in the safe administration of medication however ongoing competency assessments have yet to be undertaken. The manager was advised to date ointments when they are opened. One professional told us ‘I believe those who do take medication are encouraged and supported to be as independent, as is reasonable by the service in question’ Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good People living at Blackhurst have access to a complaints procedure, which is accessible to people who live at the home and their representatives if they need to make a complaint and procedures are available to protect them from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live at Blackhurst have access to a complaints procedure, which was seen displayed in the dining room of the home. Discussions held with people clearly evidence that they have a good understanding of what to do if they were unhappy with the service they receive. One person said ‘I’ve never had to make a complaint because Jane and the staff are all so friendly and help us. I wouldn’t bottle things up, I’d speak to the staff if I was unhappy with something’. We have not received any complaints in relation to this service since the last inspection and the manager confirmed that no complaints have been received. The home has a copy of the local Multi-Agency Adult Protection policy and information is available for staff in the homes policies and procedures about managing the referral process. Both staff spoken with confirmed that they have received training in adult protection. The self-assessment completed by the provider states ‘All staff are to have further training in Adult Protection Procedures and the prevention of abuse’. Staff have not received training on the management of actual and potential aggression (MAPA) as recommended at the previous inspection. This training would benefit the staff team in Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 19 managing people’s behaviours that may challenge the service. The expert by experience told us ‘From what people said, the people in the home do not always get on with each other, I heard one person say sometimes they feel like killing another person because they talk so much. Another person said one person in the home steals from them sometimes’. People are supported to manage their money and following the last inspection procedures for the management of peoples finances have been reviewed as required. Records show that every time someone spends some of their money it is recorded and receipts are kept and checked by the manager. This ensures that all money is accounted for protecting service users and the staff who support them. We advised the manager to get the accounts checked by two people on a weekly basis to provide greater protection for people using and working at Blackhurst and request peoples benefits be paid directly into their own bank accounts and not into the homes business account where interest is accrued. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate The people living at Blackhurst are provided with a clean and comfortable place to live although they may benefit from the home being modernised to reflect their age range and lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Blackhurst is set in a rural valley to the northeast of Church Stretton and the property is of a country cottage style and is in keeping with the local community providing living accommodation over two floors to include a lounge, kitchen/diner, two single bedrooms and two double rooms. A separate workshop and activity room is available within the grounds. People have lived at the home many years and told us that they enjoy living there. One person stated ‘It’s a wonderful place to live, there is nothing I don’t enjoy about living here, I feel nice and safe, have independence and freedom and can do anything I want’. People who share a room indicated that they are happy with this arrangement and were happy to show us their bedrooms, which are personalised. One person indicated they would like the furniture in their room Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 21 replaced, as they are unable to open their drawers or wardrobes as the handles have broken, which was raised at the previous inspection. The need to replace furniture and furnishing is acknowledged in the selfassessment completed by the provider however a shorter timescale for replacement needs to be considered and discussed with the people using the service. Since the last inspection new windows have been fitted throughout the service users accommodation however window restrictors need to be fitted to all first floor windows for the purposes of safety. The expert by experience told us ‘On arriving at the home today I felt a bit uneasy as the home was so far away from other people, shops or buildings. I felt quite apart from the community. I also wasn’t sure which was the front door, as it was not clear. The home from the outside looked very nice and gardens looked like they were very well looked after. I was told six people live here, I thought the lounge was very small for this number and seemed very old fashioned with odd bits of furniture in it, the curtains and carpets looked old, it didn’t feel like a person’s home and definitely not big enough for six people and staff. Whilst I was being shown around the home I thought why does the manager live in the same house? As it made me feel that the home was more the managers than the people living here. I didn’t understand why people couldn’t live closer to a community. I was then shown a bedroom in which two men share…I can’t believe adults are sharing bedrooms together that aren’t a couple. I also could not believe the size of the room, it was very small for two adults and the furniture looked very old. I felt very sad these people have to share a room together, how can they ever have any privacy? The home also only had one bathroom for six people, I don’t think this is enough although one person does have a shower in the bedroom but is unable to use it due to having epilepsy’. I couldn’t understand why one lady lives with five men, although she told me that she is happy with this’. People living at Blackhurst are provided with a clean home, which is free from offensive odours. Products hazardous to health are appropriately stored and data assessments have been obtained. Both staff spoken with have received training on infection control procedures. Paper towels were not available, it was reported that some people were finding it difficult to operate dispensers therefore fabric towels are made available and changed daily. People should be offered a choice. The service is looking to further develop the infection control policy and procedures within the next six months, which will provide greater protection for the people living at the home. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 Quality in this outcome area is adequate People living at Blackhurst are supported by a committed and dedicated staff team however they may benefit from increased staffing levels and staff receiving more specialist training to enable them to be more knowledgeable offering better support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We spoke with two members of staff on duty at the time of the inspection and both people indicated that they have worked at the home for a number of years and enjoy their work. They spoke positively about the service and of their roles and responsibilities and demonstrated a good understanding of the individual needs of the people in their care and of those people we case tracked. People using the service looked relaxed in the company of the staff and it is evident that good working relationships have been developed. One person stated ‘Staff morale is good, we have a stable staff team and get on well’. Of the three support staff employed one person has obtained a care qualification known as NVQ at level 3, although the former deputy manager who provides support as and when required also holds an NVQ. The expert by experience said ‘There was two members of staff on duty, one was not very Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 23 friendly towards me and didn’t ask why we were there…I was impressed with another member of staff who returned to the home from supporting someone at college as they asked why we were here and was happy to help with any questions I might have’ The rota has been amended following the last inspection and now accurately reflects the staff on duty. Staff spoken with considered staffing levels are generally sufficient to meet the individual’s needs of the people supported, however an increase in staffing levels, particularly during evenings and weekends would provide greater opportunities for people. The expert by experience said ‘I asked if they were enough staff on for people to do what they want to do. I got the impression they only tend to have one maybe two staff supporting people. I don’t feel this is enough staff, especially in the location. People are currently going out in groups a lot and people should not have to. People need the opportunity to have choices and do thing they want to do, not continuously be in a group’. The home has a very low staff turnover and since the last inspection one person has been recruited. The staff member is very well known to the provider and the people who use the service. The provider obtained a criminal records disclosure as required and fully acknowledged that she should have ensured all information required had been obtained before the person commenced work and ensure appropriate checks for volunteers are undertaken. Discussions with staff on duty and training records seen evidence that staff have received training in safe working practices for example first aid, food hygiene, infection control, medication etc but have not received any specialist training although since the last inspection information on visual impairment, down syndrome has been obtained and made available to staff. The expert by experience reported ‘I asked if people or staff knew about Valuing People and they said no, they don’t have it around their area. This concerned me, especially from the staff member. People who work with people with learning disabilities should have good sound knowledge on Valuing People and ensure it is happening for people. I felt the staff should have training in Government policies effecting people with learning disabilities and also around having person-centred approaches to include different types of plans for people’. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good People have confidence in how the home is managed because the manager is open and approachable and understands the areas requiring further development in the best interests of the people using the service. Quality assurance systems could be further developed to identify people’s thoughts on the service provided and make changes to improve outcomes. The premises are managed and maintained in a manner, which ensures the safety of people using the service and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was opened in 1990 and is owned and managed by Mrs Veal who holds an NVQ level 4 in Care award but has yet to complete the Registered Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 25 Managers Award, as required. This now needs to be given priority. Certificates seen on file evidence that the manager has attended some training since the last inspection to include adult protection awareness, manual handling and a business seminar. The self assessment (AQAA) completed by the provider states ‘As the manager I commit to working hard at keeping the staff happy and well supported so that they enjoy their job, perform well and want to stay at Blackhurst. All this has a positive impact on the home, particularly the resident’s everyday lives’. Staff and people using the service spoke positively about how the service is managed and of their support for the manager. The expert by experience said ‘After I introduced myself to the manager I was disappointed that she asked my supporter what we wanted to do first. Why she didn’t ask me I thought wasn’t very nice and maybe she needs to have some value base training’. The provider has the support of a part-time administrator who was at the home at the time of the inspection to assist with administration and management duties. The Quality Assurance policy states ‘The home believes that no matter how good it’s services are, there is always room for improvement’. The manager has developed an implemented a quality assurance process that involves obtaining responses through the use of satisfaction surveys from people who live at the home, although feedback from staff, relatives and health and social care professionals has yet to be obtained. The surveys seen on the two peoples files indicate they are satisfied with the service generally although one survey indicated that a peer service user is bossy and the person has issues with another person, which need to be addressed. The manager has acknowledged in the self-assessment that Quality assurance and monitoring requires further development. People living at Blackhurst can now be confident that all of the health and safety concerns that we raised at the last inspection have been addressed ensuring people live in a safe environment. Service certificates were readily available in addition to risk assessments and other safety records required. Health and safety and maintenance checks are undertaken in the home to ensure that the equipment is safe and in full working order. The requirements made by the fire officer have now been compiled with to ensure the safety of the people living and working at the home in the event of a fire. It was reported that an Environmental Health Officer has visited the home since the last inspection and was satisfied with the procedures in place. Accident records evidence that one person required emergency treatment on one occasion however we were not notified, as required, which was fully acknowledged by the manager. Staff spoken with have received training in safe working practices and the manager is aware that some refresher training is required and further training for the person most recently recruited. As previously stated window restrictors are required on the newly installed first floor Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 26 windows. People using the service told us that they feel safe living at the home. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 x Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations The home should record any incidents of behaviours that challenge the service. Information will then be readily available to help with the monitoring and review of individuals to ensure they receive the appropriate support they may require. Strategies should be developed to evidence that people who use the service are supported to make choices and decisions about their lives on a day to day basis in relation to activities, meals and holidays. People who live at Blackhurst should have greater opportunities to develop their daily living skills to promote their independence within the home. Staff receive training appropriate to the needs of the current people accommodated such as the mental capacity act, deprivation of liberty, equality and diversity, person centred planning, learning disability and management of actual and potential aggression to enable them to be more knowledgeable offering better support. DS0000069037.V369060.R01.S.doc Version 5.2 Page 29 2 YA7 3 4 YA16 YA35 Blackhurst Care Home 5 YA37 The manager should complete the Registered Managers Award at the earliest opportunity so that she has the necessary qualifications required to manage the service. Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. Extracts may not be used or reproduced without the express permission of CSCI Blackhurst Care Home DS0000069037.V369060.R01.S.doc Version 5.2 Page 31 - 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. 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