Inspection on 17/10/07 for Blackrod House

This is the latest available inspection report for this service, carried out on 17th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Similar services:

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Blackrod House Chorley Road Blackrod Bolton Lancashire BL6 5JS Lead Inspector Mike Murphy Unannounced Inspection 17th October 2007 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 Blackrod House DS0000069610.V342155.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. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackrod House Address Chorley Road Blackrod Bolton Lancashire BL6 5JS 01204 690287 01204 690287 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) Mrs Irene Louise Burton Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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. The maximum number of people who can be accommodated is: 17 Date of last inspection Brief Description of the Service: Mrs Irene Louise Burton home owns Blackrod House residential care. The home can provide care and accommodation for up to 17 older people. Blackrod House is a two-storey property, situated in the centre of Blackrod, close to bus routes, shops, and other community facilities. The home has 11 single bedrooms and 3 doubles. There is a lounge, a dining room and a conservatory on the ground floor, and toilets and a bathroom on each floor. The home is fitted with adaptations and equipment suited to the needs of the resident group. Equipment includes passenger lift, level access shower and grab rails. There is an enclosed garden at the back of the house. The current scale of charges ranges from £335 and £380 per week. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection which included a site visit which the home did not know was going to happen took place on the 16th of August 2007. The inspection took place over seven hours. The inspection included discussion with residents, their relatives, a tour of the premises, inspection of care and other records maintained at the home and discussion with the manager and care staff. What the service does well: What has improved since the last inspection? What they could do better: Care records need to reflect that all residents are being weighed regularly. The home is currently using conventional bathroom scales to weigh residents – however this must be difficult for those residents experiencing mobility/balancing difficulties. It is strongly recommended that sitting scales are provided to safely and accurately determine resident’s body weight. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 6 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. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 7 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 Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 8 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. Standard 6 does not apply to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. No prospective residents are admitted to the home without their care and support needs being assessed appropriately. EVIDENCE: Before someone is admitted to the home the registered manager carries out an assessment of the prospective resident’s needs in consultation with the resident, their relatives and relevant health (for example doctors) and social care professionals (for example social workers). The purpose of such an assessment is to assist the prospective resident (and their relatives) in their consideration of how appropriate a placement at the home would be and enable the person conducting the assessment to judge if the home will be able to meet the prospective resident’s needs appropriately. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 9 3 (recently admitted) residents pre-admission assessments were inspected at this inspection. The records identified that pre-admission assessments had been carried out by the home and were supplemented by assessments conducted by Social Services. It is also noted that the format used for preadmission assessments has recently been reviewed and improved. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 10 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care provided for residents appears to be suitable, generally well organised, and meets the expectations of residents and their relatives. However how the body weight of residents is determined and recorded needs to be reviewed. EVIDENCE: The care records of three residents were inspected. These contained care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health and personal care needs of residents in a clear, organised way and were evaluated at least monthly. Risk assessments, that seek to protect resident’s health and welfare are recorded individually or incorporated into the care plans in respect of residents skin integrity (assessing the risk of pressure sores), mobility/moving and handling, and in respect of other areas of risk were also assessed at least monthly. No weight was recorded for 2 (quite recently admitted) of the 3 Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 11 residents whose care records were inspected. This should be recorded on admission and regularly thereafter – it was noted that a weight record was maintained for all other residents at the home. It is advised that whilst nutritional issues are addressed in care plans specific nutritional assessments (including a weight record) are made in respect of each resident’s nutritional status on a monthly basis. The home is currently using conventional bathroom scales to weigh residents – however this must be difficult for those residents experiencing mobility/balancing difficulties. It is strongly recommended that sitting scales are provided to safely and accurately determine resident’s body weight. Daily statements regarding resident’s progress are also recorded. All residents are registered with a local GP and it was evident that they were enabled to access dieticians, opticians, chiropodists, dentists, district nurses and other specialist services as individual residents needed. Pre-inspection comment cards completed by relatives and discussion with relatives on the day of inspection indicated that they are kept informed of all changes in their relation’s health. The practices for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate and safe. Staff responsible for the management of resident’s medicines have all received recent appropriate training. Medicine records had been completed properly. However it is recommended that all handwritten entries on resident’s medication administration records are checked and signed by 2 members of staff. Discussion with residents and staff and responses in Pre-inspection comment cards completed by residents and relatives, revealed that residents were treated with respect and that their right to privacy was upheld. Comments made included; ‘the staff treat me with respect and have always been very kind to me’, ‘they all make sure I am ok and are very decent’, ‘my relative says the staff are good and polite and make sure they are comfortable’. At the time of this inspection staff interacted positively with residents and showed them respect, protected their dignity and assisted them appropriately throughout the day. Residents and relatives all spoke positively in respect of the care and attention provided by the manager and her staff. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 12 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are being supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a very high degree of satisfaction with meals provision at the home. EVIDENCE: Discussion with residents, relatives and observations made on the day of visit indicate that the routines of daily life in the home are as flexible as possible in a group setting. Residents stated that they are able to choose what time they get up and go to bed, what activities to engage in and feel that staff inform and consult them about the care and support they need. Clearly this is very important in enabling residents to retain as much control over their life as possible. Resident’s individual preferences are detailed in their care records. Some chose to stay in their rooms rather than use one of the communal areas and this choice is respected. Residents were of the view that the leisure activities available to them were appropriate. Activities available included games, crafts, singing, bingo, Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 13 dominoes and gentle exercise. The home has a supply of books for residents’ use and occasional day trips are organised. The home has an open visiting policy. There are no restrictions on the time people visit. Evidence of this was highlighted in the visitor’s book where entries showed residents friends and relatives visiting at different times during the day and evening. The only time restrictions would be imposed is when requested by residents. Relatives spoken to during the inspection said they were always made welcome at the home and were able to see their relatives in the privacy of their own room or in a quieter lounge area. Residents spoken to expressed satisfaction with the care provided and organisation of life at the home. Meals are cooked on site in the home’s kitchen. Menus are varied and balanced and provide a wide range of choice. Meals are served in the dining room – This was appropriately furnished and provides a comfortable and pleasant area for residents to have their meals. Residents’ meal times are as reasonable and as flexible as they can be in a communal setting. Lunch was observed on the day of inspection. This was a hot and substantial meal and staff assisted and served residents their meals appropriately. Discussion with residents revealed a very high level of satisfaction with the meals provided. Comments made about the food included ‘ the food is really good’, ‘they give you proper home cooked food here’, ‘you always have a good choice and the food is excellent’. Clearly the satisfaction with the meals provided is a very important factor in residents determining how well they are being cared for. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives felt comfortable enough to and knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have a good knowledge of abuse and protection arrangements and safeguards were in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed in the home and included details of how to contact the CSCI if it was felt necessary by the complainant. Relatives said in Pre-inspection comment cards and on the day of inspection that any concerns or worries brought to the manager’s attention are responded to quickly and don’t become formal complaints. A complaints log is maintained. No complaints have been made to the CSCI in respect of the home since the last inspection. Policies and practices aimed at protecting residents from abuse are in place. Also Bolton’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had received adult protection training (refresher training for all staff had also been planned and was reflected in training records maintained by the home) and were aware of the whistle-blowing policy. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 15 Blackrod House DS0000069610.V342155.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): 19,20, 21,22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are cared for and supported in an environment that is comfortable and generally well maintained. EVIDENCE: A tour of the premises as part of this unannounced inspection revealed that the home was very clean and free of malodour throughout. Discussion with residents and visitors indicated this was the norm for the home. The lounges and dining rooms provide spacious, appropriate, comfortable and warm communal areas for residents. These rooms were decorated and furnished to a good standard. WC and bath/shower rooms were appropriately equipped and adapted to meet the health and safety needs of residents - the inspector was informed that a hydrotherapy bath was due to be fitted imminently to improve the bathing facilities for residents. Eight bedrooms were inspected on this occasion – these were clean, warm, suitably ventilated, Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 17 personalised, comfortable and appropriately furnished and equipped. They were also appropriately furnished and were supplied with a staff call buzzer. The décor and floor coverings in some bedrooms of some bedrooms were in need of attention – the inspector was informed that a programme of maintenance and refurbishment has been developed to address these issues. Residents are encouraged to bring personal items into the home and this creates a more personalised atmosphere in resident’s own rooms. Discussion with residents and their relatives revealed a general satisfaction with the bedroom and communal accommodation provided at Blackrod house. Comments made included ‘my room is kept clean and warm, it is comfortable and I am able to have my things from home in it’,’ my relative’s room is always clean and tidy’. Appropriate measures to prevent the spread of infection were in place – including adequate hand washing/cleaning facilities, laundry and sluicing arrangements, provision of disposable gloves and aprons for staff, adequate provision of house keeping staff, and appropriate arrangements for the disposal of clinical and other waste. Blackrod House DS0000069610.V342155.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment, provision and training of staff employed at the home are being managed appropriately. This is important to ensure resident’ are being cared for adequately and appropriately by staff who able to deliver this support safely and competently. EVIDENCE: Discussion with the manager and staff indicated that they were of the view that staffing levels were appropriate to meet the dependency levels and needs of resident’s. Residents and relatives spoken to were also of the view that sufficient care staff was provided to care for and support residents properly. There is also adequate provision of housekeeping, catering and ancillary staff at the home. Inspection of 3 staff personnel files revealed that these contained a completed application form, health declaration, 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity (including a recent photograph of the applicant and evidence of induction training and other training. There is a commitment to NVQ (with over 50 of all care staff having at least an NVQ 2 in care) training, moving and handling, fire safety, first aid, protection of vulnerable adults and other training provision for all staff at the home. The manager has been working in conjunction with the providers of Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 19 adult care training in Bolton to ensure that the induction and ongoing training provided by the home meets the common foundation standards and other requirements of ‘Skills for Care’ (part of the Sector Skills Council). This is to be commended. Discussion with staff revealed that they are supported and encouraged to access appropriate training regularly Blackrod House DS0000069610.V342155.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): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was being appropriately managed in a way that enables residents, their relatives and staff to feel that they are being supported properly. EVIDENCE: The home manager is experienced, has achieved the NVQ Level 4 in care and management and has completed the registered managers award. The manager stated she was in the process of submitting an application to the CSCI to become the registered manager of the home (it is a legal requirement that a manager who is registered with the CSCI is in post in all care homes). Discussion with residents, their relatives and staff indicate that the manager operates a management style that is open and accessible. The home was well Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 21 organised with a clear management structure. Senior carers and a team of care staff support the manager. The registered owner of the home frequently visits the home to support the manager. The manager has developed a quality assurance system to measure residents and their relative’s satisfaction, with the level of care and accommodation provided. This is essential as such information will enable a quality improvement plan to be fully developed and implemented to further improve the quality of life for residents. The manager informed the inspector that she intends to further develop the quality assurance system to incorporate the views of visiting doctors, nurses, social workers and others who regularly come to the home. And to develop a system of checks (for example of care records, medicines, social activities, catering, complaints/protection, the home environment, staff training and management processes generally) to ensure practices in the home are of as a high a standard as possible. Measures were in place to ensure that residents’ financial interests are safeguarded. Residents are encouraged to control their own money. However where they are unable (or choose not to) personal allowances are managed by the home. The arrangements for this were secure and appropriately documented. The health, safety and welfare of residents and others is promoted and protected. For example staff are provided with regular training and appropriate equipment to ensure resident’s moving and handling needs are met. An example of this would be for a resident who needs to be safely moved with the aid of a hoist. Fire safety training is regularly provided. Information provided by the home indicates that electrical/gas/other equipment safety inspections/servicing has been carried out at appropriate intervals. Blackrod House DS0000069610.V342155.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 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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. 1 Standard OP8 Regulation 12(1) 15(1) 17(1) 2 OP24 16(2) 23(2) Requirement The CSCI is informed in writing that all residents (who agree) are being weighed regularly on suitable weighing apparatus and that a written record of body weight is maintained for each resident. That the CSCI is informed in writing details of the proposals (including timescales) to refurbish refurbish/redecorate resident’s bedrooms Timescale for action 31/12/07 31/12/07 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 OP9 Good Practice Recommendations That all handwritten entries on resident’s medication administration records are checked and signed by 2 members of staff. Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Blackrod House DS0000069610.V342155.R01.S.doc Version 5.2 Page 25 - 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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