Inspection on 25/07/06 for Blackwell Care Centre

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Blackwell Care Centre 16/02/06

Blackwell Care Centre 20/09/05

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

CARE HOMES FOR OLDER PEOPLE Blackwell Care Centre Gloves Lane Blackwell Alfreton Derbyshire DE55 5JJ Lead Inspector Tony Barker Unannounced Inspection 25th July 2006 09:10 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 Blackwell Care Centre DS0000064322.V305178.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. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackwell Care Centre Address Gloves Lane Blackwell Alfreton Derbyshire DE55 5JJ 01773 863388 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) Ambiance Care (Blackwell) Limited Vacant Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16th February 2006 Brief Description of the Service: Blackwell Care Home is a purpose built home registered for 43 residents in the category of older people, situated in the village of Blackwell. The home can admit residents with personal care and nursing needs. Residents’ bedrooms are all single occupancy and 40 have the benefit of ensuite facilities. The care home provides a pleasant environment for the residents and accommodation is provided on two floors. There is passenger lift and staircase access to the first floor facilities. There are spacious communal areas, many with views of the grounds of the Home, which are accessible to the residents. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 8.25 hours and was a key unannounced inspection. The last inspection took place in February 2006 and was unannounced. Three residents, the Person in Charge and one member of care staff were spoken to and records were inspected. There was also a tour of the premises. Three residents were case tracked so as to determine the quality of service from their perspective. This inspection focussed on all the key standards and on the progress made towards achieving the requirements and recommendations made at the last inspection. What the service does well: What has improved since the last inspection? What they could do better: The Home’s procedures following suspicion of abuse of a resident must be consistent with the Social Services Departments’ adult protection procedures. These procedures must be available within the Home at all times. A manager must be put forward for registration. Blackwell Care Centre DS0000064322.V305178.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. Blackwell Care Centre DS0000064322.V305178.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 Blackwell Care Centre DS0000064322.V305178.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of three residents were case-tracked. The file of the resident most recently admitted – in July 2006 – contained a full assessment of need prior to admission. The Home was not providing intermediate care. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is ‘Excellent’. This judgement has been made using available evidence including a visit to this service. Residents’ health, personal and social care needs were set out in well recorded individual care plans and risk assessments. Residents were being protected by the Home’s procedures for dealing with medicines and felt they were treated with respect. EVIDENCE: Care plans were of a very good standard. It was clear from notices around the Home that relatives were being reminded of the Home’s policy of involving them in the care planning process – where individual residents were personally unable to so. However, only one of the three case-tracked residents’ files contained a residents’ or relatives’ signature confirming their involvement. Each resident had a nominated ‘named nurse’ and two nominated key workers. Recorded risk assessments were thorough and extensive. There was evidence of a good range of health monitoring and of visiting health professionals, such as Speech and Language Therapists. One resident’s file contained a disclaimer relating to the use of bed rails although there had been no multi-disciplinary decision prior their fitting. However, the Person in Charge displayed sound attitudes to the use of bed rails and gave examples showing they were used as Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 10 a last resort. A member of staff was heard asking a resident, who was sitting outside in the sun, if he had sun cream on and parasols were being used by residents. The Home had a tissue viability link nurse and it was clear that the Home takes a proactive approach to ensuring residents’ good health. The storage, administration and recording of medicines were examined and good standards were being maintained. A sheet of staff signatures was in place and each resident’s photograph was filed with their medicine charts. Two staff signatures were in place beside handwritten entries. One of the casetracked residents had been prescribed diazepam ‘prn’ (as and when required). There was no written protocol for the use of this ‘prn’ medication. Residents said they were being treated with respect by staff and one resident stated that, “Staff’s primary concern is that residents feel well in every way, including a touch and a smile”. The Inspector’s opinion of staff, on this inspection, was that they were very friendly and helpful. Staff were able to give examples of how they met residents’ need for personal privacy, dignity and choice. The Person in Charge was observed knocking on bedroom doors before entering. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14 & 15 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Residents were being provided with a stimulating lifestyle and were able to maintain contact with relatives. They were able to exercise choice in their lives and they received a wholesome and balanced diet. EVIDENCE: One resident spoke positively of the range of activities provided by the Home although another said she chose not to be involved in the Home’s structured social life. Posters of July’s activities were displayed around the Home – organised by the Home’s full-time Activities Co-ordinator – as were details of fund-raising activities. The Person in Charge said that two care staff had undertaken a training course on ‘Activities for the Elderly’ and have booked themselves on another course entitled ‘Activities for Wheel Chair Users’. One member of care staff felt that the Home’s Activities Co-ordinator was “very good with activities” and described further activities initiated by care staff, particularly at week ends when there were no structured activities timetabled. The Person in Charge described how one 96-year-old resident makes greetings cards and has placed a plastic flower petal on some name cards on bedroom doors. She further described how items are introduced into the Home on particular days each year – May Day, St.Patricks Day, 4th July, for example – as a means of orienting residents and acting as a talking point. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 12 The visitors’ book showed there was a good range of visitors to the Home each day. Residents confirmed they had regular visits from relatives with no restrictions. Bedrooms showed evidence of personal belongings being brought into the Home by residents. The Person in Charge indicated she knew how to request an advocate for a resident, if needed – from age Concern, for instance. Residents spoke positively about the quality of food provided and one said, ”they do their utmost to please”. The day’s menu was displayed on a chalk board in the dining room – with two choices indicated. A record of individual residents’ choices of lunch and tea-time was also seen. Dining tables were set attractively, with drinks, condiments and flowers on table-cloths. Food stock levels were seen to be satisfactory. The Cook said fresh vegetables and fruit were delivered daily. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Residents were being protected by robust procedures on complaints although adult protection procedures were less clear. EVIDENCE: The complaints procedure was displayed in the entrance hall and a copy was also in each resident’s room. It was appropriately worded. The Home’s complaints record was examined. There were two complaints recorded - both dated October 2005 – and appropriate action had been taken on both. The complaints form was well devised. One resident said she would speak to the particular Person in Charge on the day of this inspection, if she was unhappy about anything and added, “I am content here...this place does everything that an old person needs”. There was a very well worded ‘Whistle Blowing Policy’ although one member of care staff was unsure about it and thought she had not read it. This member of staff said she had attended a training course on adult protection recently. The Person in Charge said she had attended two Derbyshire County Council adult protection training courses, along with five other staff, and there were plans for the two remaining nurses and all other care staff to attend these courses in the future. The Home’s adult protection policy could not be found and, in discussion with the Person in Charge, the Inspector was unsure whether proper procedures would be taken following suspicion of abuse. For instance, prompt referral to the local Social Services Department was not Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 14 mentioned. However, the Person in Charge generally had a sound approach to these matters. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Residents were living in an attractive, homely and hygienic environment. EVIDENCE: The premises were attractively decorated and furnished, spacious and homely. There was some damaged paintwork in bathroom 3; and in the shower room there was a leak from the shower and a wall tile was missing. Otherwise, maintenance was to a good standard. Each bedroom had a lockable door and a lockable space and all but three bedrooms had an en-suite facility. The bedrooms seen were well personalised. The Home had three sluices and there were good hygiene standards in operation. However, the Infection Control policy/procedures could not be found. The Home was clean with no unpleasant odours. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Residents’ needs were being met by a staff group with good levels of qualifications and generally adequate competence. Residents were being protected by the Home’s recruitment procedures. EVIDENCE: The levels of nursing, care and ancillary staff, identified on the staffing rota, were good. Those staff and residents who were spoken to confirmed that there were generally adequate numbers of staff on duty although, recently, staff had been “very busy”, according to one resident. A residents’ questionnaire, completed in May, referred to the “need for more staff given higher dependencies (of residents)”. The Person in Charge said that agency staff had been used to address this issue but the latest recruitment drive had improved the levels of established staff and very few agency staff were now used. 89 of the care staff had achieved a National Vocational Qualification (NVQ) at level 2 in Care, three of whom had NVQ level 3 as well. The file of one member of staff, appointed in April 2006, was examined and was found to meet Regulation requirements in respect of her recruitment. Each staff file had a check list to ensure all these requirements were met. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 17 Documentation, relating to the Home’s three-day in-house induction course, was satisfactory. However, new staff were not all receiving full induction training, to Skills for Care specification, within six weeks of appointment. The Person in Charge pointed out that new staff are put forward for NVQ level 2 training as soon as places are available and Moving and Handling training is prioritised. She said that staff were up to date with mandatory training on this topic and on Fire Safety and Prevention. There was still need for half the staff group to have Basic Food Hygiene training and 70 to have First Aid training. The Person in Charge added that there was an adequate budget for staff training. She displayed an enthusiasm for staff training. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 & 38 Quality in this outcome area is ‘Good’. This judgement has been made using available evidence including a visit to this service. Residents and staff were benefiting from the management approach of the Home, although lack of a registered manager could, potentially, compromise their welfare. Staff were being appropriately supervised. The Home was being run in the best interests of residents and their health and safety was being promoted. EVIDENCE: There had been no registered manager in post since April 2006. The Person in Charge, on the day of this inspection, was a full time registered general nurse who was holding additional management responsibilities. She had been qualified for 38 years and had worked in nursing homes for older people for 15 years. She had a sound grasp of the management role. The Person in Charge said that newly devised quality assurance questionnaires had been sent to residents, relatives and some visiting professionals in May Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 19 2006. The written responses were examined and found to be very positive with all being ‘good’ or ‘excellent’. There had been no questionnaires sent to staff. The Person in Charge spoke about attempts to involve relatives more by holding social events on Mothers Day and Fathers Day. Also, staff meetings and residents/relatives meetings had increased in frequency, to further increase opportunities for feedback on the quality of services provided by the Home. Not all the minutes from these meetings could be found. The Person in Charge stated that staff sign a document to confirm they have read and understood certain, though not all, of the Home’s written policies and procedures. There was no Annual Plan covering all aspects of the running of the Home, although there was a maintenance programme. Just one resident’s personal money was being held in the Home’s safe. The Person in Charge did not have access to this. The Person in Charge stated she had completed the first ‘round’ of formal staff supervision sessions and produced her agenda for the second ‘round’. These notes showed that appropriate consideration had been given to using staff supervision sessions to improve and maintain good staff practices. These sessions will be held bi-monthly, she added. It was noted that the Home’s Certificate of Registration had not been updated to reflect the agreed increase of resident numbers from 40 to 43. Other aspects of standard 37 were not assessed on this occasion. A tour of the kitchen was made and food hygiene standards were satisfactory. The kitchen had been redecorated since the Environmental Health Officer’s visit in late 2005, the Person in Charge said. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 20 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 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 X 3 Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 22 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 OP18 Regulation 12(1)(a) Requirement The Home’s procedures following suspicion of abuse of a resident must be consistent with the Social Services Departments’ adult protection procedures. It must be available within the Home at all times. An application must be made to the Commission to register a manager for the Home. Timescale for action 01/09/06 2. OP31 8 01/10/06 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. 2. 3. 4. 5. Refer to Standard OP7 OP8 OP9 OP18 OP19 Good Practice Recommendations Care plans should be signed by the service user, relative, or a person acting on their behalf. A multi-disciplinary decision should be made before bed rails are used for to any individual resident. A signed record should be made of this decision. A written protocol should be in place for the use of ‘prn’ (as and when required) medication for each resident, as appropriate. Staff should be encouraged to read the Home’s written policies and procedures and sign to confirm they have read and understood them. Maintenance in bathroom 3 and the shower room, as detailed in this report, should be carried out. DS0000064322.V305178.R01.S.doc Version 5.2 Page 23 Blackwell Care Centre 6. 7. 8. 9. 10. 11. 12. OP26 OP30 OP30 OP33 OP33 OP33 OP37 The Home’s Infection Control policy/procedures should be available at all times. New staff should be receiving full induction training, to Skills for Care specification, within six weeks of appointment. Training in Basic Food Hygiene and First Aid should be prioritised, for those staff who have not undertaken this training within the past three years. Quality assurance questionnaires should be sent to staff for completion. Staff should be expected to sign a document to confirm they have read and understood all of the Home’s written policies and procedures. An Annual Plan, covering all aspects of the running of the Home, should be developed. The Home’s Certificate of Registration should be updated to reflect the agreed increase of resident numbers from 40 to 43. Blackwell Care Centre DS0000064322.V305178.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 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 Blackwell Care Centre DS0000064322.V305178.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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