Inspection on 17/10/05 for Blair House Nursing Home

This inspection was carried out on 17th October 2005.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blair House Nursing Home 20/09/07

Blair House Nursing Home 05/04/06

Blair House Nursing Home 26/01/06

Blair House Nursing Home 16/03/05

Blair House Nursing Home 17/06/04

Blair House Nursing Home 22/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Blair House Nursing Home Skirth Road Billinghay Lincs LN4 4AY Lead Inspector Roger Harrison Unannounced Inspection 17th October 2005 08:50 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 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 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 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. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Blair House Nursing Home Address Skirth Road Billinghay Lincs LN4 4AY 01526 860432 01526 860432 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) Blair.house@craegmoor.co.uk Health & Care Services (UK) Limited Care Home 30 Category(ies) of Learning disability (29), Learning disability over registration, with number 65 years of age (1) of places Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration A Condition of Registration is that the maximum number of service users in each category is as follows:16 LD (Nursing) 13 LD (Personal Care) 1 LD(E) (Personal Care) Date of last inspection Brief Description of the Service: Parkcare Homes Ltd is part of the Craegmoor Group, owns Blair House. The home is located on the edge of the village of Billinghay. Blair House provides personal and nursing care for up to thirty (30) people with a learning disability from the age of eighteen years and above. The home consists of a two storey main house with ground level extensions that overlook the recently landscaped gardens or enclosed patio area. The home stands in its own grounds with gardens to front, rear, and car parking to the front and side of the building. Resident’s individual accommodation is provided in both single use and double occupancy bedrooms. Eleven of the bedrooms have ensuite facilities. Blair House also provides day care for some permanent residents and offers two day-care places. The village itself offers a variety of amenities such as pub, shops and post office. The home provides transport to enable service users to participate in educational and recreational activities outside of the village. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a four and a half-hour period, with the inspector using a method of inspection called “case tracking”. This involved selecting three residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at the home. This was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? The level of support to residents remains consistently positive. The home is in the process of replacing some of the carpets and furniture in communal areas of the home. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 7 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 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Pre-admission arrangements and subsequent assessments ensure that each residents needs wishes and aspirations are supported in the way they want them to be. EVIDENCE: The home has a Statement of Purpose and updated Service User Guide, which, is shared with any new resident prior to admission. Visits to the home in advance of any move are encouraged to get to know new residents and their families, and to provide choice and create opportunities for gaining an understanding of their needs and wishes to ensure any new need is balanced by the needs of existing residents. Trial periods are used to ensure long term needs can be met and that residents are happy to remain at the home. On the day of inspection residents were observed moving freely around the building and going out into the community with support from staff. Through general further observation of care practice and discussions with staff team the care home evidenced they are able to meet the needs of the current group of residents. Records looked at confirmed that residents are consulted about their needs and wishes informally and through regular reviews, and are given the support that each person needs to continue to live actively and to be as physically and mentally independent as possible. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 9 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Each resident has a care plan, which reflects their physical and social needs and how each will be met. Residents are aware of their own needs, and that they are supported to make informed choices about the way they wish to live. EVIDENCE: Each resident has a detailed care plan, which reflects all physical and social care needs. Residents have a risk assessment linked to their individual care plan. Care plan reviews are undertaken monthly and risk assessments reviewed every three months or as needed. Where there are changes in need, the home undertakes further, more detailed risk assessments, which involve residents, and where appropriate their family carers. Any action taken is recorded within residents care records. This enables residents to be fully involved in any decision-making and to be supported to take risks in the way they wish to. On the day of inspection care plans were being used actively by staff to provide care appropriate to individual need. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 11 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Residents have access to a wide range of activities to suit their needs. Activities are supported in the home and wider community, which helps to ensure relationships are maintained and further developed. The home provides a nutritious diet for all residents. EVIDENCE: Care plan assessment and reviews are used to explore needs and aspirations with residents. As a result some residents choose to attend day service programmes and /or college placement. A key worker system is in place to help support residents with these programmes. Through discussion with the manager and checking of care records it was evident that a wide variety of activities are organised on a regular basis for all residents to include going to the gym, bowling, and wider trips to Scarborough, Brighton, Bridlington and Great Yarmouth. On the day of the inspection a group of residents were observed being supported to draw and colour, others were observed receiving support from staff to enjoy independent activities within the home, and eight Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 13 residents were going on a mini bus to undertake day services and vocational/leisure activities. Meals in the home are planned using a menu rota, which changes each week. Residents dietary needs are established through the assessment and care plan process but any change in needs or wishes is incorporated in the menu plan. Lunchtime was observed and it was unhurried and relaxed, with appropriate numbers of staff on hand to assist service users who required help with dietary intake. One resident told the inspector, “The food here is very good”. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20. Residents are protected by policies and procedures within the home, which are used to ensure health needs, are met in the right way and to understand wider needs in order to encourage choice and self-determination wherever possible for each individual. EVIDENCE: Residents are encouraged to self-medicate wherever possible. However, on the day of inspection all residents required support with medication. Care plans provided information of all residents medication needs and that these are reviewed regularly. There was information on resident’s files, which confirmed good relationships between the staff team and local medical practice, who provide support as needed with these reviews. During the inspection the inspector spoke to a community physiotherapist who was visiting a resident. She said “We work as a team here to meet all needs in the best way we can” Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 15 The care home has a detailed procedure that covers all aspects of medication administration, storage and safekeeping. A random inspection of resident’s medication records provided evidence of appropriate support being given to residents with medication at the right time and good day to day storage and record keeping was observed to be being maintained by the manager and senior care team to ensure the safety of residents. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Residents and family carers are encouraged to be open about their feelings and concerns. The manager and staff take action to address ideas put forward for developing practice and issues of concern. The home uses induction, training and team meetings to ensure that the policy in place for protecting residents is taken seriously and acted upon when required. EVIDENCE: The home has a complaints procedure and corporate policy on complaints, which is displayed on the notice board. The home has the complaints policy printed in Makaton. The manager has a complaints log whereby investigations or other detailed information can be stored confidentially. Some but not all residents have the ability to understand the complaints process, however all families are made aware of the complaints procedure via the statement of purpose, and service user’s guide. On the day of inspection staff demonstrated a verbal understanding of the procedure to follow in order to protect residents from all forms of abuse. The manager uses staff team meeting to discuss the need to protect residents and has arranged for further training to support staff in the understanding of abuse and reporting procedures. The manager has not needed to invoke the Adult Protection Procedure since the last inspection. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 17 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The home is in need of a decorative update. Parts of the building and grounds are in need of appropriate maintenance to ensure that the needs of all residents can be met. EVIDENCE: During the last inspection various environmental issues were found to be deficient. Concerns raised regarding replacement of carpets in communal areas have been considered, quotes have been obtained and there are plans in place to replace carpets in the corridors, and where it is needed in some of the resident’s bedrooms. Furniture to replace the existing tables and chairs in the communal dining area of the home has been obtained and the manager confirmed this would be delivered soon. However, The home is in need of continued investment, as some parts of the building are looking generally shabby and smelling damp. The homes conservatory needs to be replaced, as it is leaking and currently not able to be used, and fencing around the rear of the home is damaged, and in need of replacing to ensure the safety of residents when outside in the garden area. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 19 Concerns regarding overall maintenance of the home were discussed with the manager and operations director on the day of inspection. It was agreed that more time would be given to address specific maintenance issues A full environmental audit needs to be carried out by the operations manager with the acting manager in order to provide an action plan detailing how the management team will address concerns raised within timescales. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. The manager has robust recruitment procedures in place and provides appropriate levels of support to the care team, who are able to use training provided to support residents within the home and wider community. EVIDENCE: On the day of inspection the home was adequately staffed, with staff, who are experienced and competent to care for residents who have learning disabilities. The manager confirmed that a robust recruitment policy and procedure is in place to ensure that the team is balanced and provides appropriate physical, nursing and social support for all residents safely. The staff team were seen to work well together and told the inspector that they felt supported by the deputy manager to their job. Care staff told the inspector they are clear about their roles within the home and that they felt training opportunities are available for them to develop existing and new skills further. The home has a training co coordinator who arranges in house training as appropriate to ensure all mandatory training sessions are undertaken by new staff for example; moving and handling, food hygiene and fire safety. Staff are supported to undertake NVQ training and the established team have of appropriate NVQ qualifications Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 21 The manager, deputy and senior carer provide supervision formally for all staff with records maintained and stored securely by the manager. This system helps to ensure that any ideas needs or issues can be addressed as they arise. Team meetings are also provided to give the care team wider opportunities to contribute to development of practice within the home. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The home has a competent and committed acting manager who understands the needs of each individual resident. Resident’s benefit from the support given to staff by the manager in maintaining residents at the centre of the care giving, review and development process. EVIDENCE: The acting manager has submitted an application to the CSCI to be the registered manager and an interview has been arranged. The acting manager has an open “hands on approach” to the role she undertakes and operates flexibly to support the team in their duties. The managers office has been well organised, and provides a base for maintaining all records. These are kept appropriately by the acting manager and used in a structured way by the team to make sure care needs are met. The acting manager told the inspector that she understands her responsibilities and wishes to progress to become the homes registered manager in order to continue making a positive difference to the residents lives, and in supporting the staff team to develop practice in the right way. Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Blair House Nursing Home Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000002532.V257184.R01.S.doc Version 5.0 Page 24 YES. 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. 1. Standard YA24 Regulation 23(2)(b) Requirement The registered provider must carry out a full environmental audit of the care home and provide to the CSCI an action plan as to how they are to address the environmental concerns highlighted within this report with timescales. The conservatory is in need of being completely replaced. This requirement remains outstanding from the last inspection. The fencing around the rear of the home is damaged beyond repair and is in need of being completely replaced. This requirement remains outstanding from the last inspection. Timescale for action 31/12/05 2. YA24 23(2)(b) 31/01/05 3. YA24 16 and 23 31/01/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations DS0000002532.V257184.R01.S.doc Version 5.0 Page 25 Blair House Nursing Home Standard Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Blair House Nursing Home DS0000002532.V257184.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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