Inspection on 26/01/06 for Blair House Nursing Home

This inspection was carried out on 26th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 17/10/05

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 26th January 2006 09:30 Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 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.V275796.R01.S.doc Version 5.1 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.V275796.R01.S.doc Version 5.1 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 Mrs Glynis Branson 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.V275796.R01.S.doc Version 5.1 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 17th October 2005 Brief Description of the Service: Blair House is part of the Craegmoor Group of homes. 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.V275796.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a four-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? 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.V275796.R01.S.doc Version 5.1 Page 6 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.V275796.R01.S.doc Version 5.1 Page 7 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): Outcomes not looked at. The key standards were looked at during the last inspection undertaken on 17/10/05. EVIDENCE: Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 8 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 and family carers are aware that their needs are reflected in their care plans, 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. The Manager confirmed that reviews are plan 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 involves 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 the Inspector observed the care team providing care in a way which was reflected in residents plans and risk assessments. Residents were observed undertaking a variety of activities in one of the communal lounges both independently and with support as they wished, and the Manager confirmed that six residents were undertaking activities in the wider community. Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 9 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 and 16. 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. EVIDENCE: The Manager confirmed that Care plan 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. On the day of the inspection a group of residents were observed being supported to draw and colour and one resident told the Inspector that “Its good here, I like to draw”. Others residents were observed receiving support from staff to enjoy independent activities within the home, and six residents were undertaking day services and vocational/leisure activities. Holidays are organised using risk assessments with support from the Manager and two volunteer workers who the Inspector spoke to in during this Inspection. One volunteer is the homes previous owner and is a registered nurse. The Manager confirmed that there are four short holidays planned for this year. Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 10 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): 18 and19. 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: The Inspector observed care practice being undertaken by staff with residents in a caring and sensitive way in communal and private rooms way using time, and a variety of communication methods which residents responded to well. Resident’s rooms were observed to be personalised and the Manager confirmed that residents are encouraged to choose the decorative wall colours for their rooms and how they furnish their personal space. The Inspector spoke with one resident in her room who said “My room is my own, it smells so nice, how I want it”. Care plans provided information of all residents’ physical health care and medication needs and social needs, and that these are reviewed regularly. There was information on resident’s files, which confirmed good communication between the staff team and local medical practice/other professionals is maintained in order to provide support as appropriate as part of the review process. Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 11 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): Outcomes not looked at. The key standards were looked at during the last inspection undertaken on 17/10/05. EVIDENCE: Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 12 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. Parts of the building and grounds are in need of appropriate maintenance to ensure that the needs of all residents can be met safely. The home would benefit from a structured programme/plan maintenance and decorative update. The sluice facility in place needs to be connected fully to a hot water supply in order to support the hygiene practice of the staff team. EVIDENCE: During the last inspection it was highlighted that the home is in need of continued investment, as some parts of the buildings fabric are deteriorating. The homes conservatory roof needs to be replaced, as it is unsafe. The front gates need to be refitted or replaced and perimeter fencing is needs replacing to ensure the safety of residents when outside in the grounds of the home. It was also noted during observation of care practice that the current sluice facility in place is in need of further upgrading to ensure it is fully connected to the homes hot water supply. Concerns regarding overall maintenance of the home were discussed with the manager and Property Services Manager director prior to and on the day of inspection. As a result of this discussion it was confirmed that the organisation has agreed expenditure to commence the work needed to address specific maintenance issues and a full internal environmental audit has been completed by the manager and shared with the Property Services Manager, who told the Inspector that the overall maintenance needs of Blair House will now be prioritised and fully actioned. Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 13 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 recruitment procedures in place for staff and volunteers 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: Through a full discussion with the Inspector the manager confirmed that the organisation operates a structured recruitment policy and procedure to ensure that there is a balance of appropriate physical, nursing and social support for all residents. The Manager also confirmed that two volunteers who work with the home have appropriate checks in place in order to support residents safely. On the day of inspection the home were observed to have an appropriate mix of staff skills and levels in place, who were working actively with residents providing physical and sensitive emotional support either in their own rooms or in the main activity area. Other residents were being supported to attend outside activities and one resident was being supported to visit her doctor by a team member. During this Inspection the Inspector met with the Deputy Manager who arranges in house and wider training opportunities as appropriate to ensure all mandatory training sessions are undertaken by new staff for example; moving and handling, Adult Protection, food hygiene and fire safety. There is a structured programme of training in place for the year and the deputy Manager provided details of induction, foundation and progressive qualifications that carers are encouraged to undertake so that the established team continue to work toward appropriate levels of NVQ for care team members. Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 14 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 and 42. The home has a competent and committed Registered Manager who understands the needs of each individual resident. Resident’s benefit from the support given to staff by the manager in maintaining residents physical and social needs at the centre of the care giving, review and development process. EVIDENCE: Since the last Inspection was undertaken the Acting Manager has been formally registered with the commission to undertake the role of Registered Manager. The Inspector observed that the Manager has an open door at all times and a “hands on approach” which supports the care 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 manager and used in a structured way by the team to make sure care needs are met. The manager told the inspector that she understands her responsibilities toward staff and residents, and since the last inspection the Manager has taken action to raise concerns regarding maintenance and repairs needed to the fabric of the home with the organisation and through this use of communication she has raised the profile of the material needs of the home, which has led to a commitment to act to commence repair and maintenance work needed from the home owners. Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 15 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 X 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X X X X 3 X Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 16 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. 2. Standard YA24 Regulation 23(2)(b) Requirement The conservatory roof 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. The gates must be re fitted/ installed properly so that they are in working use at the front entrance to the home. Timescale for action 01/03/06 3. YA24 16 and 23 01/03/06 4. YA24 16 and 23 01/03/06 Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 17 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 YA24 Good Practice Recommendations It is recommended that the registered provider uses the existing internal audit carried out by the homes Manager to undertake a further environmental audit of the care home with the organisations property services Manager in order to develop a clear an action plan with timescales which fully identify and address all the environmental needs of the home. It is recommended that sluicing facilities provided are fully connected to the hot water supply in order to provide an appropriate sluicing system. 2. YA30 Blair House Nursing Home DS0000002532.V275796.R01.S.doc Version 5.1 Page 18 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.V275796.R01.S.doc Version 5.1 Page 19 - 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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