Inspection on 05/04/06 for Blair House Nursing Home

This inspection was carried out on 5th April 2006.

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.

Other inspections for this house

Blair House Nursing Home 20/09/07

Blair House Nursing Home 26/01/06

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 5th April 2006 09:30 Blair House Nursing Home DS0000002532.V286836.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.V286836.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.V286836.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.V286836.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 26th January 2006 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 either 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 en suite 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. Fees at the home on 05/04/2006 currently range from £520.00 - £1,300. p.w. Blair House Nursing Home DS0000002532.V286836.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken over a six hour period using a review of all the information regarding our Inspection records available to the Inspector about Blair House, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying 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 Blair House. This inspection 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.V286836.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.V286836.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): 2 Admission arrangements and 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 Service User Guide, which the Manager is in the process of further updating. This is shared with any new resident before admission. Care plans looked at showed that copies of the information that each resident needs when moving into the home are made available and that this is used to start a full assessment of needs. Since the last Inspection there have been two new admissions to the home. The Inspector talked to one new resident who told the Inspector that “The staff here are much better than at my old place, the best thing about being here is its near to my mum so I can go to see her, and she can come here”. The Manager confirmed that 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 needs and wishes to ensure any new need is balanced by the needs of existing residents. The Manager confirmed that she continues to build links with Social workers and health professionals which are used to identify and review the needs and wishes of each resident on care plans. One new resident told the Inspector, “Ive got a Social worker and I am going to get a key worker, they are finding out about me so they can look after me”. Blair House Nursing Home DS0000002532.V286836.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 shows 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. Records provided confirmed that 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, involving residents, other professionals 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 saw the care team providing care in the way described within residents plans and risk assessments and two residents told the Inspector they knew about their care plan and how carers supported them to take part in activities in the home and outside. Blair House Nursing Home DS0000002532.V286836.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): 12,13,15,16 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 reviews looked at confirmed that they are used to explore needs and wishes of each resident. 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. On the day of the inspection the Inspector met with a group of residents, the activity CoOrdinator and two students on placement at the home. Residents were observed enjoying activities and one of the students told the Inspector “This is a really good home, there are a wide range of activities and I am finding this work rewarding” Holidays are organised using risk assessments with support from the Manager and two volunteer workers. The Manager confirmed that there are four short holidays planned for this year. Four residents told the Inspector that meals at the home are good and the Inspector looked at menus which were varied and included details of each residents likes and dislikes. Blair House Nursing Home DS0000002532.V286836.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): 18,19 and 20. Residents are supported by staff in the right way to ensure health needs are met, and to understand wider needs in order to encourage choice for each individual. EVIDENCE: The Inspector observed nursing and 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 two residents showed the Inspector their rooms and said that they had chosen the colours themselves. 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. All residents require support with medication. The nurse in charge at the home showed the inspector the homes medicine storage and systems along with records used for giving out medicines in the correct way. These were all seen to be working in an organised way with management and disposal practice in place to make sure residents are given the right medicines at the right time. Blair House Nursing Home DS0000002532.V286836.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): 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 organisation has the complaints policy printed in Makaton, which makes it available to all residents. 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. There have been no formal complaints since the last Inspection. 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 action the Adult Protection Procedure since the last inspection. Blair House Nursing Home DS0000002532.V286836.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 have been improved to ensure that the needs of all residents can be met safely. Residents are beginning to benefit from planned maintenance and a decorative update. EVIDENCE: The Inspector looked at written comment cards sent by family carers before the last Inspection and communication from the organisation on work carried out and being planned to improve the environment for all residents. This site visit confirmed that fencing around the home has been replaced. The home owners have also confirmed that pillars at the home entrance will soon be replaced and that a full review regarding the use of the conservatory area is being carried out to make the area safe for use by residents. The Inspector did observe that some decoration and replacement of carpets has been carried out but highlighted to the Manager that the home would benefit from a full decorative update. The need to keep up with general maintenance needs was discussed with the manager and Property Services Manager before, and on the day of inspection. It was confirmed that the organisation has agreed to commence work to address overall maintenance issues and a full internal environmental audit completed by the manager continues to be used to review and update the home. Blair House Nursing Home DS0000002532.V286836.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 is supported by the home-owners with recruitment procedures 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: Information provided by the home owners confirms that staffing levels are currently being maintained well. Through a discussion with the manager it was confirmed that the organisation operates a structured recruitment policy with safety checks carried out to ensure that there is a balance skilled staff available for all residents. The Inspector met with a group of four staff during the Inspection. The group individually described the right sort of action to take to protect residents from fire and from abuse. One staff member said, “I am really committed to this role and feel I get the support of the Manager to develop my skills”. On the day of inspection there was a good mix of staff in place, who were working actively with residents providing physical and sensitive emotional support either in their own rooms or in the main activity areas. Other residents were being supported to attend outside activities. There is a printed, structured programme of training in place for the year and the Manager provided details of induction, foundation and key training that carers are encouraged to undertake so that the established team continue to work toward appropriate levels of NVQ for staff. Blair House Nursing Home DS0000002532.V286836.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): 37,39 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: The Manager was registered with the commission to undertake the role of Registered Manager on 15/11/2005. The Inspector observed that the Manager continues to have a “hands on approach” which residents respond to, and the care team confirmed supported them in their duties. The manager told the inspector that she understands her responsibilities toward staff and residents, and since the last inspection the Manager has continued to work together with the home owners regarding maintenance and decoration needed to the fabric of the home with the organisation. Through this use of communication she has raised the profile of the material needs of the home, which has led to a commitment to commence repair and maintenance work needed from the home owners in order to further promote the health and safety of all residents. Blair House Nursing Home DS0000002532.V286836.R01.S.doc Version 5.1 Page 15 Blair House Nursing Home DS0000002532.V286836.R01.S.doc Version 5.1 Page 16 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 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 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X 3 X X 3 X Blair House Nursing Home DS0000002532.V286836.R01.S.doc Version 5.1 Page 17 NO. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations It is recommended that the registered provider continues to use the existing internal audit carried out by the homes Manager to undertake an ongoing 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. Blair House Nursing Home DS0000002532.V286836.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.V286836.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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