Inspection on 24/05/05 for Blair Park Residence For The Elderly

This inspection was carried out on 24th May 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

CARE HOMES FOR OLDER PEOPLE Blair Park Residence For The Elderly Crown Road Milton Regis Sittingbourne Kent ME10 2AL Lead Inspector Robert Pettiford/Sally Hall Unannounced 24 May 2005 09:55 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 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. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Blair Park Residence For The Elderly Address Crown Road Milton Regis Sittingbourne Kent ME10 2AL 01795 423695 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Charing Healthcare Ms Sarah McKelvie Care Home 47 Category(ies) of Dementia - over 65 (10) registration, with number Old age (37) of places Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30 November 2004 Brief Description of the Service: The home is situated on the southern edge of the village of Milton Regis, on a main road leading from Sittingbourne. It provides accommodation on two floors. The premises are part adaptation and part custom-built. There is a shaft lift between floors and corridors are wide enough for wheelchairs. The home benefits from a large dining room and three alternative day rooms. There is ample parking space’s, both on site and on the adjoining side road. Local shops and other amenities are within a short walking distance and the home is on a bus route. The main line railway station is in Sittingbourne, about a mile away. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection at Blair Park took place on 24th May 2005 at 9:55am. The Inspectors agreed and explained the inspection process with the Registered Manager. Documentation and records were read, including care plans. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. A tour of premises was also undertaken. The focus of the inspection was to assess Blair Park in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. What the service does well: What has improved since the last inspection? On-going training is taking place for all staff. The home has a development programme which the Registered Manager stated meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. From records viewed by the inspector all staff had received training to NTO guidelines. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 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 Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 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 standard(s) 1,2 Service users have the information they need to ascertain whether the home can meet their needs. Service users rights are largely protected by a written contract / statement of terms and conditions which requires some minor amendments. Prospective residents have the benefit of a trial period at the home to assess whether the home can or cannot meet their needs. EVIDENCE: The inspector viewed the current information available to prospective service users. The Statement of Purpose and Service Users Guide for Blair Park was seen to include most of the information outlined in the Standards. The Registered Manager was requested to ensure that it includes all information outlined in Standard 1.2 and Schedule 1.of the Care Standards Regulations. The Registered Manager reported that a copy of the previous inspection reports are made available to service users and their families on request. A written contract / statement was available outlining service users’ rights, responsibilities, and conditions of placement is in place, some minor Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 9 amendments were seen to be needed. Each service user has been provided with a copy. In the residents’ files sampled the inspector saw that all residents are assessed prior to coming in to the home for the trial period. Residents are also reassessed if they spend a period of time in hospital. These assessments cover the requirement of the standard and are detailed. During the inspection staff were asked about the specialist training that they had had to help with the care a specific residents in there care. Staff confirmed that amongst the list of specialist training were courses on Parkinsons disease and dementia for example. The other training records showed that staff are given the skills to care for residents and the that staff are doing NVQ’s in Care. The inspector found from talking to both staff and residents in the home that residents are encouraged to visit the home and spend time at the home prior to staying for a trial period. Staff explained that this time is also used to how well the prospective resident gets on with the other residents already living at the home. Staff also explained that if the prospective resident feels comfortable and wants to come to the home then they do so on a twenty-eight day trial, during which time the assessment continues. A review is held at the end of this time with all the interested parties and if the trial has gone well the resident can choose to be come permanent. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-10 The care of residents is compromised by the care planning procedures used by the home which do not always encompass the residents’ assessment findings or reflect the daily care offered to residents. The residents are protected from harm by the home’s policy and procedures with regard to the administration and dispensing of medication though the storage of medication needs to be improved. Residents benefit from being treated with respect and dignity and their independence is promoted by the home. EVIDENCE: The plans of care seen on the files sampled covered a wide range of needs individual to the said resident but they did not always cross reference fully with the assessment. The plans detailed the care required to preserve the residents dignity while promoting independence, choice and social interaction. In the files sampled it was evident that not all the plans of care are reflected in the daily events. Examples of this were discussed with the manager. It was also evident from observation that staff do far more than they detail in the daily record. The inspector found that some of the entries were timed for the time of entry rather than the time of the event, this was particularly noticeable at night. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 11 The documentation seen confirmed that all Service users have a GP and visits from other health professionals are arranged and enabled. The health care issues of the residents were seen recorded in the daily record but the follow up action or continued observation was not always documented, leaving it unclear what the outcome had been. Several examples of this were highlighted to the Manager and her assistant. Staff said that hospital visits are enabled and if the family is not able to accompany the resident then the home tries to arrange this. The medication storage at the home was inspected the medication room was clean and tidy but the storage of controlled drugs was not adequate and some of the cupboards containing medication are not lockable. The room is however locked and the controlled drug storage is being remedied following the purchase of a cabinet that had the inner box missing. Records were kept of medicines received into the home and sent back to the pharmacy. There were no gaps seen on the administration records and medication left in sock at the end of the month had been brought forward. Staff were observed administering the medication in the correct manor. Prior to doing the medication round a staff member was observed getting the trolley ready prior to starting the round, she also cleared and cleaned the trolley at the end of the round leaving it ready for use. Advice was given to staff on the how to record the new controlled drugs that enter the home. The staff on duty were observed indirectly throughout the inspection, they were seen to interact in a positive and respectful manner with residents. Residents gave positive feedback during the inspection about the approach of the staff team, comments included “nothing is too much trouble for the girls” and “they are lovely”. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12-15 Whilst residents who suffer with dementia have access to a suitable range of activities provided by the home, other residents do not have similar opportunities provided for them. Residents maintain their independence and exercise their right to choice and control and are encouraged to maintain contact with their family and friends. Whilst the dietary needs of residents are well catered for the residents’ views and opinions are not always sought regarding the choice of meals served. EVIDENCE: The home is looking to employ an activity co-ordinator to work with the residents on the residential side of the home. The inspector was however impressed by the activities that are happening in the unit caring for people with dementia. The staff there show an understanding of the residents motivational needs and are proactive in finding new activities that interest them an individual and group basis. The residents spoken to said that they do have people come into entertain them, but that they do much through the day normally. The manager explained that they do have a vacancy for an activity co-ordinator, a post that they hope to fill soon, confirmed this. A lay reader form the church visits twice a month. The inspector was also told about children who come in to the home from the church and put on a puppet show, this is popular with the residents. The residents spoken to said that the only time they go out is when and if there families take them. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 13 All of the residents spoken to in the home commented on the food, and said how good it was and that they had daily choices offered. Evidence was seen of the four-week menu. Residents were observed during meal- time and choice was not offered as staff confirmed the resident had chosen what they would have the day before. The staff did however tell the resident what the meal was as they gave it to them. A suggestion was made to the manager to consult with residents on the day what they would like to eat rather than the day before as most residents had forgotten what they had ordered. When asked about the meals in the home some residents told the inspector that the meals are “ very nice” others told the inspector that at lunch time that day they did not really like either choice that was offered for dinner. They did not feel comfortable asking for something else, Residents also commented that because are asked the day before what they want, they forget or have changed their mind by the next day. another resident stated, “ the food was smashing and they always have something which I like”. All agreed that the meals they had was always well cooked. The home does record what each resident has eat each day, some residents would benefit from having the amount they have eaten recorded, this is so that residents with a poor appetite can be monitored. The home is able to offer special diets the assistant manager confirmed. Visitors are made welcome at any time and the resident can be helped to there bedroom if they wish with refreshments available as required. This was evidenced during the inspection and on speaking to a relative. They stated, “They were free to visit when ever they wished and were very happy with the home”. The home can provide meals for a small charge to relatives who wish to stay for this. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Service users know that their concerns and complaints are taken seriously. Service users are protected from the risks of abuse by the home’s policy and procedures. EVIDENCE: The inspector viewed a copy of the Home’s complaints procedures. The procedure included details of how to complain, timescales for response and information for referring a complaint to the Commission for Social Care Inspection A copy of the complaints procedure has been provided and explained to service users. The inspector viewed and discussed copies of the Home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training is provided in abuse. More courses are planned to ensure all staff receive the training required to protect service users from abuse. Criminal Record Bureau Checks (CRB) have been obtained for all staff. Any staff where their CRB has not been received by the home are supervised at all times. The Registered Manager is aware of her obligations with regard to ensuring the safety of Service users and protecting them from abuse. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 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 standard(s) Not inspected on this occasion. EVIDENCE: Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28.1,29,30 Service users’ care, social and emotional needs are promoted by the employment of caring and suitably trained staff. Service users are protected from potential abuse by the home’s robust staff recruitment procedures. EVIDENCE: The home has a mix of management personnel, care staff, chef and kitchen assistants, laundry assistant, maintenance specialist, and housekeeping staff. A copy of the staffing roster seen indicates that rotas have been prepared for the following month. The home provides seven AM staff and six PM with three staff working nights. The rota and observations during the inspection reflected sufficient staff to support residents to participate in activities and to meet their personal needs. The Registered Manager stated that staffing levels are regularly reviewed taking account of the changing needs of residents. The Registered Manager and the Registered Provider Company has encouraged a continuing development and training programme within Blair Park which has supported staff to attain a high level of training. Currently 20 staff have an NVQ Level II in Care or above and 7 are working towards. Three Senior Carers have an NVQ Level III in Care. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 17 Training and development are linked to the homes’ service aims and to service users’ need and individual Plans. On-going training is taking place for all staff. The home has a development programmed which the Registered Manager stated meets National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. From records viewed by the inspector all staff had received training to NTO guidelines. The manager is in the process of updating the training matrix to reflect an overall picture of staff training within Blair Park. The inspector viewed details of the Home’s recruitment procedure and a number of records relating to staff members recruited. The Home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. The Registered Manager reported all staff had received statements of terms and conditions of employment, evidence of which was seen in the file. Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected on this occasion. EVIDENCE: Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 20 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 OP7 Regulation 15, 13 Requirement A service user plan of care generated from a comprehensive assessment(see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered.Ensuring the care provided is reflected in the daily report. The registered person shall ensure that thecare home is conducted so as—(a) to promote and make proper provision for thehealth and welfare of service users;(b) to make proper provision for the care and, whereappropriate, treatment, education and supervision ofservice users.The registered person shall makearrangements for service users—(a) to be registered with a general practitioner oftheir choice; and(b) to receive where necessary treatment, adviceand other services from any health careprofessional.The registered person shall ensure that thecare home is conducted so as—(a) to promote and make proper provision for thehealth and welfare of service users;(b) to Timescale for action 1st June 05 2. OP8 1st June 05 Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 21 3. OP9 4. OP12 5. OP13 make proper provision for the care and, whereappropriate, treatment, education and supervision ofservice users.The registered person shall makearrangements for service users—(a) to be registered with a general practitioner oftheir choice; and(b) to receive where necessary treatment, adviceand other services from any health careprofessional. 13(2) The registered person shall makearrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into the care home.Regulation 16(2)(m), The routines of daily living and (n) activities made available are flexible and varied to suit service user’s expectations preferences and capacitiesThe routines of daily living and activities made available are flexible and varied to suit service user’s expectations preferences and capacities 12(4)(a),1 Service users are able develop 6(2), links with the local community 23(2)(i) and/or maintained in accordance with service users’ preferences and outings should be enabled 1ST July 05 1st july 05 1st july 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. 1. Refer to Standard Good Practice Recommendations Blair Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Park Residence For The Elderly H56-H06 S23893 Blair Park V224997 240505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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