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Inspection on 14/07/05 for Blakenhall Community Resource Centre

Also see our care home review for Blakenhall Community Resource Centre for more information

This inspection was carried out on 14th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Blakenhall Community Resourse Centre continues to provide a high standard of care despite the shortage of care staff . The Care Manager and staff are to be commended on their efforts to encourage the residents to maintain their independence through social activities both within and outside the home. In particularly the work that the home is carrying out to assisting people with cognitive impairment is to be commended as is the Dementia Care Mapping programme. Observations during the inspection saw very attentive staff providing for the individual needs of the residents using Sonas technique to help stimulate all of the senses. A small number of residents who could express themselves in a meaningful way confirmed that they were comfortable and content.

What has improved since the last inspection?

The statement of purpose for the home has been reviewed and revised. The home has provided a specially designed sensory garden, which is fully equipped with water feature, seating, lighting and umbrellas Internally a loop system has been fitted to all the lounges and new sluicing equipment has been provided in all three units.

What the care home could do better:

The home must improve the care staff cover in the units and ensure that all staff that administer medication, have accredited training The development of a Quality Assurance system that includes regulation 26 visits to the home will ensure that the high standard of care is maintained.

CARE HOMES FOR OLDER PEOPLE Blakenhall Community Resource Centre Hagger Street Blakenhall Wolverhampton WV2 3ET Lead Inspector Ian Harris Announced 14 July 2005 th 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. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Blakenhall Community Resource Centre Address Haggar Street, Blakenhall, Wolverhampton, WV2 3ET 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) 01902 553547 01902 553549 Wolverhampton City Council Anthony Edward Hipwell Older People 29 Category(ies) of Dementia (29) registration, with number Mental Disorder (29) of places Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1) Age 50 years and above. 2) No number division between the categories. Date of last inspection 21/02/05 Brief Description of the Service: [Blakenhall Resource Centre provides residential care and respite care for 29 adults over the age of 50, offering care for people with mental health needs, particularly those with dementia. The Resource Centre provides long and short stays for older people with dementia and the memory related difficulties that come with it, also providing care for people with a full range of mental health needs. The city council’s Social Services Department and the Care trust manage the centre as a joint project. There are two residential units Warwick and Windsor offering support for older people no longer able to live at home. The third unit Ludlow provides respite/short term care. There are car-parking facilities to the front of the property and an enclosed garden area at the rear. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 4 hours. The main purpose of the inspection was to check the progress made by the home regarding the recommendations and requirements made in the last inspection report. The fullest co-operation was given to the inspection officer by the Care Manager staff and residents. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 5 of the 39 Care staff were on duty, and 5 of the 29 residents were spoken to. 5 residents comments cards and 6 relatives comments card were received all with positive comments apart from 2 comments stating that the home is short of staff. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable and safe with contented residents. What the service does well: What has improved since the last inspection? Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 6 The statement of purpose for the home has been reviewed and revised. The home has provided a specially designed sensory garden, which is fully equipped with water feature, seating, lighting and umbrellas Internally a loop system has been fitted to all the lounges and new sluicing equipment has been provided in all three units. 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. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 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 Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 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) 3and 6 Appropriate assessments of need are in place and are carried out. The home does not provide intermediate care. EVIDENCE: There is evidence on the files that all the residents undergo a full multidisciplinary assessment prior to admission. The home does not provide intermediate care. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, and 9 Each resident has a comprehensive individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration and recording of medication are good with clear and comprehensive arrangements being in place to ensure resident’s medication needs are met. However medication is not being delivered in a safe and efficient way. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis. The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that these services are provided by Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 10 local practitioners. The records indicate that resident’s medical needs are being met. Medication is administered by means of a monitored dosage system. The system is breaking down and mistakes are being made. This is mainly due to lack of staff. Staff who are administrating medication are often called away and distracted by residents in need of attention. The home receives good support from the local pharmacist who does a three monthly audit of the homes medication. Not all the Staff have received accredited training before they are allowed to administer medication. The home has good draft policies and procedures, which are readily available and are used as an integral part of the care staff induction programme. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The home provides a stimulating experience for the residents where they are encouraged to maintain their independence as much as possible The home provides a range of social activities within and outside the home designed to the capabilities of the residents The meals in the home are good, offering both choice and variety and also catering for special dietary needs EVIDENCE: The Care staff and the residents who could express themselves in a meaningful way stated the residents are consulted regarding the day-to-day running of the home through residents unit meetings and by feedback from their keyworkers. The key-workers also identify interests that the residents wish to pursue. A regular programme of musical evenings, board- games, Arts and Craft sessions, Reminiscence groups and Complimentary Therapy are organised within the home. Also the care manager has organised trips to West Midlands Safari Park, Pub lunches, and visits to the city centre and Merry Hill Shopping Centre, which are very popular. The observations made and the comments received from the residents confirmed that particular attention is given to the resident’s individual preferences regarding meals. The home has produced very attractive and clear menus. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 12 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 and 18 The home has a good complaints procedure with some evidence that resident’s views are listened and acted upon. The home has good policies and procedures regarding the protection from abuse, which includes a whistle blowing policy and the staff have a good understanding of their responsibilities. EVIDENCE: The home has a comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence and a notice on the notice board in the hall. The home has a complaints file in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in the N.V.Q. training the Staff is undergoing. There have been no incidents that have needed to be recorded or reported. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 13 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) 19 and26 The standard of the environment within the home is high and there is a rolling programme of maintenance providing the residents with a very attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. EVIDENCE: The home has been established for many years and has undergone major alterations three years ago in order to improve accommodation for older people with mental health problems. The home is maintained to a high standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. The provision of a specially designed sensory garden is a great asset to the home The home was found to be clean and tidy and free from odour. The home has good policies and procedures regarding infection control and the staff have received training in food hygiene and Infection Control. All staff appeared to be conscious of the dangers of cross infection. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 14 Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 15 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 29 and 30 The home is not always staffed to a level that ensures that service users’ needs are met at all times. The home has good policies and procedures regarding the recruitment of staff, which includes all the appropriate staff checks and references. There is a very good training programme in place that ensures that the staff are competent to do their job. EVIDENCE: The inspection of staff rotas and discussions with staff indicated that the home is understaffed at times and does not meet the needs of the residents, particularly between Thursdays and Sundays. The rota indicates that there are only 5 care staff on duty to cover 3 units which means that 1 unit has only 1 member of staff covering it. This is a particular concern given the high dependency of the residents who suffer mental health problems and the responsibility to use 2 staff members to administer medication. Mistakes are being made in the administration of medication when staff giving out medication are called away to meet residents’ urgent needs. The home operates an efficient recruitment procedure and the Local Authority has registered with the Criminal Records Bureau in order to complete the appropriate checks on staff. There was evidence within the home that all the checks are being carried out. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a programme of N.V.Q. training and is working towards the minimum standard required. Also the care staff have Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 16 attended courses on Safe handling of medication, Risk assessment, Ageism, Moving and Handling, First Aid, Protection From Abuse, Infection Control, Dementia Care Mapping, Dementia Care Studies and Foundation Training in Community Health. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 17 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) 33 35 and 38 The home is a well managed home, where residents’ interests and welfare are well protected and promoted. EVIDENCE: The routines and activities within the home are flexible and built around the needs of the residents. There was also evidence to show that staff, consult with the residents as much as possible regarding the choice of meals and activities within the home. There are regular resident unit meetings where residents are consulted about menus and entertainment etc. Also the KeyWorker system in operation is designed to ensure residents’ wishes are responded to. The home is operating a good system to assist residents with the safe handling and keeping of their personal finances and good records are being kept of all transactions made. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 18 All the records and administrative procedures within the home that was, inspected were found to be well ordered and maintained. However it was noted that the regulation 26 visits are not being carried out The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues a number of staff have received training. All recommendation made by the Fire Prevention Office and Environmental Health officers have been met. Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 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 x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 1 28 3 29 3 30 4 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 3 x 3 2 x 3 Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 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 OP 33 Regulation 26 Requirement The Registered person must ensure that the Home has an effective system of Quality Assurance. This should include regulation 26 visit undertaken monthly. The registered person must ensure that the care staff hours are increased in order to provide a minimum of 2 care staff on duty in each unit throughout the working day and in addition 1 floating care staff throughout the day to assist in the unit as required The registered person must ensure that only staff that have completed the safe handling of medication and have been assessed as being compident to do so administeres medication. The registered person must analyise the mistakes made in the administration of mediction and procuce an action plan to ensure a safe system is in place Timescale for action 01/08/05 2. OP 27 18 (1) a 01/09/05 3. OP 9 13 (2) 01/08/05 4. OP 9 13 (2) 01/08/05 Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 21 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 Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor, St Davids Court Unino Street Wolverhampton WV1 3JE 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 Blakenhall Community Resource Centre E56 000036769 Blakenhall RC v234939 AI 140705 Stage 4.doc Version 1.40 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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