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Inspection on 25/04/06 for Blakesley House Nursing Home

Also see our care home review for Blakesley House Nursing Home for more information

This inspection was carried out on 25th 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.

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

The service users appeared settled and comfortable within their environment and those who spoke to the inspector expressed general satisfaction with the care they received. A visiting relative who spoke to the Inspector reported positively about the care provision at the home. All health and safety records inspected were satisfactory and indicated that the welfare of the service users was being safeguarded. Regular appropriate training has been delivered to the members of the care support staff team and they were observed being competent in meeting the needs of the service users. Overall the home was clean, hygienic and well maintained. The atmosphere was calm and homely.

What has improved since the last inspection?

The majority of requirements that were made at the last inspection had been complied with.

What the care home could do better:

One requirement was identified at this inspection and related to cooked meals.

CARE HOMES FOR OLDER PEOPLE Blakesley House Nursing Home 7 Blakesley Avenue Ealing London W5 2DN Lead Inspector Ms Jean Bovell Unannounced Inspection 25th April 2006 12:00 X10015.doc Version 1.40 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 Blakesley House Nursing Home DS0000010942.V290716.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 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. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Blakesley House Nursing Home Address 7 Blakesley Avenue Ealing London W5 2DN 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) 020 8991 2364 020 8991 5256 Mrs Margaret Nyambura Lane Mrs Margaret Nyambura Lane Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0) of places Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 16 Nursing beds for the care of the elderly 6 Personal care beds Date of last inspection 20th September 2005 Brief Description of the Service: Blakesley House is a care home for twenty-two older people. There are sixteen beds for older people who need nursing care and six beds for service users who require personal care. The Registered Manager is also the owner of the home. The home is situated in a detached house, located in a quiet residential area of Ealing. It is close to Ealing Broadway, with its shopping centre, buses, and underground and main line station. There are eleven shared bedrooms. The home has five bathrooms. Some are situated between bedrooms with access from both rooms. There are bedrooms on four floors, including the ground floor. The passenger lift does not go to the top floor, so service users are required to be able to use the stairs to those rooms. There is a lounge on ground floor, with an adjoining conservatory. These rooms are also used for meals as there is no separate dining area. There is a small private space on the ground floor, which has seating for meetings of up to four people. There are no communal areas on the other floors. There are steps from lounge to the area where the lift is located. A portable ramp for these steps is available for wheelchair use only. There is a garden to the rear of the property. The kitchen is located off the main lounge and there are separate laundry facilities and a food store located in an outbuilding in the garden. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out between 12 noon and 3.45 pm on Tuesday 25th May 2006. The Registered Manager, Assistant Manager, two registered nurses, three care support workers and 16 service users were present. One service user had been admitted into hospital. During the course of the inspection, the home’s records, policies and documents were viewed. A tour of the building was undertaken and observations were made. The Inspector spoke to eight service users and one visiting relative. The requirements that were made at the last inspection and all key Standards were examined. The Registered Manager and Assistant Manager were co-operative and provided appropriate assistance throughout the inspection. What the service does well: The service users appeared settled and comfortable within their environment and those who spoke to the inspector expressed general satisfaction with the care they received. A visiting relative who spoke to the Inspector reported positively about the care provision at the home. All health and safety records inspected were satisfactory and indicated that the welfare of the service users was being safeguarded. Regular appropriate training has been delivered to the members of the care support staff team and they were observed being competent in meeting the needs of the service users. Overall the home was clean, hygienic and well maintained. The atmosphere was calm and homely. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 6 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. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 the following standard(s): 3 and 6. An appropriate needs led assessment is carried in relation to perspective service users prior to admission. Intermediate care is not being currently provided at the home. EVIDENCE: It was evidenced on individual service users files that needs led assessments were carried out prior to admission and that relatives, social workers and medical professionals – where appropriate, were involved in assessment processes. Written confirmation that specific assessed needs would be met at the home was attached to appropriately signed contracts/statement of terms and conditions. The Registered Manager confirmed that intermediate care is provided at the home. However, none of the service users were receiving intermediate care at the time of the inspection. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9 and 10. The home has a detailed care planning system that incorporates all aspects of service user’s personal and health care needs but do not include enough information about any social needs that service users may have. The home’s medication storage, policies and procedures are all satisfactory. Service users were observed to being treated with respect and their privacy upheld. EVIDENCE: The home has a detailed care planning system that includes a mental health assessment, physical health assessment, moving and handling assessment, nutritional screening assessment and falls risk assessment. Four care plans were viewed and each showed evidence of regular review. The care planning system is numerically based with score ratings indicating the level of care needed. In comparison to the amount of detail for the service user’s health needs there was little about their social needs/interests. The Inspectors were told that the home has a part time activities co-ordinator who will find out more about individual service user’s social needs/interests and this will be incorporated into their care plans. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 10 The majority of the service users looked well cared for and appropriately dressed. One male service user was unshaven but the Registered Manager explained this was his choice, while another male service user looked slightly dishevelled after lunch, which Inspectors were told would be attended to. Some service users were observed to be very frail and being nursed in bed. All care given to these service users appeared appropriate to their needs with the appropriate pressure relieving bedding being used. The home had two service users with pressure sores but both had been seen by an external tissue viability nurse and both were responding to treatment. The previous pharmacy inspection had identified ten requirements around medication all had been met except for the need for the home’s medication policy to include a policy on service users refusing to take prescribed medication. Staff were observed to be respecting service users’ privacy by knocking on their doors before entering bedrooms. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14 and 15. Service users are encouraged to maintain their independence and are able to participate in activities of their choice. Contact with relatives and/or friends are encouraged and facilitated. The standard of the meal observed by the Inspector was not satisfactory. The home must ensure that wholesome and appealing meals are provided to the service users at all times. EVIDENCE: The social interests of the service users were recorded on care plans that were inspected at random. The Registered Manager confirmed that a part-time activities co-ordinator was employed at the home. The activities book was viewed and separate activities in which service users participated had been recorded. These included reflexology, exercise with music and bingo. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 12 On the day of the inspection service users were observed being involved in individual activities in their bedrooms such as watching television, reading or resting. Others sat quietly in the lounge. An open visiting policy is in operation at the home and contact with relatives and friends are encouraged and facilitated. Two relatives visited the home at the time of the inspection. The Registered Manager reported that social services or relatives maintained responsibility for the financial affairs of the service users but allowances were held in safekeeping at the home. The Inspector was advised that service users were encouraged to maintain as much independence as possible. They chose what they wore, hairstyles/make up, when they got up in the morning/retired at night, activities and how personal allowances were spent. Service users are able to bring valued possessions into the home and it was reflected in individual bedrooms viewed that these may include specific items of furniture, photographs, television sets and/or radio/recorders. The Registered Manager confirmed that if requested, service users and/or next of kin would be given access to personal files. A chef is employed at the home and the menus were suggestive of satisfactory meals being provided. However, the lunch content at the time of the inspection consisted of beef burgers in gravy or boiled fish in the bag. Both dishes were served with mashed potatoes and a mixture of peas/corn. These choices were not considered appealing, flavoursome or sufficiently nutritious and several service users indicated dissatisfaction with both options. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16 and 18. The home’s complaints procedure is satisfactory and the service users are being protected from abuse. A requirement under Standard 16 at the last inspection had been met. EVIDENCE: The home’s complaints procedure is clearly written, concise and easily accessible to service users and their relatives. The complaints book was viewed and suggested that no complaints were made to the home since the last inspection. One complaint that had been made prior to the last inspection had been appropriately investigated and resolved. This complied with a requirement at the last inspection. The home’s policy and procedures on the protection of vulnerable adults were satisfactory. A poster on health and safety was displayed and the London Borough of Ealing manual on the protection of vulnerable adults was in place. It was reflected on training certificates that training on health and safety and also on the protection of vulnerable adults had been delivered to the members of the care support staff team on 19th March 2006. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 14 The home is responsible for the safekeeping of the financial allowances of the service users. All monies were securely kept and individual financial records inspected were satisfactory. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26. The environment within the home is safe and well maintained. EVIDENCE: A tour of the home and garden was undertaken and no issues were identified. The home’s policy and procedures on infection control were in place and the records indicated that training on infection control had been delivered to all members of the care support staff team. The laundry/sluicing facility was satisfactory and there were no offensive odours. Overall, the home was found to be clean, hygienic and well maintained. The environment was safe and calm. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Appropriate training for meeting the needs of the service users has been delivered to all members of the care support staff team and service users are being protected by the home’s recruitment policy and practices. EVIDENCE: The Registered Manager confirmed that eighteen care staff members including seven registered nurses were employed at the home. One care support worker had obtained National Vocational Qualification – Level 2, and two care support workers were receiving national vocational training. It was reflected on the staff rota that three care support workers and two registered nurses were on duty during waking hours and that three care support workers covered waking duty at night. A number of personnel files were viewed at random and all contained the required documents. These included photo-identification, CRB clearance certificates, application forms, job descriptions, references and signed copies of contracts/statement of terms and conditions. A training programme was in place and it was evidenced on training certificates that accredited training delivered to the members of the care support staff team included dementia, wound care, diabetes, medication, protection of vulnerable adults, health and safety and manual handling. It was indicated also that new members of staff received Topps certified induction training. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 17 Care support workers who were on duty at the time of the inspection were observed being competent and sensitive in responding to the needs of the service users. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The Registered Manager is appropriately experienced and qualified and effective quality assurance exercises are being undertaken. The home has satisfactory health and safety systems in place. EVIDENCE: The Registered Manager is a registered nurse and has had a total of twentytwo years experience in caring for older people and managing care homes and has obtained the Managers’ Award. Effective quality assurance systems for self-monitoring had been put into place and it was evidenced that written comments from service users, relatives and stakeholders were being sought. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 19 All health and safety checks including those carried out for fire safety, water temperature, gas and electrical systems and portable appliances tests, were up to date. Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 25(2)(g) Requirement Care plans must include detailed information regarding each service users social and leisure interests/needs. The home’s medication policy must include a policy on service users refusing to take prescribed medication. The Registered Person must ensure that wholesome and appealing meals are at all times provided to the service users. Timescale for action 30/05/06 2 OP9 13(2) 30/05/06 3 OP15 16(2)(i) 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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 Blakesley House Nursing Home DS0000010942.V290716.R01.S.doc Version 5.1 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. 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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