Inspection on 07/07/05 for Blatchington House

This inspection was carried out on 7th 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.

Other inspections for this house

Blatchington House 14/03/07

Blatchington House 25/01/06

Blatchington House 03/12/04

Blatchington House 29/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Blatchington House Firle Road Seaford East Sussex BN25 2HH Lead Inspector Jennie Williams Announced 7 July 2005 9.40 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. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Blatchington House Address Firle Road Seaford East Sussex BN25 2HH 01323 891702 01323 490393 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) AHLE Limited Mrs Carol Breeds Care Home 33 Category(ies) of OP (33) registration, with number PD (33) of places Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of thirty-three (33) service users to be accommodated. 2. That a maximum of twenty (20) service users are in receipt of nursing care. 3. That a maximum of thirteen (13) service users are in receipt of personal care. 4. That service users are aged sixty-five (65) years on admission. 5. That service users may have a physical disability. Date of last inspection 3 December 2004 Brief Description of the Service: Blatchington House is a care home registered for 33 places. Residents accommodated must be aged 65 years or over on admission and may have a physical disability. The home can accommodate 20 residents in receipt of nursing care and 13 residents in receipt of personal care. Blatchington House is located in a quiet residential area in Seaford. It is located approximately one mile from the seafront. There is car parking availabe at the home or on the adjacent street. There is two double rooms and 29 single rooms. Rooms are located over three floors. There is a passenger shaft lift available to assist residents to access all floors. There is a large garden area that residents have access to. There were 32 residents residing at Blatchington House on the day of the inspection. Twenty in receipt of nursing care and 12 in receipt of personal care. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Blatchington House will be referred to as ‘residents’. This report is based on the findings of the specified inspection date. This announced inspection took place over eight hours on the 7 July 2005. Staff files, some policies and procedures, records, care plans, individuals’ personal allowance and medication procedures were inspected. Residents, visitors and staff were spoken with throughout the inspection process. The environment and some individual rooms were spot-checked. An organised activity was observed. The pre inspection questionnaire was sampled and the Inspector received eight comment cards from residents and one comment card from a relative/visitor. All comment cards demonstrated that residents and visitors are overall satisfied with the care and services provided at the home. What the service does well: What has improved since the last inspection? What they could do better: Documentation in the care plans could be improved. Care notes need to be expanded to provide information on the health/specific needs of the individual. The adult protection policy and procedure needs amending to state clearly that all allegations of abuse must be referred to social services and to include guidance regarding the POVA list. Please contact the provider for advice of actions taken in response to this Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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 Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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, 3, 4, 5 & 6 The home has information available to prospective residents and their representatives to make an informed decision if the home is suitable for their needs. All prospective residents are assessed prior to moving into the home. Standard 6 is not applicable, as the home does not have dedicated accommodation to provide intermediate care. EVIDENCE: The home has a Statement of Purpose and Service User Guide that is available upon request and provides prospective residents and their representative information on the services and care provided at the home. There was evidence that a newly admitted resident had been assessed prior to moving into the home. Information is obtained from other health professionals, wherever applicable. The Manager or a Registered General Nurse will undertake assessments on all prospective residents, with the involvement of a relative/representative, wherever applicable. Prospective residents/representatives are provided with an opportunity to visit the home prior to moving in if they wish. A visitor spoken to confirmed that Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 9 she visited the home prior to her mother moving in. The home has a waiting list and emergency admissions rarely occur. The home would access appropriate information if there was a prospective service user of a minor ethnic, social/cultural or religious group with any specific needs. Staff individually and collectively have the skills and experience to deliver the services and care which the home offers to provide. The home will provide respite care if there is a place available. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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, 8, 9, 10 & 11 There are some minor shortfalls in the documentation of care plans. Needs are being met at the home, but documentation needs to reflect actual current practice. Medication must only be used for whom it has been prescribed. EVIDENCE: Registered Nurses develop care plans for residents. There are some minor shortfalls in the documentation that was discussed with the Registered Nurse on duty and with Management. Care plans should reflect if turning charts or fluid balance charts are in use and staff must ensure these are accurately completed. (Turning charts - used for people who have limited movement and are at risk of developing pressure areas.) One fluid balance chart demonstrated that the individual had not had a drink since 0400hrs. It was confirmed that this was not the case. Some reviews of care plans did not accurately reflect the current situation. This was discussed with the Registered Nurse on duty, who will feedback to the other staff. Staff must ensure that care plans reflect actual current practice. Residents’ health needs are met. A resident observed to be wearing glasses confirmed that an optician saw her within the last year. The GP visits the home weekly and advice is sought from other health professionals when the need arises. It was discussed the importance of expanding the care notes of Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 11 residents and ensure care notes reflect the health needs that are identified in the care plan. Writing ‘no change’ is inappropriate. There is pressure-relieving equipment at the home to promote tissue viability. There was one resident with a pressure sore on the day of the inspection. It was confirmed that this was present prior to the admission of the resident. There were prescribed creams noted in some individual rooms being used for residents for which it had not been prescribed. Medications must only be used for whom it is prescribed. MAR charts inspected demonstrated that medications are being signed for at the time of administration. Controlled medications spot-checked demonstrated that accurate records are being kept. Seven out of eight comment cards received demonstrated that residents felt that their privacy is respected. One resident had not answered this question. All residents spoken with felt that their privacy and dignity are respected. Staff were observed to have a good professional rapport with residents. The home has taken action to address the wishes of a resident following death, as recommended at the last inspection. This is an ongoing process for the home. All information relating to an individual is kept in a file. It has been recommended to the home to ensure that all documentation being used for an individual is clearly named. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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, 13, 14 & 15 Residents have opportunities to participate in activities that are of interest and within their capabilities. Visitors are welcomed at the home. EVIDENCE: There is an activities person employed at the home. Seven out of the eight comment cards received from residents demonstrated that the home provides suitable activities. Most residents spoken with confirmed that there were enough activities on offer, should they choose to be involved. Some residents were observed to be participating in an organised activity. Visitors are welcomed at the home. Visitors spoken with were very complimentary about the care and services offered at the home. Visitors confirmed that they are always made welcomed at the home and there were no restrictions for visiting times. Residents are able to receive visitors in private. Residents spoken to confirmed that their routine of daily living is flexible and their own choice. All comment cards received demonstrated that the residents liked the food provided. Residents have a choice of meals. The majority of residents spoken with were happy with the provisions of meals. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 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 standard(s) 16 & 18 Residents/representatives are provided with information on how to make a complaint. The information provided to staff regarding the procedure for dealing with adult protection allegations could be made clearer. EVIDENCE: The home has a complaints procedure that is available at the home. One complaint had been made to CSCI since the last inspection, which was found to be not upheld. There had been three complaints made directly to the home. Records kept demonstrated that the home deals with complaints objectively and a record is kept of the action taken. It is recommended that the CSCI local office telephone number is included in the complaints procedure. The adult protection procedure needs to be slightly amended to ensure it clearly states that all allegations of abuse be reported to Social Services. This will provide clear guidance to staff left in charge of the home. The adult protection procedure needs to be updated to provide information about the POVA list. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 14 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, 20, 22 & 26 The location of the home provides opportunities for residents and visitors to access local amenities and transport. Residents live in a safe environment that suits their needs. EVIDENCE: The home is located in a quiet residential area of Seaford. Rooms are located over three floors. A passenger shaft lift allows access to all floors. There is a large garden area with wheelchair access and seating. The home has a good size dining room and suitable lounge areas. Hoists, grab rails and other aids were seen to be located throughout the home to assist maintaining independence. Rooms were seen to be individualised to reflect the residents choice and taste. There is a small shop located at the home that opens for one hour on Tuesday and Thursday. This provides an opportunity for individuals who are unable to access local amenities to purchase toiletries and confectionery. The home was found to be clean and free from offensive odours. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 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, 29 & 30 Resident’s needs are being met by the number and skill mix of staff on duty at all times. Residents are safeguarded by the recruitment procedures implemented at the home. EVIDENCE: The rota provided demonstrated that there are suitable numbers of staff on duty at all times. The majority of people spoken with throughout the inspection process confirmed that they felt there was sufficient staff on duty at all times. Visitors spoken with felt in their opinion that there were always sufficient staff on duty. One visitor commented that the call bell is answered quickly when used. One resident commented that they could wait for ‘three hours’ for the call bell to be answered. This residents call bell was tested by the Inspector and was answered within reasonable time. A member of staff spoken with confirmed that they enjoyed working at the home and did not feel ‘exploited’ as they had felt in previous care positions. All staff spoken with confirmed that they felt there were sufficient numbers of staff of duty. There is always a trained nurse on duty at all times. Visitors and residents were complimentary about the staff working at the home. The home is currently fully staffed and no agency staff have needed to be used. The pre inspection questionnaire demonstrated that there is a very low turnover of staff, therefore promoting continuity of care for the residents. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 16 Staff files inspected demonstrated that the home has improved their recruitment procedures, as required from the last inspection. It was discussed with management the importance of ensuring all applicants fully complete their application form. Any minor shortfalls were discussed with management at the inspection. Staff files contained records of training courses undertaken by individuals. The pre inspection questionnaire demonstrated that a variety of training courses had been provided to staff in the last twelve months. A newly recruited staff member spoken with confirmed that an induction programme was undertaken and they were supernumerary initially. They felt that they could have remained supernumerary for a longer period if there was the need. This staff member had worked in a variety of settings and found the practices within the home ‘excellent’. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 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) 32, 33, 35, 37 & 38 Residents and staff benefit from clear leadership within the home. Residents are safe guarded by the systems in place to monitor the health, safety and welfare of residents. EVIDENCE: Residents, staff and visitors were complimentary about the management at the home and found them supportive and approachable. The home has resident and staff meetings every couple of months, where people are provided with opportunities to air their views. The home has implemented a quality assurance and quality monitoring system. Feedback is sought from all people connected to the home and management analyses these and make changes if the need is identified. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 18 The home is not an appointee for any resident. Resident’s personal allowance kept at the home was spot-checked. This demonstrated that there were minor shortfalls in the recording system within the home. The person who usually deals with the residents’ finances was on holiday on the day of the inspection. The home must ensure that suitable measures are in place to deal with residents’ finances when this person is not working. There was evidence that receipts are kept for all financial transactions. Monies are kept securely at the home. Records are kept securely at the home. Policies and procedures are accessible to all staff and are kept at the nurses’ station. It is recommended that a quick reference guide be provided to allow staff to quickly and easily locate the policy and procedure they require. All staff are required to sign policies and procedures once they have been read and understood. The pre inspection questionnaire demonstrated that all relevant health and safety checks have been undertaken. Staff receive regular update training on all mandatory working practices. Risk assessments are in place and a record is kept of all accidents/incidents. It is recommended that the home document the action to be taken to reduce the risk of the accident/incident reoccurring. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 3 x 2 x 3 3 Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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. 2. Standard OP7 OP7 Regulation 15 15 Requirement That care plans reflect actual current practice. That care plans reflect if turning charts or fluid balance charts are in use and that these are accurately completed. (Outstanding from last inspection) That care notes are expanded to reflect the health needs that are identified in the care plan. That medication is only used for individual for whom it has been prescribed. That the adult protection policy clearly states that all allegations of abuse are to be referred to Social Services. That the adult protection procedure is amended to include information about the POVA list. That the home ensures all application forms are fully completed. That suitable measures are in place to deal with residents’ finances when the usual person who deals with this is not working. Timescale for action 31.08.05 31.07.05 3. 4. 5. OP7 OP9 OP18 17. Schedule 3 (k & m) 13.2 13.6 31.08.05 07.07.05 30.08.05 6. 7. 8. OP18 OP29 OP35 13.6 Schedule 2 16.2 (l) Schedule 4.9 30.08.05 31.07.05 31.08.05 Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 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. 2. 3. 4. Refer to Standard OP7 OP16 OP37 OP38 Good Practice Recommendations That all documentation used for an individual is clearly named. That the CSCI local telephone number is provided on the complaints procedure. That a quick reference guide be provided for the policy and procedure manual provided to staff. That the home document the action to be taken to reduce the risk of the accident/incident reoccurring. Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Blatchington House H59-H10 S13964 Blatchington House V227347 070705 stage4.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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