Inspection on 20/04/06 for Blenheim Care Centre

This inspection was carried out on 20th 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blenheim Care Centre 27/04/09

Blenheim Care Centre 18/04/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOME ADULTS 18-65 Blenheim Care Centre Hemswell Cliff Gainsborough Lincs DN21 5TJ Lead Inspector Roger Harrison Unannounced Inspection 20th April 2006 09:30 Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Blenheim Care Centre Address Hemswell Cliff Gainsborough Lincs DN21 5TJ 01427 668175 01427 668179 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) Southwark Park Nursing Home Limited Mrs Suzanne Grimley Care Home 80 Category(ies) of Old age, not falling within any other category registration, with number (80), Physical disability (80), Physical disability of places over 65 years of age (80) Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2006. Brief Description of the Service: The Blenheim Care Centre is an established care service which has recently been purchased by Southwark Park Nursing Home Ltd and comprises of three units: Blenheim House, Blenheim Lodge and semi independent flats within Blenheim House. Blenheim House and Blenheim Lodge are detached properties situated in a rural trading/industrial setting in the village of Hemswell Cliff, which offers a limited variety of amenities such as an Antiques Centre and business services. The village has a post office and shop. The Blenheim Care Centre provides personal, respite and nursing care for up to eighty people of both sexes whose age’s range from 18 years upwards, some with physical disabilities or acquired brain injury. Residents aged over 65 years are mostly accommodated in the Lodge. The home provides transport to enable residents to take part in activities in the community and for residents to visit the nearby town of Gainsborough or City of Lincoln. The units have large communal areas comprising lounge/dining-rooms and quiet areas on the ground floor. Bedrooms are located on ground and first floor. There are passenger lifts to first and second floors in both units. The gardens are separated by fencing from the surrounding buildings, having grassed and paved areas for the use of the residents. A large car park is situated at the front of the main building. The policy of the home is to foster an atmosphere of care and support, which enables and encourages all residents to live as full, and independent a life as possible. Fees at the home on 20/04/2006 range from: £330.00 - £518.00p.w. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information available to the Inspector regarding our service history about Blenheim Centres, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying individual residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at the Centres. This key inspection visit was achieved over a seven-hour period by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Care planning has been improved since the last Inspection in order to provide details regarding how each residents physical needs are being supported but there is not enough information available on all care plans to show residents needs, social interests and wishes and how these are met. EVIDENCE: The Manager told the Inspector that Admission arrangements and assessments have been improved since the last Inspection and three care plans looked at provided details regarding how each resident’s physical needs are being supported. Care plans looked at showed that some work has been carried out since the last Inspection by the Manager to begin developing care plans to include all information about each residents needs and wishes but did not always include details about individual activities and social needs. The Manager told the Inspector that work has started to make sure all residents have an up to date care plan and risk assessment and three staff members showed the Inspector four care plans that are being updated and talked about work which has started to make sure all care plans have up to date information about all needs for all residents. The home has a Statement of Purpose and Service User Guide, which the Manager is in the process of further updating to include details of the new owners who were registered with the Commission on 03/04/06. The Manager told the Inspector that this information is shared with any new resident before admission. One resident told the Inspector that; “I have been here for a few weeks and before I came here the Manager told me all about it. I get the support I need and have been really looking forward to coming here. It is great” Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 8 Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. The manager and care team encourage residents to make informed choices, supporting individuals right to take risks with support when this is needed. Care plans need to be fully in place, and reviewed to ensure changes in need and goals are acted upon to support residents in the right way. EVIDENCE: During this Inspection the Inspector spoke to six residents across both centres and the semi-independent flats about the support they received and was told that “I’ve got my own flat here, I come and go as I want with staff support”, and “I think I have a care plan, the staff talk to me everyday and I have my room just as I want it”. The Inspector also met with five staff members who said that they use a daily record sheet to share information about needs and changes for each resident and to support individuals to make choices about their daily lives. The staff team see this as part of the daily review of their work to support residents. The Inspector looked at daily records during the Inspection together with care plan and risk assessment information for four residents. The information available confirms that care plans are now being updated to make sure that information about each resident is kept on their own care plan, but there was no information about when or how reviews are undertaken. The Manager said that a review plan for all residents is to be put in place once all care plans have been completed. During the overall Inspection visit the Inspector observed sensitive communication between staff and Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 10 residents, and support being given when individuals were making choices, for example; regarding how they furnish their rooms, maintaining independence wherever possible with personal hygiene, how they would like to dress, the type of meals each enjoys and activities inside the home and in the wider community. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. The Centres provide activities for residents but these are limited to the time available to the activity Co-ordinator. Residents would benefit from more structured activity time to ensure all of their interests can be supported equally across both centres. Residents feel that the menus and meals at the home offer choice and that it is good. EVIDENCE: During this Inspection visit the Inspector talked to residents at both centres about their daily activities. Residents told the Inspector that they are asked about their interests and that some were happy with the support they get, others felt they needed more activities to meet their needs with comments ranging from; “I love it here, there is lots to do and I stay as Independent as I can” to “I wish there was more to do” and “There are no activities here that I would be interested in”. During the Inspection the Inspector observed a full group of residents enjoying a visiting music group and a smaller group doing craft activity with an activity organiser. The Manager told the Inspector that she is working with the activities organiser, who is employed on a part-time basis to cover both centres, to look at ways of developing the range of activities on offer. The home has its own transport and one resident told the Inspector about a holiday that a group of residents had been on last year. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 12 Three Residents told the Inspector that the food they get is good and the cook showed the Inspector the menu plan which is being further developed with the new home owners to ensure it offers a plan which will continue to meet the nutritional needs of residents. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Medication procedures, records and care practices are used to ensure health needs are met, and to understand wider needs in order to encourage choice and self-determination wherever possible for all residents. EVIDENCE: All residents at the centres need support with medication. The Manager and two deputy Managers are responsible for ensuring that Senior staff members follow the homes policies and procedures to carry out medication tasks to meet needs, which are detailed on medication records and are being added to care plans. Medication records looked at were up to date and contained photographs of residents to make sure each individual gets the support needed. Since the last Inspection the Manager confirmed that she has taken action to arrange more training for all staff that support residents with their medication. This will begin in May 2006 and will be repeated until all staff have received it. The Manager has also made sure that both Blenheim Centres have up to date medical reference books for staff to use in their work. One senior staff member was observed by the Inspector supporting Residents with their medication and a resident told the Inspector, “I am happy that I get my medicine at the right time. The staff support me and I am getting better with their help”. The care team were observed using a range of equipment including personal wheel chairs, hoists alongside moving and handling methods to support residents in their rooms and in communal areas of the home. One resident said “They help bath me when I want it and they help me to go out when I want to by supporting me”. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 14 Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home has measures in place for people to raise concerns or complaints and has provided some training and support for staff to make sure they are able to act in order to protect the residents from the risk of abuse or harm. EVIDENCE: The Manager has an open door policy, which residents said they felt helped them to raise any concerns direct with the Manager. The Manager confirmed that the Policy system for complaints and comments has been improved and updated to make sure that residents know who to go to if they have concerns, to include the contact details of the new owners. The Manager confirmed that staff are aware of the Policy for protecting adults in Lincolnshire and that some staff have received training in order to act to protect residents from the abuse. This training is being increased to cover all staff. Four care team members told the Inspector how they would report any concerns they had to the Manager and that they understood the training they had received in November 2005. The Manager confirmed that there had been no formal complaints made since the last inspection and through this Inspection visit comment cards were given to residents and posted to their carers to support the chance for feedback on the home. The Manager confirmed she is also in the process of circulating a questionnaire to residents about how meals and menus at the home can be further improved. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. The home is well maintained but parts of the building are in need of appropriate maintenance to ensure that the needs of all residents can be met safely. The Centres would benefit from a structured programme/plan of maintenance and decorative update. EVIDENCE: The Inspector used a tour of both centres and the self-contained flats, which were observed to be clean, with hygiene practice followed by the care team to minimise risks to residents. Four residents showed the Inspector their rooms during the Inspection. All were made personal to meet individual tastes. One resident said, “As soon as I came here the atmosphere made me feel welcome”. Both centres offer single rooms to all residents with large communal areas that are clean and open to enable residents to move around freely or with support. There are areas that would benefit from improvement as part of ongoing maintenance work which were discussed with the Manager. Blenheim Lodge has a large conservatory area, which was leaking on the day of Inspection, bathroom number 48 is in need of some renovation and carpets in communal areas of The House are in need of replacement as they are worn. The Manager confirmed that these issues would be attended to through discussion with the homes new owners as part of a wider environmental audit to be carried out. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 and 36. The manager has structured recruitment procedures and provides support to the care team, who are able to use training provided to support residents within the home and wider community. Staff would benefit further from the development of an annual training plan and structured and recorded supervision. EVIDENCE: The Manager takes responsibility for carrying out recruitment of staff and records showed that staff are employed after references and checks had been made. Five staff members told the Inspector that they had received training to help them care for residents safely and in the way they wanted to be. Records provided by the Manager show that staff have received wider training in health and safety, food hygiene, infection control, some medication and adult protection training, and that the Manager had accessed NVQ training for six members of staff as part of the development of overall training at the home. The Manager supervises staff with support from two deputy Managers on a day to day basis and there are some records available which show that the Manager is trying to make supervision and training systems more formal, but this is not yet fully in place. Staff, Supervision and training records are not maintained regularly or kept together in a structured way and there is currently no annual training plan in place. This was discussed with the Manager who told the Inspector that she is going to use group supervision and further discussion with deputy Managers to get feedback from staff in order to set up a formal training plan for the year alongside a system of supervision and record keeping across both homes and the semi-independent flats. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 18 Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The home has a competent and committed Registered Manager who understands the needs of each individual resident and recognises the need to develop care plans in order to show how residents are supported. Residents feel that the Manager listens to them and acts to support them to maintain their health, safety and welfare. EVIDENCE: Throughout this Inspection visit The Inspector observed that the Manager has an open door at all times and a “hands on approach” which supports the care team over both centres and the flats in their duties. The manager’s office is organised, and provides a base for maintaining staff records. Separate office are used in both centres for care plans to be kept and the Manager confirmed that progress on developing these will continue to make sure all current and changing care needs can be met. The manager told the inspector that she understands her responsibilities toward staff and residents told the Inspector that the Manager is very supportive. Comments received included; “If I’m not happy I soon let The Manager know. I feel they listen if I’ve got any concerns” and “I like the Manager she is easy to talk to”. Blenheim Care Centre DS0000067472.V288666.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 21 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 YA6 Regulation 15(1)(2) Requirement Care plans for all service users must be reviewed on a regular basis. Service users and their representatives (where appropriate) must be involved in the devising of care plans. [This requirement was made on 05/12/05. Some progress has been made but further work is required]. Care plans must be produced for all service users immediately following their admission, They must be designed with sufficient details to clearly demonstrate the social and health care needs of all residents and how the staff should meet those needs and kept together as one document. [This requirement was made on 05/12/05. Some progress has been made but further work is required]. Sufficient activities, which are regular and appropriate to the needs and wishes of all residents, must be provided and documented. [This requirement was made on 05/12/05. Some progress DS0000067472.V288666.R01.S.doc Timescale for action 20/06/06 2. YA6 15.1 20/06/06 3. YA14 16.2 20/07/06 Blenheim Care Centre Version 5.1 Page 22 4. YA35.2 13.6 5. YA36 18.2 has been made but further work is required]. The Manager must complete an annual staff training and development plan, and identify a designated person who will take responsibility for managing this. Staff supervision must be formally undertaken on a regular, structured basis with records maintained. [This requirement was made on 05/12/05. Some progress has been made but further work is required]. 20/07/06 20/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations It is recommended that the registered provider undertakes an internal environmental audit of the care home with the organisations Registered Manager in order to develop a clear action plan with timescales which fully identify and address all the environmental needs of the home. Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Blenheim Care Centre DS0000067472.V288666.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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