Inspection on 27/09/05 for Blenheim Care Home

This inspection was carried out on 27th September 2005.

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

Other inspections for this house

Blenheim Care Home 28/08/07

Blenheim Care Home 30/08/06

Blenheim Care Home 16/12/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Blenheim Care Home 39-41 Kirby Road Walton On Naze Essex CO14 8QT Lead Inspector Ray Finney Final Unannounced Inspection 27th September 2005 09:30 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 Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Blenheim Care Home Address 39-41 Kirby Road Walton On Naze Essex CO14 8QT 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) 01255 675548 01255 851360 R.W. Care Homes Ltd Mr Raymond Hughes Care Home 57 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (42) of places Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 42 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 15 persons) The total number of service users accommodated in the home must not exceed 57 persons 12/10/04 Date of last inspection Brief Description of the Service: Blenheim House is situated in a residential area of Walton-on-the-Naze and is close to the town centre and the beach. There are local shops and amenities close by. Accommodation is offered on three floors accessed by conventional stairs or by lift. The home has a range of comfortable communal areas and there is a large and well-maintained garden to the rear. Wheelchair access into the garden is provided by ramps. There are 51 single bedrooms, some with en suite facilities and 3 double rooms, all with en suite facilities. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The last published inspection report was for an inspection carried out on 12th October 2004. An additional visit was carried out on 26th May 2005 and, although a formal inspection report was not published, the findings of the inspectors from that visit are taken into account in this report. This unannounced inspection took place on 27th September 2005 over a period of 6 hours. The inspector was given every assistance during the day by the Registered Manager Mr Raymond Hughes and for part of the inspection Debbie Carson, Responsible Individual for R.W. Care Homes, was present. During the day of inspection, three members of staff were spoken with, one visiting health professional and four service users. The inspection also included a tour of the home, evidence gathered from samples of records and observations of interactions between service users and members of staff. The visiting health professional spoke well of the home and service users spoken with were communicative and appeared happy and relaxed. Interactions between service users, staff and Manager were observed to be good. What the service does well: What has improved since the last inspection? All radiators in the home had been covered, many with soft covers. Safety valves had been fitted to all but 9 of the water outlets and work on the remainder was scheduled to be finished. The home had an assessment of the premises carried out by a consultant Occupational Therapist and had put a plan for improvements in place. There was evidence of improvements to the environment in respect of service users with dementia, such as clear signage to assist with orientation. An extensive programme of redecoration had been implemented and service users’ rooms were decorated to a high standard, with evidence of new furniture in many of the rooms. Since the last inspection staff had received training in care planning and dementia care and the call system had been updated. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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 Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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): 2, 3 and 4 (standard 6 is not applicable). Service users were provided with written contracts detailing terms and conditions. The needs of service users were assessed before admission to the home. The home made a good effort to meet the needs of service users. EVIDENCE: The manager said that service users had a contract with the home, which was in place after a one-month trial period. Records show that the contracts were signed by the home Manager and service users or their representatives. Service user records examined showed evidence of pre-admission assessments carried out by the manager and COM5s for service users referred through Care Management arrangements. The inspector observed good clear signage to assist service users who were disorientated because of dementia. Staff training records showed that the home provided appropriate training to meet the needs of service users. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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 service users’ health, personal and social care needs were identified and documented in individual care plans. The home ensured that the health care needs of service users were met. Service users were protected by the homes policies and procedures for dealing with medicines. Service users were treated with respect and the home upheld their right to privacy and dignity. EVIDENCE: Records from service user files were examined and showed that information was well organised. Detailed plans of care were in place and there was evidence of comprehensive risk assessments. The inspector saw evidence of reviews of care plans. Staff spoken with said they were involved in care planning. One senior carer said it was “really useful to do the care plans as they guide the care given”. Manager and admin staff informed inspector that there had been in-house training for senior staff on care planning. Records examined showed that service users access health care services according to assessed need. A visiting health professional informed the inspector that the district nursing team visit the home regularly – twice weekly to change dressings and twice daily for diabetes care. The inspector was Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 10 informed that the home works well with the district nursing services, communication is good and issues are raised promptly. The district nurse felt that staff could use the hoists more frequently as sometimes staff were inclined to support service users manually. The manager informed the inspector that hoists were always used when needed. The G.P. was visiting the home during the inspection. The inspector examined the medication room, drugs and how they were stored. A monitored dose system was in place. The controlled drugs book and medicine administration records were inspected. All were found to be in order. Records examined show that the majority of relatives who responded to the quality-monitoring questionnaire felt that the home frequently achieved a high standard in respect of ‘personal care, privacy and dignity’. The inspector observed that service users were spoken with in a courteous manner by both members of staff and management and staff knocked on doors before entering service users rooms. Service users were well dressed and the hairdressing room was in use for much of the time of the inspection. The inspector was informed that the home held ‘clothes parties’ where someone visited with a variety of clothes for service users to try on and purchase if they wished. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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 The home was able to meet the interests and needs of the service users. There were good links between the local community, relatives and service users. Service users were supported to make choices and retain control over their lives, although some service users with dementia were limited by their abilities and capacity. The home offered a wholesome, varied diet that was enjoyed on the whole by service users. EVIDENCE: On the day of the inspection the inspector saw evidence of a variety of activities appropriate for elderly people and those with dementia. The manager said the activity co-ordinator worked both with individual service users and groups. There were large sized playing cards and games designed for reminiscence. The manager said that ‘music and movement’ was enjoyed by many service users. The inspector was told that service users have opportunities for ‘trips out’ and a visit to the garden centre with refreshments was very popular. The manager said that wherever possible on these trips, service users managed their personal monies. Staff spoken with said that visitors were always made welcome and all relatives who responded to the quality monitoring questionnaires agreed. The inspector saw information prominently displayed in Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 12 the hallway. There were leaflets about both local community activities and inhouse activities. Service users’ rooms showed evidence of a variety of personal possessions and service users spoken with on the day of the inspection were happy and relaxed. Menus were inspected and showed that a variety of food was offered to service users. Fresh fruit and vegetables were delivered from a local supplier. Comments received from relatives included “mealtimes are always good with a variety day by day” and “mealtimes are always looked forward to”, although one relative felt that “arguments between other residents” sometimes spoiled mealtimes. The inspector observed that drinks and snacks were offered throughout the day. One service user brought a cup of tea into the office and sat with the manager and admin staff, who said that this happened every day. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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): These standards were not inspected on this occasion. EVIDENCE: No evidence was looked at for these standards at this inspection. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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 the following standard(s): 21, 22, 25 and 26 Lavatories and washing facilities were sufficient and suitable to meet the needs of service users. The home ensured service users had the specialist equipment they needed to maximise their independence. Overall service users lived in safe, comfortable surroundings, although some water safety valves needed to be fitted. The home was clean, pleasant and hygienic; however, there were no sluicing facilities and laundry floor needed to be refurbished. EVIDENCE: On the tour of the premises the inspector saw a total of six bathrooms, three of which had assisted baths. The manager informed the inspector that many service users were self-caring and the number of assisted baths “works very well”. A comprehensive assessment of the premises had been carried out by an independent organisation. The Occupational Therapist’s environmental report was available and was examined by the inspector. The inspector saw evidence of grab rails and ramps to maximise service users’ independence. Three hoists Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 15 were available and there was evidence that they had been serviced just within the last year; the manager informed the inspector that hoists were due to be serviced again at the end of the month. A new call system was in place and staff carried ‘alarms’ to call for assistance when necessary. The inspector observed that all radiators were guarded, many with soft covers. Safety valves had been fitted to most water outlets, but some work remained outstanding (for further details see evidence for Standard 38). Service users’ rooms were observed to be bright and airy with appropriate natural lighting and ventilation. During the tour of the premises the inspector observed a high standard of cleanliness throughout the home, with no unpleasant odours either in service users’ rooms or in communal areas. Staff and visitors to the kitchen were given aprons to wear and the inspector observed the use of protective gloves by staff handling food. The floor of the laundry needed to be replaced; Ms Carson said that this would be done as soon as possible. Mr Hughes and Ms Carson informed the inspector that they had looked at options within the home for sluicing facilities but felt that the standard of hygiene within the home was good and practices ensured service users were safe. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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 and 30 The home had adequate staffing levels to meet the needs of service users currently living in the home, however regular reassessment is needed to ensure the high needs of service users with dementia is met. Staff had the skills to ensure service users were cared for safely. A training programme was in place to ensure staff were trained and competent to meet the needs of service users. EVIDENCE: The manager said that he tried to ‘stagger’ shifts so that more staff were on duty for busy times such as first thing in the morning. Staff spoken with commented on the number of service users with higher support needs and felt that this was increasing. Staff spoke of changes since the new company took over. One said that some staff had been wary of change but there had been positive things happening. One member of staff said they “had more time to sit and talk with service users” and one said that an extra carer had been rostered on to the afternoon shift and that had made “all the difference”. One member of staff said that it was a large home and the layout made it time consuming and sometimes difficult to ‘keep track’ of service users if they were ‘wandering’. Records inspected showed that eight members of care staff had completed NVQ2 and two members of care staff had completed NVQ3. The inspector examined training records that showed some staff had received training on pressure sore prevention, stroke awareness by the Stroke Society, falls Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 17 prevention and the administration of medication. The Alzheimer’s Society had delivered training on Person Centred Care. The majority of staff had received training on dementia care. Staff spoken with said there was “loads of training”, including manual handling, infection control, abuse, food hygiene and fire safety. One member of staff said that there had been dementia training but they would like more. Ms Carson informed the inspector that further training around dementia was planned. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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): 33, 36 and 38 The home had an effective quality assurance and monitoring system to ensure the best interests of service users were promoted in the running of the home. Staff were adequately supported and supervised. In general the health, safety and welfare of service users and staff were promoted. However, completion of installation of water safety valves and resurfacing of laundry floor was needed. EVIDENCE: Records of a quality monitoring survey that was carried out in April 2005 were examined. The collated report showed a 33 response to the questionnaires that had been sent out. The results showed an overall high level of satisfaction with the home from those who responded. Staff spoken with said that they got good support from the manager; he “is brilliant” and will listen. Interactions observed by the inspector showed that the working relationship between manager and staff was good. Staff spoken Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 19 with said that staff meetings are held every two months for senior staff and that supervisions were ‘informal’. Records examined showed that supervisions were taking place, although the records would benefit from being signed and dated by all staff, as some signatures were missing. During a tour of the premises the inspector observed that safety valves had been fitted to some water outlets. The manager said that all but 9 of the water outlets now had valves. The inspector was shown the valves that have been purchased for the remainder of the outlets and the manager stated that the work was due to be completed the following week. The inspector observed that the laundry floor had not yet been replaced; the manager said that the new company had an action plan for carrying out improvements (see standard 26). The inspector saw records of fridge temperature checks that had been carried out. Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X 3 3 X X 2 2 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 X 2 Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP25 Regulation 13 (4) (a) (c) 13(3) 16(2)(j) Requirement The registered person must ensure that safety devices are fitted to all water outlets. This is a repeat requirement. The laundry floor must be replaced by impermeable flooring that is readily cleanable. The home must ensure they make suitable arrangements for maintaining satisfactory standards in respect of sluicing. This is a repeat requirement. The registered person should ensure the health and safety of service users and staff in respect of regulation of water temperature (see 1 above). This is a repeat requirement. Timescale for action 30/09/05 2 OP26 31/12/05 3 OP38 13(4)(a) 30/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 22 Blenheim Care Home DS0000062882.V251928.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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