Inspection on 28/08/07 for Blenheim Care Home

This inspection was carried out on 28th August 2007.

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.

Other inspections for this house

Blenheim Care Home 30/08/06

Blenheim Care Home 16/12/05

Blenheim Care Home 27/09/05

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 Burwood Key Unannounced Inspection 28th August 2007 10:00 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 Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 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.V349559.R01.S.doc Version 5.2 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 (0), Old age, registration, with number not falling within any other category (0) of places Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 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 Persons of either sex, aged 65 years and over, who require care by reason of dementia The total number of service users accommodated in the home must not exceed 57 persons 30th August 2006 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 passenger lifts. The home has a range of comfortable communal areas and there is a large and well-maintained garden to the rear of the building. Wheelchair access into the garden is provided by way of ramps. There are 51 single bedrooms, some with en suite facilities and 3 double rooms, all with en suite facilities. Current fees charged by the home are between £374:00 and £550:00. Information about the service provided by Blenheim House is contained in the home’s Statement of Purpose, Residents Guide and the home’s newsletter. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on the 28th August 2007 with the assistance of the registered manager, administrative staff, people who live at the home, care staff, and visitors, my thanks to them all. The site visit was conducted between the hours of 10:00am and 3:00pm. The inspection involved a tour of the premises, looking at records, documents, and talking to people who live at the home, staff, including the cook, and visitors. Additional feedback was received from surveys completed by staff, residents and relatives. Feedback was positive about the standard of care, support, and the commitment of the management team during a period of change. The presentation of the Annual Quality Assurance Assessment was good, well laid out and contributed positively to the overall inspection visit report. A total of 22 standards were inspected and met during this site visit. Two of the standards relating to the homes environment exceeded national minimum standards. At the end of the site visit feedback was given to the manager regarding the inspection visit and their support for another R.W. Care Home situated near to Blenheim House. What the service does well: The home provides an excellent standard of accommodation that is comfortable, clean, regularly maintained and refurbished when required. Communal areas are furnished and decorated to a high standard and are set out for the comfort of all people living at the home. The home’s staff are well qualified to meet the diverse needs of residents currently accommodated. Training and development opportunities for staff are provided, and ensure that all residents’ assessed needs are professionally met. Residents’ personal health care and social needs are well supported by a team of experienced and trained care staff. The management and support for staff is good. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 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.V349559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People coming to live at the home can expect to receive up to date and accurate information about the services provided. The home’s assessment process is well managed and ensures that prospective residents needs are comprehensively detailed before moving into the home. EVIDENCE: The home’s information documents (Statement of Purpose, Policies and Procedures and General Information) have been updated with the following paragraphs containing more specific information for families, people wishing to use the service and their advocates/representatives: • Arrangements for recognising and respecting equality and diversity, and the privacy and dignity of people living at the home. DS0000062882.V349559.R01.S.doc Version 5.2 Page 9 Blenheim Care Home • • • Care Plan Reviews. Arrangements for dealing with complaints. The importance of quality assurance monitoring. The files of three people living at the home were examined and found to include comprehensive pre-assessment information, including a Mental Health Needs Assessment in which to generate a good care plan. The registered manager said assessment of needs involved the person being assessed and their families where possible. One of the people whose care was considered in detail on this inspection visit (case tracked) had previously received respite care and was familiar with the home. Another person spoken with said they had visited the home and met staff and other people living at the home before deciding to move in. One of the visiting relatives spoken with confirmed that the admission process was good and professionally managed. The home does not provide intermediate care. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home ensures that the health care needs of individuals are identified and met. The medication and healthcare arrangements in the home are very well managed and ensure the good health and wellbeing of people living at the home. EVIDENCE: The care files of the three people who were case tracked contained their medical, personal and social care needs, ensuring that their cultural and social requirements are known to the staff and how they were to be met. Staff spoken with said they are aware of the diverse needs of people using the service and have received the appropriate training to enable them to respond to their needs. The staff that have not so far received specialist training have received an information booklet to help them to deal with the demands and care of people with dementia. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 11 Evidence was noted that annual and monthly reviews had taken place. Records were in place regarding professional’s visits to the home, with referrals and outcomes recorded. Regular meetings between management and senior care staff ensure that all people living at the home have their health and social care needs reviewed. Senior staff spoken with confirmed that they were involved in health review meetings and further discussed individual changing needs during their supervision sessions with the manager. An examination of the home’s medication room and records was undertaken with the ordering, storage, administration, including controlled drugs and their disposal found to be correct. Senior staff said they were responsible for the administration of medicines and had undertaken the necessary training to ensure the safety of people who were prescribed medication. Staff who were observed during the site visit were seen to be interacting with people living at the home and showed an understanding of the needs of older people and those with dementia. They were seen to be patient and kind. People spoken with felt their privacy and dignity was respected and that staff are sensitive when they needed help with personal care. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living at the home experience a varied life at the home with visitors encouraged, various formal and informal activities made available, and good meals. EVIDENCE: On the day of the site visit people living at the home were involved in a range of in-house activities with the newly appointed Activities Co-ordinator who is assessing peoples’ individual social and recreational needs and is currently following the guidance contained in the Alzheimer’s Book of Activities. Residents are also provided with the opportunity to access community facilities within the area. Up to date information about activities is made available through the home’s newsletter and the residents’ notice board. The manager explained that dedicated quiet areas had been established to encourage people living at the home to be able to read, play card games and puzzles. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 13 Visitors to the home were spoken with and said that they are always made welcome, and could visit as often as they wished. One relative spoken with commented on how well the home was managed and the excellent standard of care that was provided. During a tour of the premises it was noted that residents’ rooms contained items of personal interests, photographs and ornaments. Due to levels of ability, some residents’ choices were limited, although staff were observed encouraging residents to make choices in their daily routines, particularly in relation to arranged activities and during mealtimes. One person with a sight impairments was being assisted in a caring manner by a member of staff with their meal. Menus were inspected and showed a variety and choice of meals and records were in place of meals taken by residents. A new menu format had been introduced that included photographs of particular meals, further development was being considered to include a wider variety and choice. The format was tested during the site visit by some resident’s, who found the new system easy to use. Various safety records associated with food temperatures and equipment checks were seen to be in place. Following the last visit by an Environmental Officer, the recommendations regarding work required to improve the kitchen facilities had been completed. (See Environment Standards for details). Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home has an open culture where individuals feel safe and supported to share any concerns in relation to their protection and safety. Arrangements for the protection of vulnerable adults and staff training are good and help protect people who live at the home from abuse. EVIDENCE: Blenhiem House a clear complaints policy and procedures that had been updated to include the timescales for the manager or others to respond to any complaints raised. The manager said that no complaints had been received for a number of years. Complaints records examined verified this. One person living at the home said if they had any concerns or problems they would talk to the manager. Information is made available to people who live at the home, relatives and visitors through notices displayed in various locations throughout the home and information contained in the home’s Statement of Purpose. Policies and procedures relating to the protection of vulnerable adults were in place with appropriate guidelines for staff to follow should a complaint of abuse be made or they observe an incident of abuse taking place. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 15 All staff have completed training in recognising and reporting incidents of Adult Abuse. Members of staff spoken with confirmed that they had undertaken the appropriate training and would know what to do if they witnessed an incident of abuse. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. The home provides a well-maintained environment through the renewal of equipment and facilities that ensures the comfort and safety of people living and working there. EVIDENCE: A number of improvements have been carried out to the home’s interior since the last inspection. The refurbishment of bedrooms, including replacing carpets and curtains has been completed, together with decorating of rooms as they become vacant. One of the bathrooms has been completely refurbished and another converted into a walk in shower room. A toilet room has also been refurbished. Wheelchair access to the gardens has been improved and new garden furniture purchased to encourage residents to take advantage of the pleasant surroundings. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 17 The kitchen has been completely refurbished and new refrigerators, freezers and a dishwasher installed and commissioned. Laundry facilities remain the same with arrangements for bedding and towels contracted out privately. People living at the home have their personal items of clothing laundered at the home by dedicated full time laundry staff. Sufficient staff are employed through out the week to ensure that the home is kept clean and tidy. This includes weekend cover. Monthly Regulation 26 inspections bring to light any maintenance, repair or cleaning issues that need attention and cover both environmental and safety aspects. Also, residents’ and staff meetings include items relating to the cleanliness and comfort of the home. Policies, procedures and risk assessments are in place to provide as safe an enviroment as possible for people living at the home and staff. Staff are fully trained and briefed on the procedures to adopt to control the spread of infection and with health and safety regulations. The manager produced a check list that summarises the evidence on the standards of hygiene and control of infection. Regular checks on the alarm and manual handling equipment ensures that residents are safe and comfortable. People living at the home have the opportunity to inform the manager and senior staff of any concerns they may have about their own rooms and the communal areas, or any changes they would like to make via one-to-one meetings with the manager, at residents meetings, or through the home’s quality monitoring system. One resident’s partner informed the registered manager via the home’s surveys that the front door bell was not effective when visiting the home, particulary if everyone was in the rear garden. The registered manager said this was in hand and a new bell will be fitted that can be heared from the gardens. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff in the home are trained, skilled and in employed in sufficient numbers to support and meet the needs of people who use the service. The service operates a robust recruitment process that helps to keep vulnerable people safe. EVIDENCE: Staffing rotas were examined and the manager supplied dependency level documentation to the inspector during the site visit. Dependency levels were calculated on low, medium and full occupancy of the home. At the time of the site visit the manager pointed out that fifteen shifts would need to be covered per week through additional working by care staff and some adjustment to the staff rota to ensure there is maximum coverage at busy times. The manager said the home has two vacancies for full time staff and an interview was booked for one of the vacant positions. The recruitment files of three members of staff were sampled and inspected and found to contain the appropriate checks and personal information required before they commenced employment at the home. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 19 A full range of policies and risk assessments are in place to ensure the safety and wellbeing of people living in the home. Staff spoken with and records seen confirmed that they had undertaken training in safe working practices; safeguarding adults and dementia. One member of the care team is the Health and Safety co-ordinator for the home and has completed the appropriate training. The manager presented the inspector with a copy of the training planned and completed for the period January to November 2007. Most of the staff spoken with had achieved the National Vocational Qualification (NVQ) Level 2 award. Other staff had booked onto the Level 2 and 3 courses and would be starting this year. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s is well managed and is run in the best interests of the people living there. Residents’ personal wellbeing and safety is promoted through staff training, comprehensive policies, procedures and regular safety checks. EVIDENCE: The management of Blenheim House remains the same as the last inspection with the registered manager providing good support for residents and staff. The registered manager has also been supporting one of the other organisations Care Homes. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 21 People living at the home commented on how well they are treated and that the registered manager tries to ensure that they are listened to. During the site visit the interaction between the registered manager, residents and staff was observed to be good. A record of quality monitoring is carried annually, published and distributed to people living at the home, their families and health professionals. The results of the surveys included positive and negative comments about the home that would be responded to by the registered manager in order to improve the service provided. In addition to the quality monitoring process of surveys sent out, procedures and systems are in place to complete audits/checklist’s relating to all aspects of the service that could contribute to the quality assurance system. The registered manager and people living at the home confirmed that they attend meetings with the home’s staff and their relatives and representatives are also welcome. The following changes have been implemented as a result of the most recent feedback from people living in the home and their representatives: • • • • New food containers to ensure that meals are served hot at the tables and for those who choose to eat in their rooms. Rooms renumbered in a more logical sequence to help residents negotiate the building. All room doors have personal items known to the people who occupy them. A bathroom converted into a walk in shower room and another bathroom refurbished. The home has also purchased a stand hoist to speed up transfers. Health and safety reports are completed weekly together with checks on fire, water temperatures. Service agreements were in place for the home’s lift and disability equipment. As previously reported the home has a health and safety representative who has undertaken the appropriate training and liaises with the Fire Service and service contractors. Certificates for gas appliances, electrical installations and insurance cover were seen to be in place and up to date. Staff training and development files seen included health and safety training in safe working practices. Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 22 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 ENVIRONMENT CHOICE OF HOME Standard No Score 1 2 3 4 5 6 Standard No 19 20 21 22 23 24 25 26 Score 3 X 3 X 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 3 17 X 18 3 4 X X X X X X 4 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 Blenheim Care Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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.V349559.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Home DS0000062882.V349559.R01.S.doc Version 5.2 Page 25 - 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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