Inspection on 30/08/06 for Blenheim Care Home

This inspection was carried out on 30th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Blenheim Care Home 28/08/07

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. Final Key Unannounced Inspection 30th August 2006 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.V309695.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.V309695.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 (15), Old age, registration, with number not falling within any other category (42) of places Blenheim Care Home DS0000062882.V309695.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 (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 16th December 2005 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 a passenger lift. 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 £367:00 and 470:00. 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.V309695.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 30th August 2006 with the assistance of the Registered Manager, residents, staff, and visitors, my thanks to them all. The site visit was conducted between the hours of 10:00am and 4:00pm. The inspection involved a tour of the premises, looking at records, documents, and talking to staff, including the cook, and visitors. Additional feedback was received from staff, residents and a visiting District Nurse, who was providing treatment for a service user. She was complimentary about the service and care provided by staff, and that she had no concerns about the management of the home. Feedback and interviews with residents, relatives and staff were positive about the standard of care, support, and the commitment of the management team during a period of change. A total of 23 standards were inspected with twenty-two of the standards being met. At the end of the site visit, the findings were discussed with the Registered Manager, and advice and guidance given. What the service does well: The home provides a homely environment that is decorated and furnished to a good standard and is well maintained. Residents’ personal health care needs are well supported by a team of experienced and trained care staff. The management of the home and support for staff is good. Training and development opportunities for staff are provided, and ensure that residents’ needs are professionally met. Menus are varied and appropriate formats are in place to assist residents with the selection of meals. Blenheim Care Home DS0000062882.V309695.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. Blenheim Care Home DS0000062882.V309695.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.V309695.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Detailed assessments are completed before residents are admitted, and a trial period undertaken to ensure that the placement is right, and needs can be met. EVIDENCE: From the three residents’ files examined as part of the site visit and case tracking process, there was evidence in place to confirm that that preassessments had been completed by the Registered Manager prior to visits to the home, and being admitted. Further information was available through Care Management documentation (COM 5’s). On admission, further periods of assessment are carried out to help ensure that the placement is correct for the resident, and that the home can successfully meet their assessed needs. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 9 One resident spoken with confirmed that she had visited the home prior to her admission and had also received respite care on occasions. The Registered Manager said that all residents were having individual profiles completed to ensure that information was made available for staff at a glance without having to find information in care files. The home does not offer intermediate care facilities. Blenheim Care Home DS0000062882.V309695.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 at least once during a 12 month period. 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 residents are identified and met. The medication system is well managed, promoting the good health and well being of residents. EVIDENCE: The care files of two residents (D.A. and J.P) were examined and found to be sufficiently detailed with all aspects of health, personal and social care needs identified and planned for. Comprehensive risk assessments were noted in files, and also in the completed residents’ individual profiles. 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. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 11 For residents who have hearing difficulties, a loop system is provided and covers most areas of the premises. Some residents who contributed to the site visit discussions were able to confirm their involvement in the care planning process. Others spoken with were not so able, and relied on relatives being involved. Each of the files examined contained a history of each resident’s life that had been completed by their relatives and/or friends. 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. Staff were observed interacting with residents, and showed an understanding of the needs of older people and those with dementia. Staff was seen to be patient and kind. Residents spoken with felt their privacy was respected and that staff are sensitive when they needed help with personal care. Blenheim Care Home DS0000062882.V309695.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 at least once during a 12 month period. 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. Residents experience a varied life at the home with visitors encouraged, various informal activities made available, and good meals. EVIDENCE: On the day of the site visit staff were observed to be assisting residents with activities, Activities are scheduled to take place each morning after coffee break and include exercise and games appropriate for those with dementia and the elderly. The home’s staff are currently following the guidance contained in the Alzheimer’s Book of Activities. The home’s Activity Co-ordinator had recently left and is to be replaced by the previous person who had responsibilities for Activities; she will provide one to one, and group activities every weekday afternoon. 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. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 13 Visitors to the home were spoken with and confirmed that they are always made welcome, and visiting hours were flexible. 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 some arranged activities and during mealtimes. Menus were inspected and showed a variety and choice of meals and records 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. A recent visit by an Environmental Officer made recommendations regarding work required to improve the kitchen facilities. The registered manager said contractors have assessed what is required and work will begin at the earliest opportunity. Blenheim Care Home DS0000062882.V309695.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 inspected at least once during a 12 month period. 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. Staff had a good knowledge and understanding of Adult Protection issues, which help protect residents from abuse. EVIDENCE: Key standard 16 was met in full at the last inspection. There have been no complaints received by the home or the Commission for Social Care Inspection (CSCI) since the home’s last inspection. The home’s Adult Protection and Whistle Blowing policies were clearly and comprehensively detailed. Staff spoken with confirmed that they had received appropriate information in recognising and responding to abuse situations during their induction training and further information through the Essex Protection of Vulnerable Adults Committee booklets. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 15 Blenheim Care Home DS0000062882.V309695.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents live in safe, warm, well-decorated and furnished home, that is regularly maintained inside and outside to a high standard The home has systems in place to control the spread of infection in accordance with published professional guidance, and safeguard the health of residents, staff and individuals visiting the home. EVIDENCE: From the evidence found during a tour of the premises and discussions with the registered manager, there had been a continuation of the refurbishment programme since the last inspection visit. Most of the residents bedrooms had been redecorated, carpets renewed and furniture replaced. Residents and visitors spoken with commented on the positive changes to the environment and how much brighter the home was. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 17 The registered manager confirmed that pre-set valves control the temperatures of all hot water outlets and they are tested on a regular basis to ensure that residents are protected from scolding. Laundry facilities provided were clean, hygienic and were used mainly for the residents’ personal clothing. Items such as bedding were contracted out to a private company. The floor of the laundry room had been replaced with a permeable surface that is cleanable. The home does not have sluicing facilities but has provided the Commission for Social Care Inspection (CSCSI) with a sluicing rationale that outlines the procedures should a resident need to use a commode at night. Staff have received training in relation to infection control measures. and are aware of the Universal Hygiene Rules. Toilet management programmes and protocols are in place ensuring the dignity of resident’s are maintained, should they need to use a commode during the night. The Acting Manager was advised to incorporate this information in the home’s Infection Control Policy and Procedures. Blenheim Care Home DS0000062882.V309695.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 at least once during a 12 month period. 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 Staffing levels at the home are not consistent with the assessed needs of residents and may have a detrimental effect on their health and wellbeing. The home operates a robust recruitment process that helps to keep vulnerable adults safe. A varied programme of training ensures that staff are competent to meet the needs of residents, and help to keep them safe. EVIDENCE: Staffing rotas were examined and dependency levels were checked against the Department of Health guidelines. The Residential Forum calculates that there should be 926 hours required based on the correct dependency levels of 50 residents, but care staff per week covers only 762 hours, this is a shortfall of 164 hours. The registered manager spoke of trying to use additional hours provided by night staff during the busy morning period and trying to provide the same cover during the busy afternoon period through flexible working arrangements. Staffing levels should be based on full occupancy and taking into account the increasing levels of higher support required by residents who have dementia, and other residents who are older. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 19 10 members of staff at levels 2 and 3 have completed national Vocational Qualification (NVQ) training. Support is offered to staff that wish to access the training. The files of three members of the care team were examined and one was found to contain the required information before commencement of work with vulnerable adults. Two new members of staff of the care team are working in the home under supervision until all of their documents are in place. The registered manager confirmed that both individuals are not providing personal care to residents. Staff training profiles were examined and included mandatory training undertaken, and more specialist training associated with dementia awareness. Further training has been booked for staff to attend a Good Practice in Dementia Care. Staff have received dementia training related to challenging behaviour since the home’s last inspection. Records of individual staff training needs and further training planned are kept on the home’s training tracker chart. The home’s staff notice board was seen to provide forthcoming training courses booked for staff to attend. Blenheim Care Home DS0000062882.V309695.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 at least once during a 12 month period. 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 regularly reviews aspects of its performance through a programme of self-review and consultations, which includes the views of residents, relatives and staff. The home’s policies and procedures regarding residents’ finances help ensure that their financial interests are safeguarded. Residents’ personal wellbeing and safety is promoted through staff training, comprehensive policies, procedures and regular health and safety checks. Blenheim Care Home DS0000062882.V309695.R01.S.doc Version 5.2 Page 21 EVIDENCE: The management of Blenheim House remains the same as the last inspection with the registered manager providing good support for residents and staff. He has also been supporting one of the other organisations Care Homes and the acting manager. Residents spoken with commented on how well they are treated and 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. Residents financial records were inspected at the home’s last site visit and met the standard. The same system of recording and the safekeeping of residents’ finances existed at the time of this site visit. A record of a quality monitoring survey that was carried out in March 2006 was examined. The collated report showed that a total number of 51questionnaires were sent out and 23 were returned. The overall results showed that there was a high level of satisfaction from those who responded. The results also 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. 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. Certificates for gas appliances, electrical installations and insurance cover were seen to be in place and up to date. Staff training and development files included health and safety training in safe working practices. Blenheim Care Home DS0000062882.V309695.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 CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 3 X X X X X 3 3 STAFFING Standard No Score 27 2 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.V309695.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. 1 Standard OP27 Regulation 18 (1)(a) Requirement The registered person must ensure that at all times suitably qualified, competent, and experienced persons are working at the home in such numbers as are appropriate for the health and welfare of residents. Timescale for action 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Blenheim Care Home DS0000062882.V309695.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: 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 Home DS0000062882.V309695.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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