Inspection on 16/01/06 for Blenheim House

This inspection was carried out on 16th January 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 House 29/10/07

Blenheim House 14/11/06

Blenheim House 16/08/05

Blenheim House 21/03/05

Blenheim House 13/10/04

Blenheim House 11/02/04

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

CARE HOME ADULTS 18-65 Blenheim House 28 Blenheim Road Deal Kent CT14 7DB Lead Inspector Mrs Penny McMullan Unannounced Inspection 16th January 2006 10:00 DS0000023192.V263361.R01.S.doc Version 5.0 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 DS0000023192.V263361.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 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. DS0000023192.V263361.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Blenheim House Address 28 Blenheim Road Deal Kent CT14 7DB 01304 362534 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) Robinia Care South East Ltd Mr Michael Gregory Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000023192.V263361.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: Blenheim House is part of the group of homes owned by Robinia Care South East Limited. The home is registered for three people with learning disabilities. The property is a terraced house in a residential area of Deal, within easy walking distance to the main town, beach and leisure facilities. The property has three storeys, on the first floor there are two bedrooms, a bathroom, toilet, and smoking room, The gound floor consists of an en suite bedroom, lounge and office. There is a dining room and kitchen in the basement which leads out to the garden. The garden has a paved area, with steps and some planted shrubs. Mr Michael Gregory is the Registered Manager who is also responsible for both Westbury Lodge and Bleheim House. DS0000023192.V263361.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mr Michael Gregory the Registered Manager was not available at the time of the inspection however the Deputy Manager Emma Roberts was able to come down from Westbury Lodge to assist with the inspection. Mrs Roberts has been in post for two weeks and is also the Assistant Manager for Westbury Lodge. Although she is new to Blenheim House she has worked for Robinia Care for some considerable time and is an experienced senior member of staff. Mrs Roberts is also familiar with the residents at Blenheim having worked with them at other Robina Care homes. The home is in the process of updating the Statement of Purpose to reflect the changes to the management structure and on completion will forward a copy to the Commission. On arrival at the home the residents were just leaving to go on a shopping trip. The Inspector carried out part of the inspection with Emma Roberts in the premises whilst the residents were out and then returned after lunch to speak to the residents and staff. The Registered Manager holds the keys to the filing cabinet where staff records are stored. This cabinet was locked therefore some records could not be viewed; consequetly the staffing standards have not been assessed on this visit. The unannounced inspection took place over 3.5 hours, one resident was spoken to and four members of staff. The other two residents did not wish to speak to the Inspector. A brief tour of part of the building was also carried out. There were two members of staff on duty to support three service users. The home was relaxed with a homely atmosphere. During the afternoon the inspector observed part of the staff meeting, which was structured and informative, and demonstrated staff awareness and knowledge of the needs of the residents in the home. What the service does well: Staff support residents to participate in all activities of their choice promoting their independence. The home ensures that all residents are involved in their care plans and their opinions are listened to and within the agreed limitations acted upon. There are weekly resident meetings to ensure all residents have the opportunity of expressing their views on all aspects of the home. DS0000023192.V263361.R01.S.doc Version 5.0 Page 6 Staff interaction with the residents is respectful and supportive. One resident said that the food was good and with the assistance of the staff he is able to shop and cook for himself. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Staff say the Company provides good training, ensuring they have the skills to provide good quality care and support. 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. DS0000023192.V263361.R01.S.doc Version 5.0 Page 7 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 DS0000023192.V263361.R01.S.doc Version 5.0 Page 8 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): EVIDENCE: None of the above standards were assessed on this inspection. However the home is in the process of updating the Statement of Purpose re the changes in the management structure and will forward a copy to the commission on completion. DS0000023192.V263361.R01.S.doc Version 5.0 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 The care planning system is clear and consistent to provide staff with the information they need to meet the resident’s needs. EVIDENCE: The care plans are detailed and thorough and cover all aspects of health and social care. Accidents/incidents are recorded and health care needs are monitored in the care plan. One resident confirmed his participation in the care planning process and said he attended reviews. Risk assessments and any specific restrictions on limitations of daily life are recorded, signed and agreed with all residents. DS0000023192.V263361.R01.S.doc Version 5.0 Page 10 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. 16, 17 Employment and training opportunities are sought by the home to encourage residents to find a job. The home provides stimulating activities to meet the needs of the residents. The home promotes choice, independence and freedom of movement to residents whilst providing a risk management strategy recorded and agreed in the care plan. The residents are supported to maintain a well balanced diet and residents confirmed choice and variety of meals. EVIDENCE: One resident is attending a computer course and although aware of accessing college course was not interested at this time. Residents are supported to assist with allocated tasks at Westbury Lodge. They are encouraged to develop skills to take part in any opportunity for employment and are assisted with budgeting skills. DS0000023192.V263361.R01.S.doc Version 5.0 Page 11 Each resident has a day activity programme, which may include bike riding, fishing, walking, and keeping rabbits and tropical fish. The home reviews the activity programme on a monthly basis to ensure the residents have their choice. One resident enjoys watching DVD’s and the football. He expressed a wish to go night fishing and staff said they would look into this possibility. Overall there are adequate activities being provided but residents and staff feedback indicates that they would like to do even more if there was additional funding available. The home has their own transport and local transport, train or bus services are easily accessible. Residents all have a key to their room and are able to choose when they wish to be alone. One resident said staff always knock on his bedroom door before entering and his privacy was always respected. Daily chores are identified in the individual care plans and the home was in good order, clean and tidy. The staff and residents have joint responsibility for the care of the tropical fish. One service user keeps rabbits and they are cared for in hutches in the back garden. There are risk assessments in place for residents to be left alone in the home and one service user has his own key to the premises. The home supports residents to choose and buy their own food. They are given a budget to purchase their shopping and go to the local supermarket. With the assistance of the staff the meal is then prepared and cooked by the resident. Staff monitor this programme to ensure that a well balanced nutritional diet is provided to all residents. One resident confirmed that he was supported in choosing a healthy diet and said the food was good. All of the necessary checks are being carried out to ensure the food is stored and cooked appropriately. DS0000023192.V263361.R01.S.doc Version 5.0 Page 12 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): 20 The systems for medication administration are good with arrangements in place to ensure resident’s medication needs are met. EVIDENCE: The administration of medication is minimal in the home and new storage facilities have been provided. The medication administration sheets (Mar sheets) were in good order. Receipt of medication is in place and the staff signature list is also recorded. All of the staff administering medication have received medication training and policies and procedures are in place. DS0000023192.V263361.R01.S.doc Version 5.0 Page 13 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 The home has a satisfactory complaints system and residents said that their views are listened to and acted on. EVIDENCE: The home has a clear Complaints Procedure, which is included in the Service User Guide. The format is in large print with signs and symbols. One resident says he is able to voice his concerns with the staff and would complaint if he needed to. The home records all concerns or complaints no matter how minor and ensure that action required is taken. There have been no formal complaints since the last inspection. DS0000023192.V263361.R01.S.doc Version 5.0 Page 14 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): 24,25,30 The standard of the environment within the home is good providing residents with a comfortable and homely place to live. The lack of guarding of the radiator in one resident bedroom potentially puts one resident at risk. Laundry facilities are satisfactory and policies and procedures are in place to control the risk of infection. EVIDENCE: The premises are homely and relaxed. The home is clean and tidy and residents and staff ensure that all daily tasks are completed. The residents get involved in the redecoration of the home and with the staff are in the process of planning any redecoration for this year. The window in the lounge is in need of repair/replacement and the home is in the process of getting quotes to complete the work. There is also a large crack in the plaster on the wall by the stairs. This has been professionally assessed and is being monitored to effect repairs if required. The Company have a maintenance team to ensure repairs are completed and overall although there are some areas which require painting the home is well maintained. DS0000023192.V263361.R01.S.doc Version 5.0 Page 15 Residents are able to personalise their rooms to their choice and radiators are individually controlled. Due to the care needs of one resident it is recommended that the home risk assess the guarding of the radiator and pipe work in one residents room. A recommendation has been made in this report. One resident said he is happy with his room and has his own key. The home is clean and tidy with no offensive odours. Laundry facilities are domestic and the washing machine is in the kitchen. Residents and staff are aware of the policies and procedures in the home. DS0000023192.V263361.R01.S.doc Version 5.0 Page 16 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 The staff have a good understating of residents support needs. This is evident from the positive relationships, which have been formed between the staff and residents. EVIDENCE: The home has one staff vacancy, however a new staff member will be commencing in February and the home will be fully staffed. The Assistant Manager, Emma Roberts, has been in post for two weeks and has worked for the Company for some years. All staff have received mandatory training and specific training such as epilepsy has been provided and staff are booked to attend a training course on autism. There are 3 staff who have NVQ2 or above and three currently completing. Staff demonstrated their understanding of meeting resident’s needs and are committed to providing good quality care. DS0000023192.V263361.R01.S.doc Version 5.0 Page 17 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): 42 The home is providing a safe environment for residents to live in. EVIDENCE: Standard 37 is now a core standard but could not be assessed at this inspection, as the Registered Manager Mr Gregory was not available. However Mr Gregory has many years experience supporting and managing people with learning disabilities and those with challenging behaviour. He is in the process of completing his Registered Manager Award. Mandatory training is being provided to all staff. Fire Safety Records were inspected and in good order. All of the staff and two residents have attended a fire training course. Accident and incidents were recorded and certificates of servicing confirm that all appliances have been checked. There are records with regard to Health and Safety and Control of Substances Hazardous to Health requirements and data sheets are in place. The Company also carry out monthly Health and Safety checks on the home. One member of staff DS0000023192.V263361.R01.S.doc Version 5.0 Page 18 confirmed that he has compelted the induction and has completed his training to achieve the Certificate Working with People with Learning Disabilities. DS0000023192.V263361.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000023192.V263361.R01.S.doc Version 5.0 Page 20 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. 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. 1 Refer to Standard OP26 Good Practice Recommendations To risk assess the guarding of a radiator and pipe work in one resident’s bedroom DS0000023192.V263361.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 DS0000023192.V263361.R01.S.doc Version 5.0 Page 22 - 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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