Inspection on 29/05/07 for Blenheim House

This inspection was carried out on 29th May 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blenheim House 20/12/05

Blenheim House 12/07/05

Blenheim House 20/09/04

Blenheim House 21/04/04

Similar services:

The Highlands

1 Lanark Close

Beaconsfield Court Care Home

Ann Charlton Lodge

The Gardens Care Home

Westmoor View Nursing Home

Ashlea Mews Residential Home

St Aiden`s Cottage

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

CARE HOME ADULTS 18-65 Blenheim House Trenchard Avenue Thornaby Stockton-on-Tees TS17 8HJ Lead Inspector Brenda Grant Unannounced Inspection 29th May 2007 10:00 Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 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 House DS0000038025.V341407.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blenheim House Address Trenchard Avenue Thornaby Stockton-on-Tees TS17 8HJ 01642 527923 01642 528481 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) Stockton-on-Tees Borough Council Mrs Angela Mary Rutland Care Home 29 Category(ies) of Physical disability (29) registration, with number of places Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Four named individuals who are over the age category are able to reside at the home for as long as regular reviewed assessment determines their needs can continue to be met by the service. 20th December 2005 Date of last inspection Brief Description of the Service: Blenheim is a purpose built home providing care for 29 younger adults with a physical disability. The home is managed by Stockton-on-Tees Borough Council. Blenheim House offers accommodation and personal care for long stay residents and those people requiring respite care. The home is on ground level but there are also two first floor flats, one of which has been converted for use by up to three residents. Each bedroom is for single occupancy and they are a minimum of 10 sq. m. the first floor flat can be used by those wishing to share a bedroom. The home has three communal lounges and bedroom areas are divided into three units, with each unit having a kitchen/dining room. The large room that is used for activities is called a ‘multifunction’ room as it as also used for Social Evenings. It has a relaxation area with a water-bed, coloured lights and music is available. The ‘multi-function’ room also has a pool table, computer, music system, TV and a piano that are for resident’s use. There is a well kept quadrangle garden area, with seating, for residents to sit outside in warmer weather. The home is close to local shops and amenities. There is a car park at the front of the home. The fees, charged to residents, ranges from £78 to £643. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced inspection. We assessed the information from: the Pre Inspection Questionnaire which was completed by the manager, seven survey forms that a resident has been assisted to complete and we carried out a visit to the home. The visit took place over one day, six hours fifteen minutes in total. Observation, of the interaction between staff and residents, took place and there was discussion with six residents, two staff and three assistant unit managers. We looked around the home as well as examining a number of records which included those for; residents and staff files, health and safety and maintenance checks, complaints, medication and minutes from staff and resident meetings. The findings from the inspection were of the manager and staff providing an excellent service; creating a safe and homely environment and making every effort to meet the needs of individual residents. What the service does well: The outcome of the unannounced inspection was of the manager and staff working well to deliver an excellent service, which is to the benefit of the residents living at Blenheim House. Management and staff are enthusiastic with all aspects of their work and they obviously enjoy caring for the resident group. Residents benefit from the home having dedicated managers and staff who regularly volunteer, their own time, to support and assist residents to go for outings, appointments and holidays. Comments from resident’s surveys were: “I am very happy living at Blenheim House, it is my home.” “The staff always listen to what I say.” “I enjoy being at Blenheim House and get on well with the other residents. I also like to join in activity groups and socialising. I choose to go on holiday at least once a year.” “Staff treat me very well.” “Care staff are very dedicated to their job role.” “The managers and staff provide a very caring environment.” “I always make my own decisions.” Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 6 Residents are obviously very satisfied and happy with living at Blenheim House. Residents are encouraged to live their lives as they wish and they are fully involved with all aspects of their care. 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 House DS0000038025.V341407.R01.S.doc Version 5.2 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 Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standard: 2 Resident’s individual aspirations and needs are assessed and residents are fully involved with the assessment process. EVIDENCE: Resident’s files were examined. The files included care management assessments, giving details of the resident’s; likes and dislikes, abilities, needs and how the person is to be supported by the service. The home includes that information into their documentation. Views of residents and, where appropriate, their families are included in the record. Residents confirmed they were fully involved with the assessment process and with choosing to live at Blenheim House. Areas of risk are also included in the documentation. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards: 6, 7 & 9 The home has Care Plans, for each resident, which are regularly reviewed. The plans also contain Risk Assessments and include how risks are to be managed. Resident’s files inform how they are supported and assisted with making decisions and living their lives independently, as they are able to, within their capabilities. EVIDENCE: A sample of Care Plans was examined. They gave information of resident’s needs, capabilities and general details about; likes and dislikes and lifestyle. The Care Plans include: aims and objectives, the needs of the resident and how the needs are to be met. Care Plans included Risk Assessments that gave details of actions to take to reduce the risk/hazard to an acceptable level. Care plans are regularly reviewed; residents and staff said residents are fully Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 10 involved with their Care Plans and the reviews. Care Plans were seen to be appropriately stored in a lockable cabinet. All seven survey forms, which residents were assisted to complete, gave information that residents always make their own decisions about what they want to do each day. One resident’s survey form commented, “The managers and staff empower me to make my own decisions” and another informed, “I always do whatever I want”. Staff and residents said, staff respected resident’s having the right to make their own decisions. Staff said, that right is limited only through the assessment process, involving the resident, and as recorded in individual Care Plans. Residents said, they can choose when to get up and go to bed. One resident said, “Staff help me to get ready every morning; during the week I get up early for going to work but at week-ends I stay in bed later”. Staff said residents are supported with making decisions, such as: taking part in various activities and going on outings, shopping and anything the resident wishes to do. A resident, said, “Staff come to the shops with me and they help me when I want to go to different places”. An assistant unit manager said, “Residents are regularly asked if they would like to do different activities and staff give support and encouragement to help residents to enjoy different experiences”. An assistant unit manager said, “Residents are supported to be as independent as possible. Some residents choose to do their own washing and others like to help staff with the housework”. One resident said, “I like to keep my bedroom tidy”. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards: 12, 13, 15, 16 & 17 Residents are supported to have an independent lifestyle and they are provided with opportunities for personal development. Resident’s individual diets are catered for and the home has a planned menu but there is flexibility depending on resident’s taste and dietary needs. EVIDENCE: Staff said, residents are supported with taking part in appropriate activities and there are some residents who are assisted to attend day care placements. The home has a member of staff who organises various activities. The activities are planned around different times of the day so that residents who attend day care can also be involved with the activities. One resident said, of that member of staff, “She is great”. All residents said, they enjoyed the activities offered at the home and there are a good variety of things to do. Individual resident’s files included a record of all of the activities offered at the Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 12 home. Staff said, the home tries to make sure activities are suitable for each resident. Residents and staff said, many staff volunteer to support residents to go out of the home and to social events. The assistant unit manager said, “Staff also volunteer to go on holiday with residents”. One resident’s survey form informed that staff support residents with helping residents to build relationships and staff are very sensitive about this. One resident said, “My relative lives a long distance away. When they visit they are always made to feel welcome and the home organises accommodation for them”. The relationship between staff and residents was seen to be very comfortable and relaxed. Residents spoke freely to staff and staff spoke to residents in a respectful manner. Residents said they are able to spend time in their bedrooms or be with other people, as they wish. Residents are offered a key to their bedrooms so that residents can keep their bedrooms locked when the room is unoccupied. The home has a planned menu that has alternatives but residents are offered other food if they wish to have something different. A resident spoken with said, “The food is always very nice and well cooked”. The cook said, there are some residents who have special dietary requirements and the home makes sure they are appropriately catered for. The assistant unit manager informed, there are times when the home caters for residents who, because of cultural or religious beliefs, need to have specially prepared food. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 18, 19 & 20 Residents have satisfactory support and assistance with all social and healthcare matters. EVIDENCE: Residents said, the home makes sure resident’s preferences are considered when staff carry out personal care tasks. Staff said, they make sure personal care needs are carried out in a sensitive and correct manner. One resident said, “My personal care is done the way I want it” and another resident said, “I think I am looked after very well”. Equipment is provided to assist staff and residents with personal care tasks and staff records confirm staff having completed training for using the equipment. The home keeps records, all health care matters. The record does not allow the reader to easily determine the regularity and type of healthcare appointments that have taken place. The records include details of the outcomes of appointments. All residents are offered annual healthcare checks and community nurses give ongoing healthcare support when it is needed. The Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 14 assistant unit manager said, the home can arrange for specialist healthcare support, to individual residents, when it is needed. Staff said, they support residents with arranging and attending healthcare appointments. The Medication Administration Records were examined. Records had signatures of the staff who has administered the medicines to resident. Medication was kept in a lockable facility. Staff records confirmed appropriate staff had completed training for administering medicines but there was not a record to show staff had been trained to carry out a specialist medication administration procedure. The home has some residents who look after their own medicines. For those residents the home has completed Risk Assessments that are regularly reviewed. The assistant unit manager said, when the medicines are delivered to the home, all of the medicines are passed to the named residents but there is no record to confirm the resident has received the medicine. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards: 22 & 23 Residents are confident their views are listened to and they are protected from abuse, neglect and self-harm. EVIDENCE: The home has satisfactory policies and procedures for protecting residents from abuse and for taking action if a resident wishes to complain. The home has not received any complaints since the last inspection but there are two official letters, on file, that compliment the management and staff for the care they give to residents. The home has a satisfactory complaints recording procedure, should it be needed. Staff spoken with, said they were aware of the safeguarding procedures, the Whistle Blowing policy and of the actions to take if there was a need to report an allegation of abuse. Staff files confirmed that staff had completed training for the protection of vulnerable adults. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 24 & 30 Residents live in a homely, comfortable and safe environment that is kept clean and hygienic. EVIDENCE: Resident’s surveys informed, the home is always kept clean and tidy. One survey commented, “The domestic staff are exemplary” and “Angela (the manager) is very particular and thorough on this subject”. We looked around the home and confirmed there is a homely and comfortable environment. Residents have been involved with choosing the colour schemes, furniture and furnishings for their bedrooms. One resident said, “My key worker went shopping with me, to help me choose things for my bedroom”. The home was observed to be in good order and there is ongoing maintenance work that takes place to keep the building up to a good standard. However, one of the kitchen/dining rooms has chipped kitchen worktops and drawers and the fridge door was dented and scuffed. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 17 The home has plenty of room, for residents to move around, and the building is comfortable, airy, clean and free from offensive odours. The home is accessible to wheelchair users and other people who may be disabled and there are ‘touch pads’ for residents to open doors. Residents were seen to be freely moving around. Records confirmed there are systems to control the spread of infection. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards: 32, 34 & 35 Residents are protected and supported by the home’s recruitment procedures and staff are appropriately trained to care of the residents at the home. EVIDENCE: Staff files that were examined confirmed the home’s recruitment procedures are followed and all of the required details were kept in the files. Staff said, they thought the home’s recruitment procedure was very thorough and only appropriate staff are employed at the home. Staff said, they had completed the required basic training and there are many training courses regularly offered; to give staff the opportunity to further their knowledge and skills in caring for the residents at the home. In the last twelve months there has been training for: first aid, moving and handling, food hygiene and health and safety. The home’s diary has a record when and who has completed training but staff’s training profiles were not kept up to date therefore it was unclear when training updates are needed. It is commendable that 75 of staff had successfully completed the National Vocational Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 19 Qualification to at least Level 2. This exceeds the National Minimum Standards requirement of 50 of care staff attaining that qualification. Staff said, they work well as a team. From talking to staff and residents, it was obvious that staff enjoyed their work and there is a good rapport with all who live and work at Blenheim House. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standards: 37, 39 & 42 Residents benefit from a well run home. The home regularly reviews and develops the service so that the changing needs of residents are addressed. The health, safety and welfare of residents and staff are promoted and protected. EVIDENCE: The manager has had many years experience as manager of the home. Staff said they think the home is well run and one member of staff commented, “The manager is very compassionate and the residents come first with everything we do – that’s what we are here for”. The manager makes sure staff and residents have the opportunity to give their views about the running of the home. There are regular staff and resident meetings; where various Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 21 aspects of the home are discussed and all present can comment on how the home is run. The home also has a quality assurance system in place; so that extra information and views can be gained from interested parties. All of this information is used to formulate aims and objectives, in an annual business plan, to further develop and improve the service for the residents who live at the home. The organisation carry out monthly monitoring visits to the service and the managers also carry out checks on a regular basis. A number of health and safety records were examined and found to be satisfactory. Records examined were for: accidents, fire, gas, electrical, water and equipment all confirmed there are regular health and safety monitoring checks and maintenance work carried out. Blenheim House DS0000038025.V341407.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 2 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 2 2 X 4 X 4 X X 4 X Blenheim House DS0000038025.V341407.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 YA20 Regulation 13 Requirement The home must record all training for administration of medication that includes specialist administration procedures, so that is can be verified the training has taken place. Records of all medicines, held by the home, must be recorded and include when medicines are passed to residents, so there is an ongoing record of all medicines. The chipped kitchen worktops and drawers and the dented and scuffed fridge door, of Kitchen 2, must be repaired or replaced to keep the kitchen in good order. Timescale for action 31/07/07 2. YA24 16 31/08/07 Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 24 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. 2. Refer to Standard YA19 YA32 Good Practice Recommendations Resident’s files should clearly show the regularity of healthcare appointments. Staff’s individual training profiles should be kept up to date, to enable the reader to know what training has been completed. Blenheim House DS0000038025.V341407.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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