Inspection on 16/02/07 for Bliss Residential Care

This inspection was carried out on 16th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Bliss Residential Care 25/09/07

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 Bliss Residential Care 23 Cobham Road Westcliff On Sea Essex SS0 8EG Lead Inspector Sarah Hannington Unannounced Inspection 16th February 2007 08:30 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 Bliss Residential Care DS0000067960.V330044.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. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bliss Residential Care Address 23 Cobham Road Westcliff On Sea Essex SS0 8EG 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) 01702 351267 01702 333512 fatihtekin_vet@hotmail.com Mr Fatih Tekin Mr Erbil Gulhan Manager post vacant Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (14) of places Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Bliss Care home is situated in a residential area near to the seafront. The home provides care and accommodation for fourteen residents. Accommodation is over two floors with access provided by a shaft lift. The home has a communal lounge with a separate dining area. There is a small garden. Residents use their own bedrooms for privacy. There is limited parking to the front of the property, but there is parking close by in the roads. A mainline railway station, local shops and bus routes are close by. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the Inspection one of the proprietors Mr Fatih Tekin was present throughout the site visit. A tour of the home took place and Staff, relatives and residents were spoken with during this inspection. The Key inspection site visit took place over a period of 4.5 hours. The visit mainly focused on the all Key standards. Since taking over the home and being registered in 2006 the proprietors are in the process of developing the service as a whole. Mr Tekin and Mr Gulhan are in the process of developing the service, the staff team and implementing policy and procedures that ensure residents receive a good care and quality of life. The relatives and residents spoken with felt that the new owners had improved the quality of care in general and that the staff team are benefiting under their guidance. The home has already implemented a quality questionnaire and which has been sent out to residents, relatives and other professionals and this, together with any other added details affecting the service information, will be included in the next inspection report. What the service does well: What has improved since the last inspection? What they could do better: Assessments in general are being developed further, so that they include other professional’s agreements, recommendations on outcomes and action plans. Further development of staff’s general awareness around risk monitoring and preventative practice are being implemented, this is in relation to all health monitoring and accurately recording of charts consistently. Staff to develop a better understanding of the ‘Royal pharmaceutical guidelines’ and the homes policy and procedures around administration for resident’s medication. Consultation in general with residents or their representative over individualised activities, care plans, risk assessments is further developed by Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 6 including dates that consultation went ahead, residents or representative views, signatures and review dates. Staff ratios need to be monitored and an accurate record of the rota needs to reflect this. 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. Bliss Residential Care DS0000067960.V330044.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 Bliss Residential Care DS0000067960.V330044.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 area is adequate. This Judgement has been made using available evidence including a visit to this service. The home needs to change the statement of purpose and service user guide. Admissions to the home are planned and a full assessment is carried out. A system is in place that gives the family and new resident an opportunity to visit the home to see if the home meets the residents needs and wishes. EVIDENCE: The home has recently increased its bedroom facility from eleven to fourteen and changed its name to Bliss residential home. These changes need to be reflected in the statement of purpose and service user guide. All care plans included initial assessments carried out prior to admission. All care plans are in the process of being re-organised to give a comprehensive break down of each resident’s need including associated risks. However in some care plans risk assessments did not clearly evidence that all parties, such as a multidisciplinary team, had agreed the action that may restrict or infringe on an individuals rights. This type of risk assessments need to be developed further so that it clearly records, evidences and shows that consultation with all Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 9 parties involved had gone ahead and had all agreed to the final outcome of action to be taken. The home does not provide intermediate care. Bliss Residential Care DS0000067960.V330044.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 area is adequate. This Judgement has been made using available evidence including a visit to this service Residents health and personal care needs are partially met. Procedures are in place for the safe handling, recording and storage of medication. Health care professionals are involved in the healthcare of the residents at Bliss. EVIDENCE: The service has good links with various health professionals and many of the staff are highly trained in, Occupational Therapy, foot care and pressure sore assessors. Health charts and monitoring systems are in place for some individuals, however staff are not consistently recording on them and gaps were evidence on monitoring sheets. Other monitoring sheets need to be implemented to enable staff to track resident’s progress and be able to alert and contact professionals prior to a situation developing further. This will allow the team in general to practice in preventative manner and will utilise the staff that are trained in ‘specific’ monitoring and assessment skills to be used efficiently. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 11 In general further development of staff’s general awareness around risk monitoring and preventative practice need to be developed and addressed by the means of raising awareness and training. This is in relation to all health monitoring and accurately recording of charts consistently, such as prevention of pressure sores, monitoring of nutrition, fluids, prevention of falls, monitoring of weight gain or loss, turning charts and recommended assessed Physiotherapy exercises. The team need to develop better awareness or be refreshed of the ‘Royal pharmaceutical guidelines’ and the homes policy and procedures around administration for resident’s medication The proprietor is addressing these issues and on the day of inspection had some good strategies planned, including refresher courses, updating on training and had already addressed some of these issues with individual staff. The proprietor is currently in the process of changing medication as a whole to a ‘Boots’ MDS (Monitored dosage system). Medication is stored in a lockable cabinet and the administration records were being maintained in accordance with agreed procedures. Training records indicated that all staff that administers medication have had medication training. Consultation in general with residents or their representative over individualised activities, care plans, risk assessments, including dates that consultation went ahead, residents or representative views, signatures and review dates needs to be fully implemented for all residents. Bliss Residential Care DS0000067960.V330044.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 area is adequate. This Judgement has been made using available evidence including a visit to this service Daily routines in the home are flexible. Activities take place daily, residents take place in activities of their choice. EVIDENCE: Resident’s rooms were personalised and clean with free from odours. Residents and relatives spoken with spoke highly of the staff team and felt that the proprietors and staff in general were approachable friendly and caring. Relatives and residents also informed me that they could have visits at any time and were made to feel welcome. Bliss has recently employed a full time cook. Residents expressed that since the new owners have purchased Bliss the food provided, cooking and quality has improved. Menu’s or monitoring charts need to be developed further to evidence what foods are offered, to track individual nutrition and fluid intake clearer than it is presently. On the day of inspection relatives were asked about the food and were very complementary about the meals provided, the way it smelt good, looked appealing and was presented nicely. The home does not have activity co-ordinators. The residents recently had a singer come in and they informed me that they enjoyed this very much. Residents spoken with on the day of inspection had expressed they would like more activities to be put into place and one resident had stated to me that even though they may not join in, they would like to observe. Information Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 13 documented within individual care plans detailing activities undertaken by residents indicated infrequent activities/meaningful stimulation offered and/or provided. During the inspection time was spent touring the building and chatting to individual residents, it was clear that the staff on duty are making the use of the time they have to carry out the many practical duties they have to fulfil. Bliss Residential Care DS0000067960.V330044.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 area is good. This Judgement has been made using available evidence including a visit to this service the home has a detailed complaints procedure, which is accessible to the residents at the home. Systems are in place to protect residents from abuse. EVIDENCE: No (POVA) Protection of Vulnerable Adults issues have been highlighted since being registered. All complaints information is up to date. No complaints have been made to the CSCI. POVA training is in place for most staff and there are further plans for remaining staff to attend this course. The proprietors and acting manager need to evidence that consultation with residents or their representative and professional such as Occupational Therapist assessment for equipment such as bed rails are in place within residents files, including correspondence, meetings, professionals assessments, the homes risk assessments and care plans. Additionally if necessary an infringements of rights paperwork also needs to be included to evidence consultation has taken place with all interested parties. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 15 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 area is good. This Judgement has been made using available evidence including a visit to this service Bliss Care home was bright, clean and provides residents with a safe, comfortable and attractive environment. EVIDENCE: On the day of inspection the home was observed to be clean, tidy and odour free. Overall the home environment is in the middle of being refurbished and re-decorated since being purchased. Despite this and the on going work in the home it remains homely, comfortable and practical for the use of residents at Bliss. The proprietors have recently increased their number of beds from eleven to fourteen. The proprietors and acting manager need to either replace or make good the fridge in the kitchen, as the reading from the temperature evidenced it was running to high. In communal areas and some of the resident’s bedrooms, hot water is running above the requirement of 43 degrees, mixer valves need to be checked and adjusted. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this area is adequate. This Judgement has been made using available evidence including a visit to this service At present there are sufficient staff employed in the home to meet the personal care needs of the residents, however consideration to individual and group activities needs to be considered further. Arrangements are in place for staff supervision and training. Staff recruitment procedures and practices were not satisfactory. It was found that staff files were seen unclear, incomplete and inaccurate. EVIDENCE: The proprietor Mr Tekin is also the new acting manager. Mr Tekin has a number of years experience in the care sector and is presently studying the NVQ4 in care. The present acting manager has clearly made a positive impact on the running of the home. Staff and residents appear contented with the current situation of the home being under his leadership. The acting manager has made sure that continuity of service and quality of care has been maintained throughout this transitional period for the residents and staff of the home. Service users are benefiting from a strong management team and they have been successful in maintaining the level of service to a good standard. The proprietor and acting manager Mr Tekin is already in the process of addressing the need for a bigger staff team and has been successful in employing new staff. A full time cook has also been employed. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 17 It was reflected on the rota that there are three sometimes four members of staff in the morning shift. However on some afternoon shifts for a period of 4 hours during 5-9 pm only two staff are sometimes being provided. Staff ratios need to reflect client individual as well as the assessed group need, rather than how many residents are in placement at anyone time. The staff team have had a number of recent training packages planned for this year, which includes all mandatory and POVA training. Staff recruitment records evidenced that application forms were completed, interviews were held, two references obtained, criminal records bureau checks undertaken and proof of ID and photograph kept. Contracts of conditions of service and job descriptions were issued to new staff. Copies of training certificates were also kept on staff files. The home has just developed a quality assurance system and surveys have gone out to relatives and other professionals who use the service. The home has had one response back from a community liaison nurse that was very complementary about the service. Once all these surveys are back the manager will collate and make a plan of action according to the outcomes and will forward this to the CSCI. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service the home is well managed in a caring, friendly way and is run in the best interests of the residents. Supervision of staff needs takes place regularly and yearly appraisals carried out. EVIDENCE: Relatives support all residents regarding their personal financial management. The home only holds sums of monies for personal allowance expenditure. Relatives provide this. Records of payments and balances had been kept and random samples inspected were found to be appropriately maintained at the time of this inspection. Staff training records confirmed that training courses are being provided and organised in moving and handling, fire safety, food hygiene, first aid and infection control. Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 19 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 20 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 OP7 Regulation Reg 15 (1)(2)(a) (C)(d) Sch 3 (1)(b) 2 OP8 Reg 13 (1)(b) Reg 16 (1)(2) (c) Sch 3 (3)(p)(q) Requirement The registered providers must ensure that consultation with residents or their representative over care plans goes ahead and that this is evidenced. That date signatures and review dates to be included. Timescale for action 31/05/07 31/05/07 The registered providers must ensure that that consultation with residents or their representative and professional such as OT assessment for equipment such as bed rails are evidence within residents files, including correspondence, meetings, professionals assessments, the homes risk assessments and care plans. And an ‘infringements of rights’ form put into place. The registered providers must ensure that all health charts such as prevention of pressure sores, monitoring of nutrition, record and prevention of falls, monitoring of weight gain or loss, turning charts and recommended assessed DS0000067960.V330044.R01.S.doc 3 OP8 Reg 13 (1)(b) Reg 14 (1)(a)(2) Reg 16 (1)(2)(n) Reg 17 (1)(a) 31/05/07 Bliss Residential Care Version 5.2 Page 21 Sch 3 (3)(m)(n) (o) Sch 4 (13) 4 OP9 Reg 13 (2) Reg 17 (1) (a) Sch 3 (3)(i) Reg 12 (4)(b) Reg 14 (1)(a) Reg 15 (1) Reg 16 (2)(m)(n) Reg 23 (2) Reg 18 (1)(a) Reg 19 physiotherapy exercises are recorded accurately and consistently by staff. The registered providers must ensure that Staff follow the ‘Royal pharmaceutical guidelines’ and the homes policy and procedures around administration for residents medication. The registered providers must ensure that suitable arrangements are made for all residents to receive a varied programme of `in house` and community based activities. That consultation with residents or their representative over choice of activities is evidenced. That dates; signatures and review dates are included. The registered providers must ensure that there are suitable staff ratios for all residents to receive personal care and activities. The registered providers must ensure that the temperature of the fridge is remedied or if not, that the fridge is replaced. 30/04/07 5 OP12 31/05/07 6 OP27 30/04/07 7 OP38 Reg 23 (4)(5) Sch 4 (12)(d)(e) (14)(15) Reg 13 (3)(4)(5) Reg16 (2)(g)(j) Reg 16 (2)(g) 30/04/07 8 OP38 The registered providers must ensure that Hot water complies with the health and safety legislation and requirements regarding hot water being no more than 43 degrees. DS0000067960.V330044.R01.S.doc 30/04/07 Bliss Residential Care Version 5.2 Page 22 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 OP1 Good Practice Recommendations The registered providers must ensure that a new Statement of purpose and service user guide reflects the changes in accommodation, staff ratios and change of name of the premises. The registered providers must ensure that all mandatory and POVA training booked for this year goes ahead as planned. The registered providers must ensure that a registered manager is in place. The registered providers must ensure that the quality assurance system action plan is forwarded to the CSCI. 2 OP30 3 4 OP31 OP33 Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Bliss Residential Care DS0000067960.V330044.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!