Inspection on 28/06/07 for Bloomfield Care Home

This inspection was carried out on 28th June 2007.

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

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

Other inspections for this house

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Bloomfield Care Home Salisbury Road Paulton Bath Bath & N E Somerset BS39 7BD Lead Inspector Andrew Pollard Key Unannounced Inspection 10:00 28th June 2007 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 Bloomfield Care Home DS0000069236.V337900.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. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bloomfield Care Home Address Salisbury Road Paulton Bath Bath & N E Somerset BS39 7BD 01761 417748 01761 415814 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) Barchester Healthcare Homes Ltd Mrs Joyce Jones Care Home 102 Category(ies) of Dementia (40), Dementia - over 65 years of age registration, with number (40), Old age, not falling within any other of places category (102) Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. May accommodate up to 62 Persons over 50 years of age, requiring nursing care. May accommodate up to 62 persons aged 65 years and over requiring personal care Manager must be a RN on parts 1 or 12 of the NMC register Staffing notice dated 26/09/01 and NCSC letter re: revised staffing levels dated 7th January 2004 apply. May accommodate up to 40 persons with dementia requiring nursing and/or personal care aged 50 years and over. A named person is a RN on parts 3 or 13 of the NMC register must be responsible for the running of the Beech Walk and Downside Units. Date of last inspection Brief Description of the Service: Bloomfield Care Centre is registered for 102 residents requiring nursing or personal care; included within this is a dementia unit for up to 40 residents. The centre was purpose built in this rural location, which can be accessed by car or bus. Accommodation is provided in single rooms; some have en-suite facilities. Recreational space is provided in nine lounge areas and five dining rooms; there is also a hair salon and therapy room. There is a lift to all areas and a meeting/ conference room is also available. There are two gardens, one with an enclosed area with patio and grass for the safe use adjoining the Dementia Care unit. The other adjoins fields with a patio area and a productive greenhouse, which is enjoyed by all residents. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was conducted unannounced over 2 days and focused on the assessment of key standards. The main purpose of the visit was to check on the welfare of the residents, ensure the premises are well maintained and to examine health and safety procedures. The Commission for Social Care Inspection’s Pharmacist Inspector examined the arrangements for administering and managing of medication in October last. Prior to the visit the inspector spent some time examining documentation accumulated since the previous inspection, including the Annual Quality Assurance Assessment (AQAA), notified incidences in the home, (Regulation 37 notices) and the unannounced reports conducted by the Registered Providers (Regulation 26 notices). The inspector sent questionnaires “Have your say” to residents in the home prior to the inspection and five were completed and returned. Surveys were also given to relatives, visitors and visiting health and social care professionals, six of these were also completed and returned. Information from these has been collated and is detailed throughout the report. The inspector spent time throughout the visit in discussions with the registered manager and deputy, the administrator staff members and a number of residents and visitors. Staff were observed indirectly going about their daily routines. Records and files relating to the day-to-day running and management of the home were examined. Residents care plans and care files were examined. The inspector toured the premises. There was a high degree of satisfaction expressed by all of the residents spoken with. Based on the comments made and through the inspectors observation it is evident that the home is run in their best interests and to ensure their needs are being met. Overall the results of consultations were positive and the standard of record keeping and management was high. Feedback was given as the visit progressed on the outcome of the inspection. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Further development of the care planning documentation and moving forward in a person centred way. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 7 The previous high standards in other aspect of the homes operation have been maintained. 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. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 8 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 Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 9 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): 1,2,3,5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective clients and their families are given relevant information in written or verbal form about the home. Contracts and terms and conditions of services are provided to all clients. The assessment procedure is clearly written and a thorough assessment of prospective residents needs is carried out. EVIDENCE: A brochure containing a service user guide and statement of purpose is made available to prospective residents and their families. All residents and relatives stated in their surveys that they and their families had received information about the home prior to admission. People spoken to felt their admission was well managed. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 10 There is no change in pre-admission assessment practice. The manager or senior nurse visits all prospective residents prior to admission to access their care needs. A pre-admission form is completed, which forms the basis of the subsequent care plan. In addition all social service placed residents have a completed CM4 and CM7 assessments from the community services. The pre-admission assessments were fully completed and informative. The manager or a senior nurse meets with prospective residents prior to admission. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. People spoken with felt the home had a good reputation and there is a waiting list for admission. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. People spoken with felt the home had a good reputation and there is a waiting list for admission. A month’s trial period on both sides is usually undertaken to ensure that everyone is happy with the arrangements and to ensure that the placement is suitable. The care documentation of several residents was reviewed. The documents were well presented and provided detail of the pre-admission assessment of care needs including the liaison with relevant health professionals, these records had been signed by the assessing Registered Nurse (RN). Areas such as hygiene, mobility, nutrition, pain, sleeping and social interests are included. Soon after admission the resident meets with the cook and activity organiser to identify their particular wishes for diet and activities. The administrator meets with residents and families to discuss financial arrangements and invoicing details. Residents’ files contained contracts and terms and conditions, which are signed on admission. All residents confirmed in their surveys that they had received a written contract. Residents are referred to the Primary Care Trust for assessment of funding under the Registered Nurse Contribution (RNC) or Continuing Health Care (CHC) funding. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 11 Assessment is an ongoing process and following admission to the home a full detailed assessment of the residents care needs has to be established over the initial few days. Care assessments had been regularly reviewed and updated, this included detail of the Risk Assessments and evaluation. The RN’s conduct a supplementary system of handover at each shift. This includes a written synopsis of all the residents immediate care needs and any urgent actions required in the environment. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 12 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): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans provide a holistic approach to the care needs of its residents and are supported by evidence of regular review and evaluation of care outcomes. Good arrangements are in place for residents to access primary healthcare services. The staff provide appropriate personal and nursing care to maintains residents’ health, well being and dignity. The staff properly store, administer and record medication on behalf of residents. Staff have a good awareness of individuals’ needs and treat the residents in a warm and respectful manner. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 13 EVIDENCE: A named Registered Nurse (RN) and key-worker work with individual residents and or their family to develop and maintain the care plan. The home is working toward a fully person centred and feelings based approach to care to reflect peoples wishes and desires and improve their quality of life. It is intended to have a more narrative approach in the first person where relevant. Each resident has a brief biography written and a person centred assessments where their wishes, likes and dislikes are put at the centre of the care provision. There were clear directions in relation to each resident’s personal and social needs, such as communication, mobility, cognition, interests/hobbies and family and friends. Health care plans included pressure area risk assessments, moving and handling guidelines, wound care, nutritional profiles and risk assessments for falling risk. A care review meeting takes place regularly for each resident, with their involvement and where relevant family members and key worker wherever possible. The reviews allow opportunity to discuss and evaluate residents’ care plans and any issues or concerns they may have. End of life Care Plans have not formally been established in the home whereby residents will be encouraged to think ahead about the care they would like to receive if their health deteriorates. However two RN’s are linked with the local hospice and will be tasked with introducing the system in the near future. Administration of medication was discussed with on of the unit RN’s and is considered to be safe. A full pharmacist inspection was conducted in October 06 and all was generally good order. Policies and procedures for receiving, storing, administering and disposing of medications are in place and meet with current legislation. A procedure for self- administration and storage of medication is in place and residents are well supported to undertake this if able. Records of the General Practitioner visits/contacts with resident’s and outcomes were noted together with specialist referrals and visits from other healthcare professionals including Audiologists, Chiropodists, Opticians and Dentists. The home accesses local GP surgeries, and it was reported that the GPs are supportive to the home. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 14 The majority of residents and relatives surveyed said they felt their care needs were usually well met and two saying they always were. All the residents spoken with said, “They were satisfied with the overall level of care being provided”. They spoke highly of the staff saying they were, “Friendly and caring”. A relative said,” My mother is very contented with the service she receives and we also like it”. Staff were seen to respect the residents’ privacy and dignity. They were seen to knock on doors and wait for a response before entering. Residents and spoken with said this was usual practice. Residents and visitors spoken with confirmed that residents were treated with respect. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 15 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): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A range of social and recreational activities is arranged that seek to enhance the quality of life for the residents, which is both enjoyable, stimulating and meets individual preferences and expectations. Residents are able to maintain close contact with families and friends. Resident’s families are informed of issues related to their relatives and to take part in activities running in the home. The food is of a high standard and provides choice and a balanced diet for residents. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 16 EVIDENCE: Bloomfield has a full time and two part time co-ordinators that organises the varied activity schedule. Time is spent with the residents gathering information on their ideas and suggestions for activities or events. Posters are displayed advertising monthly programmes. The staff also promotes awareness of what is available verbally. There is a wide range of activities both for individuals and groups around the care home. There is a planned event most days, which includes entertainers as well as organised trips from the home using the new min-bus. Trips have taken place to Glastonbury, Radstock and Chew valley amongst others. Residents spoken with were complimentary about the activities and said they participated in and enjoyed most events. A recent Burns night was a big success and a summer garden party is planned for mid July. Feed back from surveys was positive about the daily opportunities to have meaningful activities. The home holds a number of annual fetes; coffee mornings; and members of the local community are invited. All relatives are invited to the organised functions where food, drink and entertainment are provided. One person said, “I like the way we are involved and invited to events in the home”. Other comments were, “I am always made to feel welcome” and “Good events, helpful and friendly staff”. Activities and food are regular agenda items for residents/relative forums so that people can influence the style and nature of these services. The home aims to operate a relaxed and open visiting policy. There were a number of visitors spoken with who were impressed with the services on offer in the home. A Christian church service takes place on a monthly basis and communion and songs of praise take place. At present there are no people of other faith or ethnic background in the home. The organisation has policies and a commitment toward valuing and understanding diversity and challenging any form of discrimination. Hair Salon is open from Monday to Friday and is welcomed by residents at Bloomfield. Coffee and tea is available and residents spend time chatting or reading magazines. There is a Reflexology and Aromatherapy suite available; treatments are bookable at an additional cost. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 17 Each care plan contained details of residents’ family and friends. Some of the ‘Life Story’ section of care plans, which had been completed, described family/friend relationships in more detail. Two relatives spoken with said they were made welcome and felt they were kept in touch with what was going on. The inspector joined some residents for lunch; the meal was well presented and well cooked. The residents all felt the standard of food was very good with choice and ample portions. Staff were seen to treat people with sensitivity and respect offering appropriate support so to enjoy their meals. Residents can chose to eat meals in their rooms, lounge or the dining area. The atmosphere was relaxed and unhurried. Surveys indicated that three people said they usually enjoyed their food and two people said sometimes. In contrast people spoken with were full of praise for the quality of the meals. People with advanced dementia who often wander have their meals supplemented with a selection of finger foods that they can eat even if not sat at table. Some residents also make use of a kitchen facility to be involved with cooking and baking. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 18 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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements in place for staff training and awareness related to safeguarding of adults. There are robust and comprehensive policies in place to protect residents investigate complaints or manage any allegations of abuse. EVIDENCE: A copy of the complaints procedure is on display in a well-frequented part of the home. There have been no complaints received by the home or the Commission since the last inspection. Visitors and staff comments showed that people feel comfortable discussing any concerns with senior staff or management. One relative survey was submitted to The Commission that indicated dissatisfaction with the care being provided to a resident. The person did not want this recorded as a formal complaint and a meeting with the family and senior staff has been arranged to resolve the issues and agree a positive way forward. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 19 All residents who completed a survey indicated that they knew who to talk if they were not happy and how to make a complaint. Comments included, “I’ve never had cause to complain but if I did I would speak to Joyce”. The home promotes staff training and education in the protection of vulnerable adults (POVA) on induction and by annual updates. A number of staff are undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of safeguarding adults from abuse. Making sure as far as possible that residents live in a safe environment. The policy of the home is not to hold or manage resident’s personal money. The Home follows the Bath and North East Somerset Council guidance addressing the safeguarding of adult. The appropriate Policy and Procedures are in place and guidance is available to staff. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 20 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): 19,20,21,24,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Bloomfield is a clean, well-equipped home with a good standard of accommodation suitable for older residents. The communal areas are homely and residents are encouraged to personalise their rooms. The standard of cleanliness is high. The grounds are attractive and used to benefit of residents with dementia and those without. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home is set out as five units over two floors, with a range of suitable adaptations in place throughout the home to assist people who may have limited mobility. The home provides specialist equipment when necessary including pressure relieving equipment, profiling beds. Individual assessment and provision of mobility and other aids are carried out and qualified therapists are consulted for any specialist needs. There are handrails in communal corridors, which assist residents to move around the home independently. There is lift access to each floor. A Loop system has been installed to assist residents with a hearing problem in the communal areas. Accommodation is provided in single rooms; some have en-suite facilities. Recreational space is provided in nine lounge areas and five dining rooms; there is also a hair salon and therapy room. There are two gardens, one with an enclosed area with patio and grass for the safe use adjoining the Dementia Care unit. The other adjoins fields with a patio area and a productive greenhouse, which is enjoyed by all residents. Bloomfield has a friendly with a pleasant relaxed atmosphere. It is decorated and furnished to a high standard that creates a comfortable and homely ambience. All the rooms visited during the inspection were appropriately equipped to meet the needs of the residents. Some had brought in small items of furniture. Each resident had many pictures and personal possessions in their rooms. One resident said, ”I like my room and have a lovely view”. Others spoken with said that if any maintenance issues occur these are dealt with promptly. The environment for the dementia unit has been developed in accordance with good practice for services for people with dementia. There is good use of plain colours on the walls, which contrast well with the flooring. Consistent colours are used on doors to identify certain rooms, such as toilets and bathrooms. Plain fabrics are used in curtaining and each room is well lit. The house was clean and free from unpleasant odours. Residents’ surveys confirmed that the home is always fresh and clean and one resident stated, “There are very high standards of cleaning in all rooms and the laundry provides an excellent service”. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 22 The kitchen was well equipped, clean and spacious. Documentation was provided to show that required temperature checks were being carried out on fridges and freezers and for cooked meals. A recent Environmental Health check found everything to be in order. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 23 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment procedures and records are well managed and in good order to protect residents. The home is well staffed with appropriately trained and experienced staff. Staffing Levels are in accord with or exceed the Staffing Notice requirements. A positive approach to staff training and development is evident. The training programme incorporates national training targets. There is a high percentage of staff with an NVQ 2 level qualification or on training programmes. EVIDENCE: The staffing levels are in accord with or exceed the staffing notice. The manager ensures that staffing levels are related to the level of care required by the residents. The domestic, catering, admin and laundry staffing levels are satisfactory. Full time maintenance and activities staff are also employed. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 24 The employment policies include and equal opportunities policy and monitoring system. The inspector viewed the personnel records for several staff members including new recruits. Staff files seen showed that employment practice and records were in good order. The manager is introducing an initiative to bring residents into the interview and induction process for new staff. Criminal Records Bureau (CRB) disclosures are carried out prior to recruitment and repeated tri-annually. Registered Nurse (RN) PIN’s are validated annually. RN turnover rates are very low. The home has a small bank of staff and agency use is minimal. There is an induction programme, which covers all mandatory training, including Fire, Manual Handling, Health and Safety, understanding diversity and rights and the Protection of Vulnerable Adults. All new staff are linked with and shadow a senior staff member during their first shifts to enable continuity and continued training throughout the induction process. A company training officer works at the home 25hrs a week. There are four National Vocational Qualification (NVQ) assessors at the home. In-house training uses a selection of learning aids such as using videos with associated questionnaires in relevant topics. Staff are introduced to a feelings based approach to dementia care which the manager considers has shown a notable improvement in quality of life for people on the dementia units and created a calmer and more relaxed atmosphere. Staff informed the inspector that they found this style of training of benefit and gave examples of previous training sessions and how these had helped to bring such topics into their working day. The NVQ programme is well organised, sixteen staff have level 2 qualification and five are currently on programmes. However this level of attainment is below the target of 50 of care staff achieving NVQ level 2. Staff demonstrated a caring, committed attitude to their roles and responsibilities in ensuring they provide quality of care to the residents. It was evident from interactions witnessed between staff and residents’ during this inspection that staff worked hard to develop positive relationships with people living at Bloomfield. All residents’ surveys agreed that staff were available when they needed them and listened and acted upon what the residents had to say. However, one person felt staff response to bells at night was slow and two people commented that there was not enough staff some days. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 25 Several residents’ expressed very positive views about staff and the care they receive comments included, “They are caring and helpful and supportive” and “The home is very well run, the staff look after the residents and families very well”. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 26 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): 31,33,35,36,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager is supported well by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The home is well managed and run taking into account the views and wishes of the residents and relatives, as they are able. There are good arrangements in place to maintain and service the equipment and facilities in the home. The Home protects the health and safety of residents and staff. The staff supervision and appraisal arrangements are good. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 27 EVIDENCE: During the inspection the manager Mrs. Jones was able to demonstrate good, effective leadership and management skills that relate to the aims and purposes of the home and feels fully supported and encouraged by managers within the company. Detailed Regulation 26 reports are completed and submitted to the Commission monthly. Residents have regular contact with the manager. A resident stated, “She was very caring”. Another resident said, “How they found her to be approachable”. Head of units meet at 10 a.m. for a daily update “what’s happening at Bloomfield today” meeting so staff throughout the departments are aware of important news or information. Also monthly staff meetings are held, enabling staff to have input and receive feedback concerning the running of the home. Staff spoken with agreed that the manager encourages an open and positive atmosphere and feel confident to approach the manager with concerns. Regular resident/relative forums are held and play an active role in shaping the provision of care and services in the home. Residents are encouraged to manage their own money however a number of relatives have taken Power of Attorney arrangements and manage day-to-day expenditure. Most matters are dealt with through the monthly invoicing system. The supervision of staff has been established and is at present 2 monthly, records are kept and contain details of training requests and requirements. Appraisals are also undertaken. Health and safety records showed that relevant inspections and maintenance has been carried out at the required intervals for the fire alarm, fire fighting equipment, gas and electrical services, hoists, lift and all other relevant services and equipment. Detailed audits of plant and equipment are carried out regularly. Generic risk assessments have been reviewed for the resident and staff areas. These have been updated with records accordingly. Members of staff have been delegated responsibilities for aspects of Health and safety in the home and receive relevant training. The home has a system of training staff in Moving and Handling. Accident records were viewed and mostly evidenced minor falls, follow up comments were recorded until the accident had been concluded. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 28 The fire log was viewed and satisfactorily completed. Fire drills and training records evidenced compliance to the requirements. The home carries out quality assurance surveys of residents and relatives to assess the satisfaction with regards to the service that the home provides. The results from the last surveys were very positive. The results have enabled the home to identify strengths and weaknesses within the service and provide information to create a development plan for the following year. The results of the commissions surveying and discussions with residents and relatives during the visit were overwhelmingly positive with all aspects of care, food, activities and the quality of staff being praised. There was one exception that is being dealt with under the complaints procedures. Comments included, ”The home provides a safe caring and happy environment” and “They help people maintain a well rounded life with excellent food, good entertainment and lovely surroundings”. All nine residents who responded to the survey indicated that the home always met their needs. The relevant insurance policy is in place and on display in the entrance hall. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 29 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 3 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 4 X 3 X 4 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 3 X 4 Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 30 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 2 Refer to Standard OP11 OP35 Good Practice Recommendations Formalise end of life care planning. Increase the level of training for care staff toward NVQ level 2 to attain at least 50 of staff holding that qualification. Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection South West Regional Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AP 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 Bloomfield Care Home DS0000069236.V337900.R01.S.doc Version 5.2 Page 32 - 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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