Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 23/01/07 for Blyford Residential Home

Also see our care home review for Blyford Residential Home for more information

This inspection was carried out on 23rd January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is clean, well maintained and homely. The day of the inspection was cold and it was noted that the home was well heated. Interaction between staff and residents was observed to be positive and respectful. Residents were observed to look well cared for, comfortable and happy. There were positive interactions observed between residents living at the home. Health and safety checks at the home were regularly undertaken, such as fire, water and electrical and actions to resolve issues were undertaken promptly.

What has improved since the last inspection?

The service users guide included CSCI (Commission for Social Care Inspection) contact details. The staff team had received updated POVA (protection of vulnerable adults) training, which included a video of abuse in the care home and the staff team completed work sheets, which related to the video. During the last inspection it was noted that there were insufficient records available regarding the falls of one resident. These were provided to the inspector following the inspection and the records clearly identified the resident`s falls and actions they were taking to provide their safety.

What the care home could do better:

Four residents records were viewed, two did not include the required documentation such as care plans and health care information. One of the residents was accommodated in the month of the inspection and the second was accommodated five months prior to the inspection. All required documentation was included in two long-standing residents records. Two staff recruitment records were viewed, one held all the required documentation and one did not contain any written references. The staff member had been recruited in 2003, there was a memorandum in the records from the services human resource department stating that references had been requested and that they would be forwarded to the home when they were received. There was a smell of urine in the corridor at Woodleigh, and a staff member was observed removing the soiled sheets from one bedroom. The manager confirmed that they were aware of the problem and that a new carpet and bed was to be delivered at the home 8th February 2007. The home keeps records of formal complaints received, it is recommended that they maintain a record of verbal concerns raised and actions taken to the individuals raising the concern satisfaction. The medication administration is poor. CSCI have issued an enforcement notice, however the service has failed to fully comply with the notice and further action may be taken. This matter must have a high priority otherwise CSCI will consider further enforcement action for non-compliance.

CARE HOMES FOR OLDER PEOPLE Blyford Residential Home 61 Blyford Road Lowestoft Suffolk NR32 4PZ Lead Inspector Julie Small Unannounced Inspection 23rd January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Blyford Residential Home DS0000037146.V325656.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. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blyford Residential Home Address 61 Blyford Road Lowestoft Suffolk NR32 4PZ 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) 01502 405420 01502 405429 sharon.hurren@socserv.suffolkcc.gov.uk Suffolk County Council Mrs Sharon Jane Hurren Care Home 36 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (1), Old age, not falling within any other category (12) Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 1. Rosedene House may accommodate persons of either sex, over 65 years who require care by reasons of old age (not to exceed 12 persons) 2 Foxfields House may accommodate persons of either sex, over 65 years who require care by reason of a diagnosis of dementia (not to exceed 12 persons). 3 Woodleigh House may accommodate persons of either sex, over 65 years who require care by reason of a diagnosis of dementia (not to exceed 11 persons). 4 1 named person, over 65 years of age, and with a mental disorder, as detailed in the variation application accepted by CSCI on 8th July 2005 may be accommodated on Woodleigh House. 5 The total number of service users accommodated in the home must not exceed 36 persons. 3rd April 2006 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Blyford is a residential home, which was purpose built and is owned by Suffolk County Council. It is situated in a quiet area of Lowestoft, to the north of the town. Although it is some distance from the town centre there are some shops and facilities nearby. The building is single storey and divided into three houses, Rosedene, Woodleigh and Foxfields. Each house offers accommodation for twelve residents in single rooms with en suite facilities. Rosedene is registered to provide for twelve older people who need care, not nursing care, and Woodleigh and Foxfields each offer care to twelve older people with dementia. The houses all have their own front doors, lounges, dining areas and indoor conservatory space. The gardens are attractive, secure and accessible to the residents. There is a day care service within the same building, which the residents can attend if they choose. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Tuesday 23rd January 2007 over a period of six and half hours. The inspection was a key inspection which focused on the core standards relating to older people and was undertaken by regulatory inspector Julie Small and pharmacy inspector Mark Andrews. The pharmacy inspector completed a detailed inspection of the homes medications procedures and records, for which there is ongoing enforcement action. Since the last key inspection in April 2006 the Pharmacy Inspector has visited the home on several occasions. This report has been written using accumulated evidence gained prior to and during the inspection. The homes manager, Mrs Sharon Hurren facilitated the inspection. Seven staff members were met and spoken with and six residents were spoken with during the inspection. Further methodology used included the observation of work practice, a tour of the building and records were viewed. The records viewed included complaints records, resident’s records, health and safety checks, menu’s and staff recruitment records. Details of further records viewed are included in the main body of the report. The inspector was welcomed into the home by both staff and residents and information requested was provided promptly and in an open manner. What the service does well: What has improved since the last inspection? The service users guide included CSCI (Commission for Social Care Inspection) contact details. The staff team had received updated POVA (protection of vulnerable adults) training, which included a video of abuse in the care home and the staff team completed work sheets, which related to the video. During the last inspection it was noted that there were insufficient records available regarding the falls of one resident. These were provided to the Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 6 inspector following the inspection and the records clearly identified the resident’s falls and actions they were taking to provide their safety. 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. Blyford Residential Home DS0000037146.V325656.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 Blyford Residential Home DS0000037146.V325656.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, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can expect that they are provided with the information they need to make a choice about where to live and that they have their needs assessed before they move into the home. The home does not provide intermediate care. EVIDENCE: The home has a comprehensive Statement of purpose and Service Users Guide. The previous inspection identified that the CSCI contact details were not included in the service users guide, this was now in place. One service users spoken with who had been admitted to the home since the last inspection said that they and their family had looked at the home and visited several times before they made the decision to move into the home. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 9 They said that they could not recall if they had been provided with a Statement of Purpose and Service Users Guide, but they said that their family member had some documents. Four residents records were viewed and included detailed needs assessment completed by the placing authority. There were assessments in place completed by the homes manager, which identified that the home could meet their needs. The manager was spoken with and said that they undertook all assessments of prospective service users before they moved into the home and identified if the home was appropriate to meet their needs. The home does not provide intermediate care. There were two beds available for respite care, the manager reported that they would no longer be providing this service and that all residents would be accommodated on a permanent basis. Blyford Residential Home DS0000037146.V325656.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, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents cannot be assured that their health, personal and social needs are set out in an individual plan of care and that their health care needs are met. Residents can expect that they are treated with respect and their privacy is upheld. Residents cannot be assured that they are protected by the homes medication procedures. EVIDENCE: Four residents records were viewed and contained a life story, which had been completed by the resident or their family members, daily records and a spider chart of their needs and preferences with regards to issues such as what they liked to eat and methods of supporting them in their personal care. Two records included care plans and night care plans which identified their care requirements to meet their needs. There was evidence that they were regularly updated with the residents changing needs and progress. Two Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 11 residents records did not contain care plans, one resident had been accommodated at the home January 2007 and one August 2006. A staff member spoken with explained that it was the responsibility of the resident’s key worker to complete the care plans. The manager confirmed this and agreed that they would provide a time scale for the care plans to be completed after the residents moved into the home. There was evidence in all records of health care appointments and treatment they received such as optical, dental and medical. Three records included the GP names and contact details and one did not. Two residents records included nutritional assessments and tissue viability assessments and two did not, although the blank documents were contained in their records. One residents records included evidence of psychological support and support from a district nurse which they had received. Two residents records included continence assessments and two did not. All records had regular weight checks. One resident’s records included details of their wishes at the time of death and one noted that the resident had reported that they did not wish to discuss this issue. Staff spoken with explained the needs that service users had and confirmed that they read the care plans on a regular basis to inform the support they provided. A resident spoken with said that they and their family had been consulted with regarding the care they received at the home. They said that there was a telephone, which they could use to speak to their family, and that their letters were delivered unopened. During a tour of the building it was noted that there was a telephone which residents could use in private in each of the homes units. Residents spoken with confirmed that their privacy was maintained and that staff always knocked their bedroom door before entering, this was observed during the inspection. One resident said that their visitors could visit them in their bedroom or in any of the communal areas in the home. Residents reported that staff were respectful and caring. A residents care plan viewed explained that they required support in ensuring that they did not remove their clothing in communal areas. A staff member was observed supporting a resident when they had began using the toilet and left the door open. The staff member ensured the door was closed and explained to the resident why they were closing the door. The Commission issued a legal statutory enforcement notice on the 24th October 2006 in relation to the home’s medicine management practices. During this inspection the Commission’s Pharmacist Inspector Mr M Andrews Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 12 carried out an inspection to monitor the homes progress in complying with the enforcement action. On observing part of the morning medicine round, Mr Andrews found medicine administration practice satisfactory. Some medicines for residents who got up late were administered later in the morning. This is indicated on the MAR (medication administration record) charts. The inspection included an audit of current medication records (period 01/01/07 to 28/01/07) against medicine stocks available for administration. Sample audits were taken on medicines and record-keeping practice in all units. The aim of the audit was to determine if the home could demonstrate by its record-keeping practice that medicines have been safely administered to residents in line with prescribed instructions. The findings of the home’s own internal audit of the previous 28-day MAR chart cycle undertaken on 31/12/06 was also considered. Whilst some medicines could be fully accounted for and records demonstrated their safe medicine administration, for others there were discrepancies indicating continued concerns that these medicines may not have been properly administered. Where there are deficits of medicines it is possible that excessive doses have been administered to residents. Where there are surpluses, medicines may not have been given when records of their administration have been completed. The home’s internal audit of the most recent 28-day period undertaken on 31/12/06 also showed some discrepancies. Resident-specific information in relation to the findings of the inspection has been forwarded to the home in separate correspondence. In conclusion, the above findings indicate that whilst there has been some improvement and the home is currently complying in part with the statutory requirement notice there continues to be some non-compliance where the health and welfare of residents is at continued risk. The Commission remains concerned that the home still cannot demonstrate that all medicines are being given to residents in line with prescribed instructions and is considering taking further legal action. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. Residents can expect that they are provided with a programme of activities which satisfies their interests and needs, that they maintain contact with their family, friends and representatives, that they are helped to exercise choice and control over their lives and that they receive a wholesome balanced diet. EVIDENCE: Residents spoken with said that there were activities in the home which they could participate in if they wished. They reported that they particularly enjoyed bingo with prizes and Sunday worship. Resident’s records viewed evidenced when they had participated in activities which included manicure and hand massage, quiz and sing song with an entertainer. There was notices of daily activities displayed in each unit and included the above activities, as well as reminiscence, art and crafts, memory games, Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 14 baking and painting. There were television sets, videos and music centres in each unit with a range of music and films, which they could use. There was a range of board games and books also available. A notice of Sunday worship was displayed in each unit and included visits from several places of worship in the local area such as Salvation Army, Holy Communion, Presbyterian, Community and Evangelical churches. Residents spoken with said that they had regular visits from their family and friends and that they could visit in their bedroom, in the communal areas or go out for the day. They said that the staff always welcomed them into the home. During the inspection one resident was waiting for a telephone call from a family member. Residents said that they were consulted with regarding the care that they received and felt that they had a say in their lives. A resident said that they had bought some items of furniture to use in their bedroom. The homes menu’s were viewed and evidenced that a balanced and varied diet was provided. There was a choice of three main meals for lunch and lighter meals in the evening. There were vegetarian options available. Residents said that they could request something else if they did not like what was on the menu. Residents were observed enjoying their lunch during the inspection, which they enjoyed in the dining area in the unit where they lived. One resident had chosen to have their meal in their bedroom and staff supported this. Staff were observed regularly offering drinks to residents throughout the day, and were supported in having their breakfast as they chose. Some residents were observed preparing their own cereal, toast and hot drink. A resident was observed watching television in their room, and they had a table with a jug of cold drink within their reach. One resident’s records viewed identified that the resident wished to have a cold drink on their bedside table during the night. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 15 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. Residents can expect that their complaints will be listened to and acted upon and that they are protected from abuse. EVIDENCE: There was a comprehensive complaints procedure. The complaints records were viewed and there had been no complaints received since the last inspection. The manager was spoken with and said that residents sometimes ask for a concern to be looked into, for example wanting something specific on the menu or reporting an environmental repair. It was reported that these were actioned straight away. The manager agreed to report concerns and actions taken, which would identify how they had acted upon any informal concerns that residents had raised. Training records viewed identified that the staff team had received updated POVA training since the last inspection, which included watching a video, ‘abuse in the care home’ and completing work sheets. Questions on work sheets included naming types of abuse, how residents were vulnerable to abuse and what documents were in the care home which related to the protection of residents and where they were kept. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 16 Staff spoken with explained and understood their roles in reporting concerns of abuse. There was ‘no secrets’ information displayed on a notice board in the home and there were leaflets which residents and visitors could help themselves to. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 17 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, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can expect to live in a clean, hygienic, safe, comfortable and well maintained environment and that they have comfortable bedrooms with their own possessions around them. They cannot be assured that there will be no offensive odours in the home. EVIDENCE: A tour of the building was undertaken and it was noted that the home was warm, adequately lit, clean, tidy and well maintained. Resident’s bedrooms had the recommended furnishings and were personalised with resident’s personal belongings such as photographs, flowers and memorabilia. One resident said that they had bought some of the items of furniture to their bedroom from their home. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 18 Residents records viewed contained risk assessments for holding their own keys, however, not all were completed. Residents confirmed that they had their own keys for their bedrooms and that there was a lockable space where they could keep their belongings in if they wished. All bedrooms were single occupancy. The maintenance staff member was spoken with and explained their responsibilities with regards to the health, safety and maintenance of the home. Records were viewed which evidenced that they regularly undertook water temperature readings at storage and outlet areas, which met the recommended temperatures. The staff member said that the water outlets were fitted with safety valves, which maintained the temperature at around 43oC. Emergency lighting was regularly checked. There was a smell of urine in the corridor of Woodleigh. A staff member was observed removing soiled linen from the room during the morning of the inspection. The manager reported that they were aware of the smell and had ordered a new carpet and bed, which were to be delivered 8th February 2007 for the resident’s bedroom. The laundry was viewed and had suitable washing machines and hand wash facilities. There was a sluice in each of the homes units. There was hand washing facilities throughout the home and provided hand wash gel and disposable paper towels. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 19 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. Residents can expect that there is sufficient staff who are trained and competent. They cannot be assured that all required recruitment records are kept in the home. EVIDENCE: Staff and residents spoken with said that there was sufficient staff on duty to support the residents needs. Staff said that there was ‘float staff’ who supported each unit throughout busy periods. The manager reported that one staff member had left and that there was two staff who were due to retire. Interviews had taken place to fill the posts and during the inspection three permanent staff and two relief staff who were recruited arrived at the home to complete their CRB (criminal records bureau) checks before they started work at the home. There had been some sickness of staff, which had been covered by relief and permanent staff. At the last inspection it was noted evidenced that the home had met the 50 target of staff to have achieved a minimum of NVQ (National Vocational Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 20 Qualification) level 2. The manager said that there were more staff who had begun working on their award since the last inspection, training records, which were viewed, confirmed this. Two staff members spoken with confirmed that they had recently begun working on their award. Staff training records viewed evidenced that staff received regular training which supports them in their work role. Training provided included TOPSS (now Skills for Care) induction, manual handling and refresher training, first aid, food hygiene, COSHH (control of substances hazardous to health), POVA and dementia awareness. The staff team had recently viewed an ‘abuse in the care home’ video and worked on work sheets which tested their learning. Staff spoken with said that they had received the above training while working at the home and that they felt that the training provision was sufficient to meet their needs to provide a service to the residents living at the home. They confirmed that if they identified a particular training course they wished to complete that they would be supported to attend. Each staff member had a personal development plan, where their training needs were identified and discussed. Two staff records were viewed and one held the required information such as identification, two written references, CRB check, application form and interview notes. One staff record did not include two written references, there was a memorandum present from the human resources department stating that the two references had been requested and that they would be forwarded to the home when they were received, all other required information was present. The individual had been working at the home since 2003. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 21 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 poor. This judgement has been made using available evidence including a visit to this service. Residents can expect that the homes procedures safeguard their finances and that staff are appropriately supervised. Residents cannot be assured that their health and safety is promoted and protected and that management of the home meets with standards due to the non-compliance with regulations relating to medication. They cannot be assured that regular Regulation 26 visits are undertaken. EVIDENCE: Resident’s finances records were viewed and the staff member who maintains them was spoken with. All finances were banked and centrally held in the Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 22 homes head office. All receipts for spending were maintained and were reimbursed to the home. Each resident had a personal account number and their individual finances could be tracked and audited when required. Staff spoken with reported that they received one to one supervisions and peer group supervisions during staff meetings. Supervision records were viewed and evidenced that they discussed their progress in their role, resident’s needs and the philosophy of care in the home. The manager had a management qualification and NVQ level 4 care. They confirmed that they attended regular training courses to update their knowledge and explained courses they were due to attend and had attended. These included oracle training in December 2006 which involved budgets/computer, manual handling refresher and risk assessor training. The manager reported that they did not have regular supervisions, they said that their last supervision was some months before the inspection where they had discussed medication, and that their line manager had since left the organisation. The manager said that there had been no Regulation 26 visits since May 2006. A copy of the report had been forwarded to CSCI. The inspector had requested further Regulation 26 visit reports from the responsible individual prior to the inspection and reports were received for August, September and October 2006. There was no evidence of the visits after this date. At the previous inspection it was noted that quality assurance questionnaires had been undertaken to residents and their representatives. Residents review records were viewed and evidenced that residents and their family and representatives were provided with an opportunity to give their opinions of the care and service they received. There had been the non-compliance of repeat requirements which resulted in enforcement action provided through inspection, as noted in Health and Personal Care section in this report. These issues were regarding requirements related to the safe administration, storage and recording of medicines which provided a risk to the health and safety of residents. Staff training records viewed evidenced that staff were provided with health and safety related training including COSHH, manual handling, food hygiene and TOPSS (now Skills for Care) induction. Accident and incident records were viewed and evidenced that they were completed routinely when accidents occurred. Health and safety records were viewed, which included regular fire safety checks, water temperature checks at outlet and storage areas, electrical appliance and gas boiler checks. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 23 The maintenance worker was spoken with and reported that they had responsibility for ensuring the health and safety checks in the building were undertaken. They demonstrated a good knowledge of requirements and provided all documentation requested promptly. They said that they had recently purchased water thermometers, which were in each bathroom, and that staff check the temperatures of the bath and shower before the residents used them. There were health and safety related notices displayed in areas around the home for the attention of staff. Notices included COSHH and methods of disposing of waste in a safe manner. There was a stock of disposable gloves and aprons available for staff to use when undertaking personal care duties. Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 24 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 3 X 2 Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP29 Regulation 19(1)(b) Schedule 2 17(1)(a) Schedule 3 16(2)(k) 15(1) Requirement The registered persons must ensure that documents set out in Schedule 2 must be kept in the home. The registered persons must ensure that records regarding the service users which are set out in Schedule 3 are kept in the home The registered persons must ensure that the home is free from offensive odours The registered persons must ensure that each service user are provided with a written plan as to how their needs in respect of their health and welfare are to be met The registered provider must ensure that the registered manager is appropriately supervised The registered provider must ensure that monthly monitoring visits are undertaken in accordance with Regulation 26 The registered persons must take steps to ensure full and accurate records for the receipt DS0000037146.V325656.R01.S.doc Timescale for action 28/02/07 2. OP7 OP8 28/02/07 3. 4. OP26 08/02/07 28/02/07 OP7 OP8 5. OP36 18(2) 28/02/07 6. OP33 26 28/02/07 7 OP9 13(2), 13(4), 15/02/07 Blyford Residential Home Version 5.2 Page 26 and administration of medicines are completed demonstrating that medicines are safely administered at all times in line with prescribed instructions. This requirement is not fully complied with following the statutory requirement notice issued 24/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP16 Good Practice Recommendations It is recommended that a record of verbal concerns raised and actions taken be kept Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Blyford Residential Home DS0000037146.V325656.R01.S.doc Version 5.2 Page 28 - 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!