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Inspection on 04/02/08 for Blyford Residential Home

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

This inspection was carried out on 4th February 2008.

CSCI found this care home to be providing an Good service.

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.

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

Interaction between staff and residents during the inspection was observed to be positive, professional and friendly. Staff were attentive to the resident`s needs. Staff spoken with and observations of work practice evidenced that staff had a good knowledge of the resident`s individual needs. The home was clean, well maintained and attractively furnished. Residents were observed enjoying the communal areas of the home. There was a good choice of meals available for people living at the home.

What has improved since the last inspection?

Staff recruitment records viewed included two written references and CRB (criminal records bureau) checks. The recruitment procedure safeguarded the people living at the home. The improvements in the medication procedures further safeguarded people living at the home. Records were maintained regarding the use and administration of prescribed creams. A medication review had been undertaken regarding PRN (as required) medication. The daily records viewed were legible and abbreviations were no longer used, and they could be readily understood by staff who read them.

What the care home could do better:

Although care plans were in place, they would benefit from being more detailed and clearly explain the support each resident required. Further detailed information would be of benefit in the care plans to identify the behaviours that residents may display, which was stated as `agitation`.

CARE HOMES FOR OLDER PEOPLE Blyford Residential Home 61 Blyford Road Lowestoft Suffolk NR32 4PZ Lead Inspector Julie Small Unannounced Inspection 4th February 2008 11:00 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.V358979.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.V358979.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.V358979.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Rosedene House may accommodate persons of either sex, over 65 years who require care by reasons of old age (not to exceed 12 persons) 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). 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). 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. The total number of service users accommodated in the home must not exceed 36 persons. 1st May 2007 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. During the last inspection the manager informed the inspector that fees for the home were £386 per week. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The unannounced inspection took place on Monday 4th February 2008 from 11.00 to 17.00. The inspection was a key inspection, which focused on the core standards relating to older people and was undertaken by regulatory inspector Julie Small. The report has been written using accumulated evidence gained prior to and during the inspection. The registered manager was present during the inspection and the manager and staff spoken with provided the requested information promptly and in an open manner. During the inspection three staff recruitment records, training records, four resident’s care plans, two resident’s needs assessments and accident records were viewed. Further records viewed are detailed in the main body of this report. Observation of work practice was undertaken and four staff members and four people who lived at the home were spoken with. Prior to the inspection an Annual Quality Assurance Assessment (AQAA) was sent to the home and was returned to CSCI (Commission for Social Care Inspection) in the required timescales. Staff, relative/visitor, health professional and service user surveys were sent to the home. Seven staff, seven relative/visitor, five health professional and six service user surveys were returned to CSCI. What the service does well: Interaction between staff and residents during the inspection was observed to be positive, professional and friendly. Staff were attentive to the resident’s needs. Staff spoken with and observations of work practice evidenced that staff had a good knowledge of the resident’s individual needs. The home was clean, well maintained and attractively furnished. Residents were observed enjoying the communal areas of the home. There was a good choice of meals available for people living at the home. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Blyford Residential Home DS0000037146.V358979.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.V358979.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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect that their needs are assessed prior to moving into the home. The home does not provide an intermediate care service. EVIDENCE: The records of two newly admitted residents were viewed, which held detailed needs assessments undertaken by the placing authority. The records included details of their dementia diagnosis. The manager was spoken with and said that they undertook all assessments of prospective residents before they moved into the home and identified if the home was appropriate to meet their needs. However, it was noted that visits to the individuals and discussions with their relatives had not been recorded. The Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 9 manager agreed that they would record any visits in the future to evidence that visits and discussions had taken place. The manager said that they had asked family members to provide information regarding the resident’s history, which would support staff in discussions and life story work with them. Previous inspection reports noted that visits undertaken by the home’s manager and information received from family members were clearly recorded. The AQAA stated ‘Prospective service users are fully assessed prior to moving into the home and have a fully informed choice about where they wish to live. Admission does not take place without the home receiving a Community Care Assessment of need and the home completes their assessment. Assessments are completed to ensure that the home is able to meet the needs of the prospective service user and visits are arranged to the home prior to admission when appropriate to enable them and their families to see where they will be living and meet other residents and staff’. The service user surveys asked if they had received enough information about the home before they moved in so that they could decide if it was the right place for them. Four answered yes, one answered no and one said that they could not remember. The relative/visitor survey asked if they got enough information about the home to help them to make decisions. Five answered always, one answered usually and one answered sometimes. Blyford Residential Home DS0000037146.V358979.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 good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect that their needs are set out in an individual plan of care, which identified that their health needs are met, that they are treated with respect and that they are protected by the home’s medication procedures. EVIDENCE: Five resident’s care plans were viewed, which included details of the support they required to meet their needs. There was a ‘spider chart’ which summarised their needs and preferences, such as what they liked and disliked to eat. The records detailed what the individual’s preferred form of address was. A resident was spoken with and said that they preferred to be called a name other than their first name and they confirmed that staff used their preferred form of address. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 11 The manager explained that there had been the introduction of revised care plan templates, which were being piloted in another local authority home. A staff member spoken with explained that they had planned to undertake and summary of each individual’s care plan, which could be used by staff for easier reference. It was noted that the care plans may benefit from increased detail, such as when residents displayed ‘agitation’, to include details of how they displayed the behaviours and actions staff should take to support them. Resident’s changing needs and preferences were identified in records. There were signed records, which evidenced that care plans were updated by staff on a monthly basis. There were records of care plan reviews. The review meetings included the resident, their family and their key worker, which evidenced that the residents and others involved in their care were consulted with regarding their care plan and the support provided. The AQAA stated ‘All residents have a care plan - this is reviewed and updated regularly. The care plan is a record of the resident’s care needs and wishes. It also includes manual handling risk assessments for each resident and information for staff to follow to meet the care needs. There is also a daily running record section for staff to complete each shift to give continuity of information’. Staff spoken with reported that the care plans identified the needs of people who lived at the home. The staff survey asked if they were given up to date information about the needs of the people they supported. Six answered always and one answered usually. Comments included ‘passed on information from the team leader and written care plans’ and ‘I am able to read their records and I receive a verbal hand over’. The service user surveys asked if they received the care and support they needed. Five answered always and one answered usually. The relative/visitor survey asked if the home met the needs of their friend or relative. Six answered always and one answered usually. The survey asked if the home provided the support that they expected or agreed. Five answered always and two answered usually. The daily records viewed were legible and there were no abbreviations used. The previous inspection report noted that there were abbreviations used, which were not easily understood. There were details of when each resident had received health care treatment, such as visits from the district nurse, chiropodist and doctor. The care plans included details of where residents wore spectacles, dentures or hearing aids and the support they required when wearing and cleaning them. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 12 The service user survey asked if they received the medical support that they needed. Five answered always and one answered usually. The health professional survey asked if individual health care needs were met by the home. Four answered always and one answered usually. Comments included ‘the staff make great efforts to meet the sometimes very complex health care needs of individuals. They have shown great flexibility and appreciation of individual differences’ and ‘they strive to meet individual health needs and have support from district nurses/psychiatric nurses when appropriate’. Resident’s records viewed each contained a record of falls, summary of their personal history, dietary requirements, record of family visits, activities which they had participated in, continence management, behaviour incidents which were different form their usual behaviour, weight checks and nutritional screening. Risk assessments were in resident’s records regarding fire evacuation, using a wheelchair and manual handling, which identified the risks and methods of minimising the risks. Resident’s privacy was respected. All bedrooms in the home were of single occupancy. During the inspection staff were observed knocking on bedroom and bathroom doors and waiting to be invited in, before entering them. Interaction between staff and residents was observed to be positive and respectful. Staff were observed to be attentive to resident’s needs and were observed asking them if they would like drinks and if they were comfortable. Residents spoken with confirmed that the staff were respectful. The health professional survey asked if the home respected individual’s privacy and dignity and five answered always. Comments included ‘the dignity of their residents is a high priority and they will advocate where necessary for additional resources to improve their quality of life’ and ‘in the extensive contact I have had with the service every effort has been made to ensure dignity and privacy of individuals’. The medication administration during lunch time was observed. A staff member explained the procedures during the medication administration. Staff were observed to ask residents if they wished to take their medication, which was placed from the packaging into small pots. The staff member signed the MAR (medication administration records) charts, when medication had been taken. The home used MDS (monitored dosage system) and medication, which was not stored in the MDS blister packs, was counted and the total of the remaining medication was recorded on a running total sheet. PRN (as required) medication administration was recorded in red ink and the amount of medication, such as one or two tablets, was recorded. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 13 There were records of clear medication audits viewed, which were regularly undertaken by senior staff. At the hand over of each shift the senior staff checked the medication records. Prescribed creams and their administration were recorded in resident’s care plans and on MAR charts. Training records were viewed and evidenced that staff were provided with medication training. Some staff had completed medication Skills for Care knowledge sets. There were records of in house medication training provided to staff, which included observations undertaken by senior staff. The AQAA stated ‘We regularly carry out medication audits to ensure that we eliminate any potential errors and highlight any discrepancies’. The health professional survey asked if the home supported individuals to administer their own medication or manage it correctly when this is not possible. Three answered always and two did not answer. Comments included ‘I am not able to comment on this as all of my customers are not able to manage their own medication. I have never had any concerns with the staff supervising medication for my customers’ and ‘the home has made great progress in managing the resident’s medication and this is now always handled correctly’. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 14 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. People who use the service can expect that they are provided with activities, which are of interest to them, that they are supported in maintaining contacts, that they are supported to exercise control over their lives and that they are provided with a healthy and balanced diet. EVIDENCE: Three resident’s care plans were viewed, which included a record of what activities they had participated in. The activities included watching a DVD film, completing puzzles, singing, musical bingo, quizzes, listening to music, religious services and memory and reminiscence activities. The care plans detailed resident’s individual interests. Residents had enjoyed a recent tea dance and a visit to a pantomime. Resident’s spiritual needs were observed by religious services held in the home from various denominations in the area, such as Christian and Catholic. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 15 During the inspection residents were observed undertaking various activities, which included reading a newspaper, watching television, listening to music and chatting to staff and each other. Two residents were observed to be engrossed in a television called ‘Flog It’ and said that they would rather watch their television programme than speak to the inspector. Since the last inspection the home had recruited two volunteers to work individually with residents who wished to participate. One volunteer had not yet worked at the home as they were awaiting the return of their CRB check. The records of one volunteer were viewed, and they had recorded which residents they had worked with and that they had discussed what they wanted to do in the sessions, which included chatting about their history and completing puzzles. Residents said that they had plenty to keep them busy, that staff in the home listened to them and that they felt that their choices were respected. The service user survey asked if there were activities that they could take part in at the home. Three answered always, two answered usually and one answered sometimes. Six service user surveys stated that the staff listened to them and acted upon what they said. The AQAA stated ‘Social activities, outings and in house activities are all recorded on resident’s care plans. We have photographs of our tea dance held recently which the residents enjoyed immensely. We have a hairdresser who attends three days per week and also a barber. We also offer an external service which allows residents to purchase shoes, slippers and clothes. Activities cookery co-ordinator has been leading a group of residents in making cakes on the units which is hugely enjoyed by the residents’. Records of a recent resident’s meeting were viewed, where they were provided with information about the home. Records of resident’s review meetings, which included the resident and their families, evidenced that they were consulted with regarding the care that they were provided with. The AQAA stated ‘Residents meetings are held and recorded to show the needs and requests of the residents. At review meetings residents are able to make known their wishes and requests about their daily lives, social events, the catering services, the environment and their rooms. We have conducted a questionnaire for residents to identify whether they feel they have a say in the running of the home’. The health professional survey asked if the home supported individuals to live the life they chose. Four answered always and one answered usually and comments included ‘as far as I have seen the residents seem happy and have their own property’ and ‘the carers go out of their way to ensure the residents choose to live the life they wish’. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 16 The relative/visitor survey asked if the home supported people to live the life they chose. Five answered always and two answered usually. Care plans viewed included details of contacts with family members and friends, which residents enjoyed. A resident spoken with said that they had regular visits from their family and that they were always made welcome in the home. The relative/visitor survey asked if the home helped their friend or relative to keep in touch with them. Five answered always, one answered usually and one answered sometimes and one commented ‘Visits are welcome at any time. Visitors are welcomed by staff who offer tea/coffee’. Seven surveys stated that the home always kept them up to date with important issues affecting their friend or relative. Comments included in the health professional surveys included ‘they are patient and caring (from the manager to the care staff) and always have the time to speak to residents and family members’ and ‘respect people as individuals, respond to their emotional needs, liaises well with families/friends and appropriate professionals’. Residents spoken with said that they were provided with a good diet and there was sufficient food. Staff were observed to provide residents with their choice of hot and cold drinks throughout the day. The service user survey asked if they liked the meals at the home. Five answered always and one answered usually, one survey added the comment ‘definitely’. The menus were viewed and provided a healthy, varied and balanced diet. There were three choices for each meal, including a vegetarian option. There was a supplementary menu, including salads, jacket potatoes and sandwiches, which residents could choose if they did not want what was offered on the main menu. Care plans included resident’s likes and dislikes regarding food and any specific dietary requirements that they had. It was noted that the residents were enjoying three different meals, which they said that they had chosen. The meals included a fish dish, a meat dish and a salad. The meals smelled and looked appetising and staff were observed to be attentive to the residents during their meal. Records viewed, which were maintained by the kitchen staff at the home evidenced that safe and hygienic procedures were routinely undertaken. The home used the ‘safer food better business’ log book in the kitchen. Records of cleaning undertaken and fridge, freezer and probed food temperatures were viewed. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 17 The manager stated that the kitchen staff had recently attended a course regarding nutrition and dementia, which they said would increase their understanding of specific dietary needs. The AQAA stated ‘We have menu choices everyday which, after on-going consultation with the residents, reflects food that residents prefer’. Blyford Residential Home DS0000037146.V358979.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. People who use the service can expect that their complaints are acted upon and that they are protected from abuse. EVIDENCE: Previous inspection reports stated that the home had a detailed complaints procedure, which provided contact details of CSCI (Commission for Social Care Inspection). The complaints, compliments and comments book was viewed. There were several compliments received from individuals such as visitors to the home and family members. The records of complaints and concerns included clear details of how the issues were resolved and support provided to the complainant. All complaints had been resolved in a timely manner. Residents and staff spoken with said that they had a clear understanding of how they could make a complaint or raise concerns. Seven staff surveys said that they knew what to do if a resident, relative, advocate or friend had concerns about the home. Six service user surveys and seven relative/visitor surveys stated that they knew how to make a complaint. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 19 The relative/visitor survey asked if the home had responded appropriately if they had raised concerns about the home and comments included ‘not applicable but I am confident the service would respond appropriately’ and ‘never applied or had a concern’. Five health professional surveys said that the home always responded appropriately if they or the person using the service had concerns about their care. Comments included ‘staff are open and honest and always respond appropriately’, ‘the service has always been quick to respond to any concerns raised and have worked appropriately to resolve some very complex issues’ and ‘they go out of their way to resolve concerns/issues and to make residents comfortable and happy’. The AQAA stated ‘All complaints, compliments made by residents, families or visitors are taken seriously and dealt with immediately and effectively in line with guidance and policy. The complaints procedure is recorded and explained in the Statement of Purpose and the appropriate forms/leaflets (Having Your Say) are provided in the reception area of the home. There is a complaints and compliments system for recording issues and outcomes - this information is passed on to Customer Rights Team each year’. Staff were informed of their responsibilities in safeguarding adults who lived at the home. Training records viewed evidenced that staff were provided with safeguarding of adults training. Staff spoken with were aware of their responsibilities in the protection of residents at the home. The home had the local authority guidance for safeguarding adults. There were notices posted in the home explaining ‘No Secrets’, for the attention of staff, residents and visitors to the home. The AQAA stated ‘Risk Assessments are completed and kept in care plans. Protection of Vulnerable Adults Policy in place. Staff receive training and information’. Blyford Residential Home DS0000037146.V358979.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, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect that they live in a safe, well maintained, clean and hygienic environment. EVIDENCE: The home was clean and well maintained. The communal areas were clean and attractively furnished. The grounds were attractive and well maintained and were available for resident’s use. There were no offensive odours in the home. The AQAA stated ‘We provide a homely environment that meets the needs of the residents. There are communal areas and quiet rooms for residents to socialise or meet in private with their visitors. There are also dining and Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 21 lounge areas on all units - the units are designed for small group living. There are sluice facilities on each unit. The home has extensive landscaped gardens. The home is very clean and well maintained and a safe environment’ and ‘The gardens are easily accessed - there are separate enclosed garden areas for people with dementia to walk freely and securely’. Residents spoken with said that the home was always clean and comfortable and they were happy with the environment. A resident said that they had a lovely bedroom. Six service user surveys stated that the home was always fresh and clean. Maintenance records were viewed, which evidenced that repairs were undertaken in a timely manner. The AQAA stated ‘Any repairs/hazards are reported immediately for action by the appropriate contractors’. The laundry was viewed and the laundry staff member was met. There were two industrial and one domestic washing machine, and there were drying facilities such as two drying machines and outside washing lines. There was hand washing facilities in the laundry. A staff member showed the inspector Skills for Care knowledge sets, which were being worked on by the staff team and included infection control. The knowledge sets included work books and the staff member said that they were discussed in their supervisions. Staff were observed using good infection control procedures during the inspection, which included washing their hands and wearing protective clothing when working with food and laundry. The AQAA stated ‘We are currently awaiting funding to replace the three bathroom suites to accommodate the fraility of our residents’. The manager was spoken with and confirmed that they were planning to update the communal bathrooms and they were selecting appropriate baths to meet resident’s needs and preferences. They said that work would commence in the near future. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 22 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. People who use the service can expect that staff are trained and competent to do their jobs and that they are protected by the home’s recruitment procedures. EVIDENCE: Three staff recruitment records were viewed and held all the required documents, including CRB checks, work history, terms and conditions of employment and two written references. The records included probationary reports for staff, which evidenced that their strengths and further support that they needed were identified. Staff training records viewed evidenced that newly appointed staff were provided with an induction, which included the Common Induction Standards. The staff survey asked if their induction covered everything they needed to know to do the job when they started. Five answered very well and two answered mostly. During the inspection there were two staff working on each of the two dementia units and one staff member on the ‘mainstream’ unit. The manager reported that there were two ‘floating’ staff, who assisted in the units as required. The manager said that there were seven resident vacancies on the Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 23 ‘mainstream’ unit and that when the vacancies were filled then staffing would be increased. Two team leaders worked on each day shift. During the night there was one waking night staff on each unit and one team leader. The staffing rota was viewed and confirmed the staffing of the home. Staff spoken to said that there was sufficient staffing at the home, however, staff sickness did occur at times. The manager said that they were advertising for increased ‘relief’ staff hours in the local press to support the home during times such as the sick leave of permanent staff. The AQAA stated ‘A 24 hour management and care cover is provided. All staff work to a four week rolling roster and annual leave and training days are covered in advance by relief staff’. The service user survey asked if staff were available when they needed them. Five answered always and one answered usually. A senior staff member showed the inspector Skills for Care work sets, which were work books on areas such as infection control, medication and dementia. The work books were completed by staff and discussed in their supervisions, which evidenced that staff were supported in continuous ‘on the job’ development. Staff spoken with confirmed that they had received sufficient training at the home to support them in their work role which included safeguarding adults, manual handling, dementia and fire safety. Staff records viewed evidenced that staff had been provided with training such as safeguarding adults, food hygiene, health and safety, manual handling, medication and dementia. The staff surveys said that they were provided with training which was relevant to their role. Comments included ‘I have had to undergo wheelchair training before I was allowed to push anyone. Also I got several course qualifications while being here’ and ‘very happy to say that a variety of training has been offered covering different topics and the senior team are always available for any queries’. The health professional survey asked if the staff had the right skills and experience to support individual social and health care needs. Four answered always and one answered usually. Comments included ‘I have only seen appropriate behaviours from carers’ and ‘where staff feel they don’t have the skills or experience for a specific need, they are quick to get support and information from the appropriate agencies/professionals’. A document, which listed staff working at the home and their NVQ (National Vocational Qualification) achievements, was viewed. Twenty four of fifty three staff had achieved a minimum of NVQ level 2 and four staff members were working on their award. The home had reached the target of NVQ qualifications Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 24 identified in the National Minimum Standards relating to older people. NVQ certificates were provided in the staff records. A senior staff member was spoken with and said that they had recently achieved K100 – understanding health and welfare, an Open University course. The AQAA stated ‘Team leaders have or are working towards an NVQ III qualification. Over 50 of carers have an NVQ II. All the domestic team and the handyperson have level I in housekeeping services’. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 25 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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect that the home is managed by a person who is fit to be in charge, that the home is run in their best interests, that their financial interests are safeguarded and that their health, safety and welfare is protected. EVIDENCE: The home’s registered manager had achieved a diploma in management, an NVQ level 4 in care and had been successful in their registered manager application with CSCI. The AQAA stated that the manager also had achieved a Bsc Honours Degree in Community Studies. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 26 Staff spoken with, staff surveys and health professional surveys stated that the manager was approachable. During the morning of the inspection the manager was receiving a one to one supervision with their manager. The manager reported that they received regular support in their role. Regulation 26 visit reports were viewed and were undertaken on a monthly basis. During the Regulation 26 visits residents were spoken with regarding their satisfaction with the service that they were provided with. Resident’s records, which were viewed, included review meetings, where residents and their families were consulted with regarding the support that they received. Previous inspection reports identified that the safeguarding of resident’s financial interests was positive. There were clear records of the balance of the individual’s finances and records of ingoing and outgoing money. The AQAA stated ‘The manager acts in the best interests of the residents and protects their financial interests in accordance with SCC policies and procedures’ and ‘Residents have lockable drawers for safekeeping their valuables or personal papers. Their personal allowances can be paid into a personal account and withdrawn on their behalf at any time’. Health and safety records were viewed and evidenced that regular safety checks were routinely made, such as water temperature, legionella, fridge and freezer temperatures, food temperatures and electrical appliance safety. Fire safety records were viewed and evidenced that regular checks were undertaken. The home had a fire risk assessment and resident’s records viewed, held a fire risk assessment, which identified methods of supporting the resident if there was need for evacuation of the home. There were fire safety notices posted around the home, which provided information of actions to take in case of a fire emergency to staff, visitors and residents. Staff training records viewed and discussions with staff evidenced that they were provided with health and safety related training such as food hygiene, manual handling, COSHH (control of substances hazardous to health) and infection control. The AQAA stated that they ‘Ensure manual handling refresher training is maintained and all other mandatory training which includes, COSHH, first aid, food hygiene, fire safety are completed each year’. Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 27 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that care plans are developed further to include specific details regarding people who use the service and their needs Blyford Residential Home DS0000037146.V358979.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge CB21 5XE 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.V358979.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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