Care Home: Blackley Premier Care

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What the care home does well There was considerable evidence of ongoing investment in the premises to ensure the standard of accommodation is well maintained. This was evident in decorating programmes and refurbishment of all bedrooms and floor covering in communal and corridor areas. On the days of the inspection the staffing levels appeared to be well maintained to meet the needs of the eleven people being cared for.Training and development programmes were well established and all staff working in the home had achieved level II and some level III in National Vocational Qualifications. People living there commented that they were well cared for and complimented staff who supported them and staff involved in catering arrangements. Care planning and evaluation of support offered to people was found to be well established and recording procedures were being reviewed to a more person centred approach, to ensure the wishes and preferences of individuals were known, recorded and delivered. What has improved since the last inspection? The most significant and noted improvement related to programmes of refurbishment, which clearly evidence a commitment to invest in sustaining a high standard of accommodation for people living there. Appropriate steps had been taken to address requirements made at the last inspection. Care plans were being developed to ensure the views and wishes of people were listened to and care was delivered in a way, which respected people preferences. What the care home could do better: No requirements were made as a result of this inspection. CARE HOMES FOR OLDER PEOPLE Blackley Premier Care 70 Hill Lane Blackley Manchester M9 6PF Lead Inspector Joe Kenny Unannounced Inspection 24 July 2008 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 Blackley Premier Care DS0000021535.V363438.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. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackley Premier Care Address 70 Hill Lane Blackley Manchester M9 6PF 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) 0161 740 8552 Bankfield Premier Care Limited Anne Mellish Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 18 service users to include:*Up to 18 service users in the category of OP (Old age not falling within any other category). 31st May 2007 Date of last inspection Brief Description of the Service: Blackley Premier Care is a residential home offering accommodation and personal care for up to 18 older people. Blackley Premier Care is situated in the Blackley area of Manchester close to public transport links into Manchester City Centre and Middleton, off Victoria Avenue and Rochdale Road. The home has a paved area to the front. At the rear of the building there is a small garden with a seating area for people to access, weather permitting. A car park is located at the side and the rear of the building. The home is a large detached building. Accommodation is provided on the ground and first floors. Access to the first floor is via a passenger lift and stairs. The accommodation is provided in 12 single rooms and 3 double rooms. None of the bedrooms have en suite facilities. All bedrooms are fitted with a washbasin. Accessible toilets and bathrooms are located on the ground and first floors within close proximity to bedrooms and lounges. The home has a large lounge and a separate dining room on the ground floor. In addition there is a conservatory leading off the main lounge. Blackley Premier Care DS0000021535.V363438.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 of the home was carried out on the 24 July 2008. This inspection included assessment of all the key national minimum standards. As part of the inspection, time was spent in discussions with people living in the home and with staff, observing practices and routines, and discussions with the manager. A series of records were examined in relation to care planning, medication, health and safety and staff files. Procedures relating to complaints, concerns, adult protection and finances of service users were also looked at. A selection of bedrooms and all communal areas were looked at on a tour of the building. The home completed and returned an Annual Quality Assurance Assessment, a self-assessment of how the home feel it is meeting national minimum standards. Seven completed comment cards from people living in the home and three completed by relatives were received by the Commission for Social Care Inspection. The findings and views expressed by people during the inspection are included in this report. 11 people were living at the home at the time of the inspection. The fees for the home ranged from £373.54 to £395:00 per week. What the service does well: There was considerable evidence of ongoing investment in the premises to ensure the standard of accommodation is well maintained. This was evident in decorating programmes and refurbishment of all bedrooms and floor covering in communal and corridor areas. On the days of the inspection the staffing levels appeared to be well maintained to meet the needs of the eleven people being cared for. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 6 Training and development programmes were well established and all staff working in the home had achieved level II and some level III in National Vocational Qualifications. People living there commented that they were well cared for and complimented staff who supported them and staff involved in catering arrangements. Care planning and evaluation of support offered to people was found to be well established and recording procedures were being reviewed to a more person centred approach, to ensure the wishes and preferences of individuals were known, recorded and delivered. 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. Blackley Premier Care DS0000021535.V363438.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 Blackley Premier Care DS0000021535.V363438.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, standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission and assessment procedures ensure people receive the information the need to assist them in making decisions about moving to the home. EVIDENCE: Arrangements for supporting people who may be considering moving to the home are clearly established and involve the manager or deputy. This is to ensure information relating to people’s needs is known by staff at the home. Copies of care plans are received from the placing authority and an assessment of needs is also carried out by staff from the home. A copy of the home’s Statement of Purpose was received on the day and evidenced that the information had been recently reviewed. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 9 Information about the home and copies of recent inspections carried out by the commission are available in the foyer. People considering moving to the home are offered the opportunity to visit the home before moving there and in most cases a relative visits on their behalf. The manager stated that people are provided with a contract of the terms of their placement on admission. Comments by service users and relatives did not confirm this as the majority of the seven completed comment cards indicated that no contract was provided. Discussions were held with the manager regarding the need to discuss issues relating to contracts and the revised Statement of Purpose with all relatives. One person is self funded and a contract of their placement was in place. The file for the person most recently admitted was examined and information provided, indicated this person had been supported appropriately when moving to the home. Files contained copies of the placing authorities’ assessment of care needs and the home’s assessment. This information is used to set out a plan of support. This home does not provide intermediate care. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans address personal, social and health care needs and inform staff of the level of support people required. Medication procedures ensure people are not placed at risk. EVIDENCE: A new care system of recording information about people’s care needs and how people should be supported by staff has been introduced since the last inspection. The introduction of the system enables the home to develop a more person centred record of people’s personal care needs, to reflect peoples choices and preferences. Key workers worked closely with people to seek their views and information was recorded in a way which reflected people’s preferences. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 11 The files examined at the time of the inspection provided information about the health and personal care needs of people and detailed information when health professionals support people. Each person is registered with a general practitioner and the district nurse attends the home to support two residents. The manager described the audiologist service as very good, the chiropodist attends when required and is private as people pay for treatment. An NHS dental service attended when required. Staff support people to go to hospital. The key worker model of care delivery is used by the home, where a named member of staff offers one to one support to named residents. Relatives commented that their relative “ has been extremely well cared for since she has been in the BPC home”. Information in the care plans is reviewed on a monthly basis to evaluate the effectiveness of care and intervention by staff. The home has a clear policy for medication procedures and all staff with responsibility for administering medication had received training and been assessed as competent in all aspects of its administration. Medication is held securely and procedures were in place to check and record medication coming into the home and medication returned to the pharmacist. On examination of the medication administration records (MAR), staff are advised to ensure any hand written entries on the MAR sheets are signed by the person entering the information and countersigned by another member of staff. There were some noted gaps in records relating to administration of creams. The senior on duty on each shift holds the key to the medication room and trolley. The trolley is secured on the corridor leading to the lounge during the day and is then located in the designated secure area developed since the last visit. Procedures are monitored internally and by the supplying pharmacist. Daily records were found to be well maintained. The records evidenced an entry on each day in the morning, evening and night. This enabled the home to evidence a clear account of the support offered to people. Risk assessments addressed issues such as dietary and mobility issues. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Daily living arrangements ensure the choices and preferences of people are respected in all aspects relating to personal and social care needs. EVIDENCE: Daily living arrangements are flexible and respected people’s wishes in terms of when they got up in the morning and how they spent their day. The majority of people do need support with personal care when getting up and dressing and staff confirmed they supported people as and when they wished to get up. Staff are encouraged by the manager and senior staff to spend time with people when supporting them. There were eleven people in the home on the day and staffing levels had been well maintained to enable staff to provide people with the support they needed. One person who remains very active and enjoys outdoor activities continues to clear the grounds, wash down external furniture and in general spends the greater part of their day outdoors. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 13 The grounds continue to offer a secure seating area and a number of potted plans had been purchased. This area can be accessed from the lounge by a fixed ramp. A programme of internal activities is posted on notice boards. Staff were observed engaging people in an activity in the afternoon. People choosing not to be involved remained in the lounge watching television. A joint birthday party and BBQ was planned, two weeks after this inspection. Time was spent in discussion with the cook. There was ample evidence of choices offered to people at mealtimes and the cook will meet people to discuss their preferences. During discussion with people on the day they said they were happy with the meals provided. Comments by relatives, completed on behalf of service users were “more variety” and one person said, “would like more fish and chips”. The manager is advised to discuss meal and menu arrangements with relatives and service users to ensure their views are taken on board. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures are in place to listen to the views and concerns of people about the service they receive. Policies and procedures were in place to protect people from harm or abuse. EVIDENCE: The complaints procedure informs people of who to contact if they have a concern about the service they receive. The procedure needed amending to refer to the contact address of the commission’s regional office. A register of complaints is kept. One complaint had been received since the last inspection. There was recorded information as to how the complaint had been resolved by the home. No complaints had been received by the commission in the period since the last inspection. Procedures relating to adult protection were reviewed by the manager since the last inspection. This included an internal audit and survey of staff’s knowledge to determine their understanding of procedures and delivery of programmes of training where any shortfalls had been identified. During discussions with staff they confirmed they had received training and were aware of what action to take if they were to witness or be made aware of abusive practice. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 15 The manager said the home had a copy of the Local Authority’s adult protection procedures. One incident had been referred to the Local Authority. The manager said the she had been advised that the incident did not require any additional action as there was supporting information in relation to the incident. The manager was advised to request a statement supporting the advice she had been given. People using the comment cards confirmed they knew who to speak to if they had a concern and named their key worker, a relative or the manager as the person they would speak to. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean, homely and well maintained. EVIDENCE: During discussions with the manager and a tour of the building and its grounds, there was significant evidence of investment in maintaining a high standard of accommodation. The grounds are well maintained, however one section of fencing did need replacing. There is a designated parking area to the rear. A secure and easily accessed area is located to the rear of the building for people to access. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 17 The interior was found to be clean and well maintained. Furniture in all rooms had been renewed and consisted of new wardrobe, bed and drawer units. The furniture was bright, homely and durable; drawer units would be fitted with a lockable unit where people request one. It is recommended that a risk assessment is carried out as to whether wardrobes need to be secured to the wall to minimise the risk of them falling forward. All rooms and corridors have new carpets and a new stand hoist and Oxford hoist have been purchased. The manager confirmed that all staff had been instructed in the use of the equipment for those people assessed as requiring use of such equipment. A new wet room has also been fitted which will offer easy access to people. On inspection of fire evacuation signs there was an absence of signage on the ground floor and the manager was advised to consult with the fire service regarding appropriate signs and planned routes out. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements meet people’s assessed needs. EVIDENCE: The staff structure for the home is a registered manager, deputy manager, seven senior care assistants and 10 care assistants. There are two cooks and one domestic also employed. Staff are deployed to ensure there are four on duty in the morning and three in the evenings. Two staff are on waking duty at night. Staffing levels continue to be well maintained, despite the fact that the home was at 61 occupancy level. Staffing hours for the week preceding the inspection and for the week covering the inspection visit were examined. The hours worked during the day were appropriate to meeting the needs of residents currently cared for. A stable and committed staff team is in place and no new staff had been recruited since the last inspection. The manager confirmed that recruitment and selection procedures remained the same as described in the last inspection of the service, where they were assessed as appropriate. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 19 During discussion with staff they said they continued to be supported in their work by the manager and that regular staff meetings and one to one supervision sessions were provided to them. One relative commenting on staff said, “They are very good and caring individuals”. Another relative commented that there “always seem to be adequate staff available”. Training information relating to staff was that all seniors have completed NVQ level III and the majority of care staff were working to achieve NVQ Level II. 66 of staff team had achieved this award. Other courses undertaken were: Infection Control and a 12-week course on Dementia awareness with Salford College. During discussion with a senior care staff, she was very positive in her comments relating to training, supervision, and confirmed that staff meetings take place and that staff are given the hours to maintain and develop social care programmes. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management and administration procedures focus on meeting the needs of people living at the home and ensure the home is run in the best interest of people. EVIDENCE: The manager holds the necessary qualifications and experience to manage the home. The service manager for the home visited the home towards the end of the inspection and confirmed that she attended the home to provide one to one support to the manager and conducted unannounced visits to assess how the Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 21 home was being conducted. A report is compiled of her visits and is held at the home. Records relating to health and safety checks on all aspects of the service were in place, relating to maintenance and service of equipment, checks and test on fire systems, and all were appropriately maintained. However, the home is again advised to develop a clear distinction between what is a fire drill and a fire sounding test. Insurance liability documents were dated to 01/12/08. Procedures were in place to manage and minimise the risk of cross-infection. All staff are provided with protective gloves and aprons. Procedures relating to people’s finances and how the home supported service users with their finances were examined. Records relating to management of finances were assessed against records and amounts of cash. The audit conducted was found to be in order. Procedures for management of the laundry service and waste were also well established. Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 OP9 Good Practice Recommendations Hand written entries on the Medication Administration Records should be signed by the person entering the information and countersigned by another member of staff. Medication records should be monitored as there were some gaps in records relating to the administration of creams. Discussion should be held with relatives and service user regarding meal and menu arrangements to ensure their views are taken on board. A statement should be received from the Local Authority safeguarding team, supporting the advice regarding a DS0000021535.V363438.R01.S.doc Version 5.2 Page 24 2 OP9 3 OP12 4 OP18 Blackley Premier Care 5 OP19 recent referral. A risk assessment should be undertaken of whether wardrobes should be secured to the wall as they may present as a hazard to persons accessing the units. Advice should be sought from the fire service regarding fire route signs on the ground floor. The manager is advised to differentiate between a fire sounding test and a periodic unannounced fire drill. The manager was also advised to ask staff attending fire drills to sign the register confirming their attendance. 6 7 OP31 OP31 Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Blackley Premier Care DS0000021535.V363438.R01.S.doc Version 5.2 Page 26 - 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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