Care Home: Blatchington House

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What the care home does well There is a Statement of Purpose and Service Users Guide (brochure) that gives prospective residents the information required to enable them to make an informed choice about where they live. Residents confirmed that they were visited by the Manager or a senior registered nurse prior to admission to the home and two stated they had been invited to visit the home to see if they liked it enough to live there.The activities provided are varied and interesting and enjoyed by the residents that participate. The menus evidence a well thought out balanced diet with a varied choice of food in line with resident`s preferences. Quality assurance systems are in place, which enables the service to monitor and improve their service. There is an open-house policy, which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard residents` finances. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The Comments received from residents and families regarding the care received included: ` Staff efficient and polite ` ` very nice staff ` ` She receives excellent nursing care and care workers are kind, considerate and supportive of her every need` There is a robust recruitment process in place to protect the residents. The training provided ensures that the staff are competent to care for the residents living in the home. Blatchington House provides a clean, safe and well-maintained environment, which is appreciated by the residents and their relatives. Comments regarding Blatchington House were generally positive and included: `I have been here for a long time and like it` ` I haven`t been here long, but its quiet and peaceful, I am comfortable`. What has improved since the last inspection? The Annual Quality Assurance Audit completed clarified areas that the management team have identified for improvement. There is evidence of continued improvement in the auditing and collating of quality assurance systems. Medication practices regarding self-administration procedures are robust and underpinned by a policy. What the care home could do better: On viewing the medication administration charts shortfalls were identified and a system needs to be devised by the home to identify when gaps are noted and action is taken to ensure that residents receive the prescribed medication.The policy and procedure for receiving verbal orders or changes to medication needs to be followed by staff to ensure the safety and well-being of the residents. CARE HOMES FOR OLDER PEOPLE Blatchington House Firle Road Seaford East Sussex BN25 2HH Lead Inspector Debbie Calveley Unannounced Inspection 26th February 2008 09:00 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 Blatchington House DS0000013964.V360288.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. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blatchington House Address Firle Road Seaford East Sussex BN25 2HH 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) 01323-891702 01323 490393 info@ahle.co.uk www.blatchingtonhouse.co.uk AHLE Limited Mrs Carol Breeds Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability (34) of places Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. A maximum of thirty four (34) service users to be accommodated. That a maximum of twenty nine (29) service users are in receipt of nursing care. That a maximum of five (5) service users are in receipt of personal care. That service users may have a physical disability. Date of last inspection 14th March 2007 Brief Description of the Service: Blatchington House is a care home registered for 34 places. Residents accommodated must be aged 65 years or over on admission and may have a physical disability. The home can accommodate 29 residents in receipt of nursing care and five residents in receipt of personal care. Blatchington House is located in a quiet residential area in Seaford. It is located approximately one mile from the seafront. There is car parking available at the home or on the adjacent street. Rooms are located over three floors. There is a passenger shaft lift available to assist residents to access all floors. There are 30 single rooms, of which two are provided with en suite facilities and two double bedrooms, of which one has en suite facilities. There are suitable numbers of toilet and bathing facilities located throughout the home to meet the needs of residents. There is a good-sized dining room and lounge rooms for residents to use. There is a large garden area at the front of the home with wheelchair access. Weekly fees range from £450 to £650 per week. There are additional fees; hairdressing (£7 - £15), chiropody (£9), newspapers/magazines and personal toiletries (at cost). Blatchington House DS0000013964.V360288.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 stars. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Blatchington House will be referred to as ‘residents’. This was a key inspection that included an unannounced visit to the home and follow up contact with resident’s representatives and visiting health and social care professionals. This unannounced inspection was carried out over 6.5 hours on the 26 February 2008. There were thirty-one residents living in the home on the day, of which five were case tracked and spoken with. During the tour of the premises eight other residents both male and female were also spoken with. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. A tour of the premises was undertaken and a range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of care staff, registered nurse and the cook were spoken with in addition to discussion with the Manager. Telephone contact was made with visiting professionals following the visit and two relatives were spoken with during the inspection visit. The information received verbally has been incorporated into this report. An Annual Quality Assurance Assessment was received from the Manager completed in full prior to this key inspection. The inspector would like to thank the residents and staff at Blatchington House for their hospitality during the inspection visit. What the service does well: There is a Statement of Purpose and Service Users Guide (brochure) that gives prospective residents the information required to enable them to make an informed choice about where they live. Residents confirmed that they were visited by the Manager or a senior registered nurse prior to admission to the home and two stated they had been invited to visit the home to see if they liked it enough to live there. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 6 The activities provided are varied and interesting and enjoyed by the residents that participate. The menus evidence a well thought out balanced diet with a varied choice of food in line with resident’s preferences. Quality assurance systems are in place, which enables the service to monitor and improve their service. There is an open-house policy, which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard residents’ finances. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The Comments received from residents and families regarding the care received included: ‘ Staff efficient and polite ’ ‘ very nice staff ’ ‘ She receives excellent nursing care and care workers are kind, considerate and supportive of her every need’ There is a robust recruitment process in place to protect the residents. The training provided ensures that the staff are competent to care for the residents living in the home. Blatchington House provides a clean, safe and well-maintained environment, which is appreciated by the residents and their relatives. Comments regarding Blatchington House were generally positive and included: ‘I have been here for a long time and like it’ ‘ I haven’t been here long, but its quiet and peaceful, I am comfortable’. What has improved since the last inspection? What they could do better: On viewing the medication administration charts shortfalls were identified and a system needs to be devised by the home to identify when gaps are noted and action is taken to ensure that residents receive the prescribed medication. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 7 The policy and procedure for receiving verbal orders or changes to medication needs to be followed by staff to ensure the safety and well-being of the residents. 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. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission, although people are not assured in writing that their needs will be met. EVIDENCE: There is a range of well-documented information about the home and the services it provides. The home has a statement of purpose and service users guide (brochure) and a copy of this is available along with the last inspection report and a copy of the homes terms and conditions of residency in the front entrance area. Relatives and relatives spoken to were clear on the service provided by the home and costs involved. It would benefit prospective residents and families if the Statement of Purpose was written in a more user-friendly format. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 10 The registration certificate is clearly displayed and was found to be accurate. Three admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre admission assessments are completed and provide a clear assessment of prospective residents care needs. These are completed by the manager or a senior nurse and discussion with the manager confirmed that these are used to ensure new admissions to the home are appropriate and that the home have the staff, equipment and environment to meet their care needs. Prospective residents’ are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. This approach should be more clearly recorded on the assessment documentation to demonstrate the procedure followed. Social care professionals spoken to confirm that pre admission assessments are always completed and that these were completed promptly and efficiently. It was confirmed that training is provided to the staff to meet the needs of the residents admitted to the home. It was however noted that the home does not confirm having regard to the assessment that the home can meet the assessed needs of the prospective resident. Intermediate or rehabilitative care is not provided at Blatchington house. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 11 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 and 11. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans provide a good framework for the delivery of care, which give clear guidance to care staff on all the care needs of all the residents. The home was found to be meeting resident’s health and general needs with accessed additional specialist support when needed. The privacy and dignity of residents were seen to be promoted, however the medication practices need to improve to ensure the continued well-being and safety of the residents. EVIDENCE: The care documentation pertaining to five residents was reviewed as part of the inspection process. These were found to include plans of care, nutritional assessments, personal histories and risk assessments. The care plan for each resident is kept in the residents’ bedroom and two residents were happy to share their care plan and were able to confirm that they discussed it with the staff regularly. The care documentation viewed demonstrated that the care was reviewed and evaluated, however as discussed, the residents would benefit from a more Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 12 person centred approach to care planning. Some minor shortfalls were identified, for example one resident who has communication problems did not have any guidance in the documentation to facilitate this vital need, the staff though were observed communicating very well with the resident. Another did not provide guidance for staff to deal with visual problems, though the staff were knowledgeable and discussed this in detail during the inspection. These shortfalls however do not impact on the positive outcomes of the residents due to the stable care team and the knowledge they have on individual residents. Daily records are completed by the senior nurse on duty, but they are limited and contained comments such as ‘washed and dressed, all care given’ and did not mention any personal details such as mood or overall well being. Carers complete a daily task tick box document, which again doe not cover the emotional well being of the residents. This was discussed with the manager during the inspection and is under review. Risk assessments for health needs are included in the care planning format used by the home, and all risk assessments were found to be completed, and followed through with an appropriate plan of action when identified as required. Staff spoken with confirmed that they received a full report on each resident daily and read the daily care documentation that is kept in the main nurses station. It was confirmed however that they did not always have the time to read the residents full care plan that is kept in the residents bedroom, two student nurses currently working in the home felt that the care plans were helpful in getting to know the resident, but time consuming. The manager is aware of this. The staff felt that their views were taken into account when planning resident’s care. Relatives and residents spoken with were very satisfied with the care provided at the home one saying that the home ‘should be congratulated for its care’ ‘my relative receives good nursing care and care workers are kind, considerate and supportive of her every need’ ‘Staff are efficient, courteous and very kind’. Residents spoken to were also satisfied, comments included ‘they look after me very well’ ‘I am have my own room and the staff are kind ’ ‘ It’s my home’. The clinical room is located on the ground floor of the home; it is kept locked at all times. There is a small fridge and temperatures of the room and fridge are recorded daily. There are policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. The systems for recording and checking controlled drugs were found to be thorough. Medication Administration Charts were viewed and were found to have some shortfalls. These included: verbal orders were unsigned and not dated, and gaps where medications were not signed for, although they Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 13 had been dispensed. These were fully discussed with the registered nurse on duty. The comparison signatures of staff able to administer medication were available. Some areas of good practice were discussed with the senior nurse on duty during the inspection regarding the stock medication and observed administration techniques. Staff were seen to be respectful and considerate to all residents and visitors, whilst attending to their needs. Two residents had lived with their spouses in the home and were able to confirm that the staff looked after them very well during their last days. They said the staff had been supportive and kind and ensured that their spouses were treated with dignity and respect at all times. There is a policy and procedure in place to guide staff in caring for residents that are dying. The induction programme contains training for staff in death and dying procedures. Blatchington House DS0000013964.V360288.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 and 15. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. EVIDENCE: There are two activity persons employed by Blatchington House and it was confirmed that in the morning, Monday to Friday, there are one to one sessions for residents and in the afternoon, group activities are organised. Weekend activity sessions are under discussion as a result of an internal audit. The programme of activities is displayed in the home and confirmed that a range of activities are offered, including excursions out, visiting entertainers, exercise classes and clothes parties. The residents were seen participating in a quiz and enjoying themselves. Staff confirmed that the activities in the home have been a great benefit to residents and that celebrations are held regularly for special occasions including birthdays. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 15 Discussions with residents confirmed that they joined in activities only if they chose to do so; some residents prefer their own company and often spent their time in their own rooms. Those that attend the activities were enthusiastic and complimentary regarding the activity provision. Library books are provided and changed regularly. Photographs of residents enjoying various functions are displayed in the home. Resident’s rooms were found to be individual and personalised and each resident has their preferred term of address recorded in their care documentation and this preference was respected. Residents were seen to have their choices respected through out the day with decisions being responded to. There is a small shop located at the home that provides an opportunity for individuals who are unable to access local amenities to purchase toiletries and confectionery, thus encouraging choice and independence. Visitors spoken to were all happy with the visiting arrangements and how staff who were said to be ‘very welcoming’ received them. During the inspection visit it was noted that the reception area was always manned during the day and visitors were greeted with assistance being provided if needed. The mid day meal was observed and was seen to be organised and well managed ensuring that those residents needing assistance were given time and able to have the assistance that they needed in an unrushed manner. It was confirmed that residents had a choice at lunchtime, which included a vegetarian choice. Those residents saying they did not like the main choice were seen to have alternatives provided that they did want. Menus are used and circulated prior to the meals being provided and records are kept on what food is eaten by each resident. All feedback about the food was complimentary and comments included ‘good food’ ‘I have choices in the meals and the meals are good’. The dining area is very pleasant and well furnished with natural light. A catering manager (head chef) is in post and the home received an Environmental Health award in January 2008. Staff were seen to be following good practice when serving and distributing the meals. The meals provided looked appetising and were served in a manner that ensured it looked attractive. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 16 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. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. EVIDENCE: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide (brochure). A system of recording complaints was demonstrated to the inspector during her visit to the home. The home has not received any complaints since the last inspection. Relatives and residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. Blatchington House DS0000013964.V360288.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, 20, 24 and 26 People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Blatchington House provides a comfortable, clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room, and rooms are homely and reflect the resident’s personalities and interests. EVIDENCE: A tour of the home confirmed that the home is well maintained and rooms are attractive with some being very personalised. Residents spoken to said that they liked their rooms one saying that the home ‘felt like her home now’. There are large attractive gardens with seating areas and these are used periodically, weather permitting. There are various communal areas, which are attractive and allow for different uses, ensuring residents have choice of how and where they spend their time. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 18 There are adequate communal bathrooms and shower rooms in the home, with specialist equipment to ensure all residents can have a bath or shower. The home has been assessed by an Occupational Therapist and specialised equipment is available throughout the home to promote independence. During the inspection it was noted that staff were using lifting and supporting equipment appropriately, however some poor techniques of moving residents from wheelchair to chair were also noted, which were addressed during the inspection visit. Call bells are provided in all bedrooms and main communal areas; it was discussed that it would benefit residents if call bell access was also available in the smaller lounge area. The home was clean and free from malodours. Good practice in respect of infection control by staff was observed during the inspection visit and there were gloves and aprons freely available in the home. Sluice and laundry areas were found to be clean and safe and the residents confirmed that their clothes are well laundered and they have no complaints regarding the laundry service. Blatchington House DS0000013964.V360288.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 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents would benefit from a review of staffing levels on a regular basis to ensure their health needs and safety are protected. Robust recruitment procedures are in place to protect residents, and staff training ensures they are aware of their roles and are able to provide the support and care the resident’s need. EVIDENCE: At the time of the inspection visit, 31 residents were living at Blatchington House. The staffing rota was viewed and the morning staffing levels were seen to be sufficient to meet the needs of the residents at this time. The manager confirmed that the staffing arrangements are flexible and respond to resident’s dependency. Staff spoken to said that there was enough staff to look after the residents to a good standard. The staffing levels fall in the afternoon to one trained and four care staff and some staff spoken with felt more staff would be beneficial to give the level of care required, the staffing levels at night consists of 1 trained nurse and two carers, this level of staff needs to be reviewed along with the completed reports of accidents and incidents. During review of the accident forms there were a fairly substantial amount of incidents during the nighttime hours and this was discussed in full with the manager. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 20 Ancillary staff are employed in addition to staff providing care. Residents’ benefit from a low turnover of staff, ensuring continuity of care is provided. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required. There was evidence of health questionnaires, Criminal Record Bureau checks, two references, a resume of previous employment and work permits where necessary. All the paperwork is kept within a locked room. All registered nurses were seen to have a current Personal Identification Number (PIN). There is an induction programme in place and this has been introduced for all new staff. Files seen confirmed this. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager. Staff and the training list seen confirmed that compulsory training such as manual handling, adult protection, first aid and fire safety are being undertaken. The manager has training matrix, which tracks the staff training needs. Staff are encouraged and supported to achieve a National Vocational Training Qualification (NVQ) and at present 11 of the 19 care staff employed care staff have achieved or are studying for an NVQ. Blatchington House DS0000013964.V360288.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 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The overall management of this home is good with effective systems in place to protect residents. EVIDENCE: The Registered Manager is a Registered General Nurse with current registration with the Nursing and Midwifery Council (NMC). The Manager is registered with the CSCI and has completed the Registered Manager Award course. She is experienced and competent to manage the home. The staff spoken with confirmed that management ethos is supportive and approachable. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 22 The Registered Manager confirmed that there is a quality assurance and quality monitoring system in place where regular feedback is sought from residents. A recent audit of activities has just been completed. Staff have meetings monthly where they are provided an opportunity to raise any issues. These are then addressed by the management team. The staff spoke positively regarding these meetings. Personal allowances are held at the home for some of the residents and it was confirmed that receipts are maintained for all financial transactions and clear accurate individual records are kept. There are some residents that have their own arrangements in place regarding their own personal finances. Staff supervision was discussed and staff supervision is in place. Staff spoken with confirmed that they receive supervision and they found it beneficial. The manager confirmed that all staff are appropriately supervised until they have received the necessary training and induction. All staff have received the mandatory training in moving and handling, health and safety and fire safety and there is evidence of a rolling plan of training that will ensure that staff continue to attend training to update their knowledge. As previously mentioned the accident forms were viewed and need to be audited and action taken as necessary and linked to the residents risk assessments as a preventative measure. It was discussed that expert advice be sought regarding those residents that have recurrent falls. In the main good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. An observed poor practice issue regarding moving and handling was discussed and action taken by the manager during the inspection visit, therefore a requirement was not made at this time. The accessibility of call bells in the small lounge areas was discussed and this was to be actioned by the maintenance manager. Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 X 3 X 2 Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1) Requirement That registered person confirms in writing that having regard to the assessment made on any prospective service user that the home can meet those needs. That the registered person ensures that that the homes medication administration procedures and policies are followed by the staff. That gaps are identified and followed up to ensure residents are receiving their prescribed medication. • That all verbal orders are signed and dated by two members of staff. That the registered person ensures that there are sufficient staff on duty at all times to meet the needs of the residents. This pertains to the evening/night shift where a significant amount of accidents have been recorded. That the registered person ensures that all accidents are followed up and expert advice is DS0000013964.V360288.R01.S.doc Timescale for action 01/05/08 2. OP9 13 (1) 01/05/08 • 3. OP27 18 (1) 01/05/08 4. OP38 12(4) 01/05/08 Blatchington House Version 5.2 Page 25 sought regarding recurrent falls. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Blatchington House DS0000013964.V360288.R01.S.doc Version 5.2 Page 27 - 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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