Care Home: Blenheim Care Home

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What the care home does well Residents and relatives told us they were happy with the care provided and considered that the staff were "welcoming", "caring", "very pleasant" and "showed compassion". One resident said "The staff are very nice". Another resident told us "All staff are in tune with my needs and very caring and sensitive". Relatives said that they were kept informed if the resident had an accident or was not well. Residents had access to a range of activities and outings. It was very positive that the activity coordinator hours were being increased further to enable more regular sessions with individual residents. The gardens had been improved with a new decking area and large planters for residents who liked to garden. Residents told us that they enjoyed the meals and were given choices at every meal. One resident said "Mr Hughes is a very good manager. He`s a caring person". A relative told us "The home is well run. Staff are always very welcoming and they look after them well". What the care home could do better: Residents and relatives told us that they would like fewer agency staff to improve continuity of care. Action was being taken to recruit new staff and to ensure that, where possible, there was a balance between the permanent care staff and agency staff. Additional support and training was being given in care documentation and this needed tobe monitored to ensure that the records were kept up to date. Staff were liaising with the GPs to ensure that all medicines given "as required" had clear instructions for administration and where appropriate a care plan. Random inspection report Care homes for older people Name: Address: Blenheim Care Home 39-41 Kirby Road Walton On Naze Essex CO14 8QT two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Francesca Halliday Date: 1 2 0 5 2 0 1 0 Information about the care home Name of care home: Address: Blenheim Care Home 39-41 Kirby Road Walton On Naze Essex CO14 8QT 01255675548 01255851360 Telephone number: Fax number: Email address: Provider web address: www.regalcarehomes.com Name of registered provider(s): Name of registered manager (if applicable) Mr Raymond Hughes Type of registration: Number of places registered: Conditions of registration: Category(ies) : Regal Care Homes (WON) Ltd care home 57 Number of places (if applicable): Under 65 Over 65 0 57 dementia old age, not falling within any other category Conditions of registration: 57 0 The maximum number of service users who can be accommodated is 57 The registered person may provide the following categories of service only: Care Home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE Date of last inspection Brief description of the care home Blenheim House is situated in a residential area of Walton-on-the-Naze and is close to the town centre and the beach. There are local shops and amenities close Care Homes for Older People Page 2 of 10 Brief description of the care home by. Accommodation is offered on three floors accessed by conventional stairs or by passenger lifts. The home has a range of communal areas and there is a large garden to the rear of the building. There are 51 single bedrooms, some with en suite facilities and 3 double rooms, all with en suite facilities. The weekly fees charged by the home were from £393.90 to £550 at the time of this random inspection in May 2010. Information about the services provided by Blenheim House is contained in the homes Statement of Purpose, Residents Guide and newsletter. Care Homes for Older People Page 3 of 10 What we found: The registered manager was on leave at the time of this unannounced inspection on 12th May 2010 but had provided us with information about the home in the annual quality assurance assessment (AQAA). The manager from Blenheims sister home visited the home during the inspection and provided us with additional information. During the inspection we had chats of various lengths with four residents and four members of staff. We sent out surveys prior to the inspection and we received eight from residents (some with the assistance of relatives) and five from staff. Comments from the surveys and conversations have been included in the report where appropriate. The home had 52 residents at the time of inspection, the majority of whom had dementia. Residents and relatives who completed our survey told us that the residents always or usually received the medical care they needed. Staff confirmed that they received good support from the local GP practices and the community nurses. A resident told us Staff arrange for me to see the GP when I need to. Residents told us that they saw the chiropodist on a regular basis and that staff arranged for them to have an optical and dental check when needed. Residents were being weighed on a monthly basis but it was not easy to track individual residents weight as the information had not always been transferred to their individual weight and follow up record. The home had the benefit of a physiotherapist once a week to assist residents with mobility problems and advise staff. Residents and relatives who completed our survey told us that residents always or usually received the care and support they needed. We looked at the care documentation for four residents. The pre-admission assessments covered residents physical and mental health needs and contained sufficient detail to assess whether the home could meet their needs. Two residents had not had any risk assessments carried out or care plans drawn up despite the fact that one had been admitted six weeks previously and one three weeks previously. Both residents had dementia. One of them had periods of challenging behaviour and the other resident had a recent insertion of a suprapubic catheter and a pressure sore that they acquired in hospital. Staff started to draw up the care plans and assessments for these two residents during the inspection. The home used computer generated care plans but needed to ensure that they were amended to reflect residents needs, wishes and abilities and did not contain items unrelated to the individual resident. Some care plans we looked at had not been updated to reflect residents current condition. One residents plan stated I can take myself to the toilet when they were no longer able to weight bear and required the hoist for all moving and handling. The plan for the care of another residents stoma was written as if they had faecal incontinence, it did not identify how staff cared for the stoma or how their diet had changed since the operation. Care plans were reviewed on a monthly basis but frequently stated no change to care plan rather than an evaluation of the residents care and care needs and whether they were still being met by the current care plan. Risk assessments were not used consistently so that risks could be identified and minimised where possible. This was an area that needed to be developed. The manager from the sister home said that they would hold a staff meeting and provide care documentation training after the inspection. We looked at the systems for medication administration. The medication administration Care Homes for Older People Page 4 of 10 records were well completed with only very occasional signatures missing. The controlled drugs (CDs) balances were correct and they were being stored and recorded appropriately. Staff were monitoring the temperatures of the room where medicines were stored and the medicines fridge on a daily basis and they were both within the safe range. There were a number of medicines that had been prescribed by the GPs to be given as required. However, on the majority of records we looked at they did not have instructions as to how staff should administer them. Staff had not completed care plans for the actions to take, if residents became agitated or had challenging behaviour, prior to administering sedatives and anti-psychotic medication. Staff said that they would contact the GPs immediately and ask them to revise the prescriptions and the manager of the sister home said that they would ensure that the appropriate care plans were written in relation to residents medication. The home had two part time activity coordinators for a total of thirty hours and were in the process of recruiting for another fourteen hours. Residents told us that they took part in activities when and if they wished. They said that activities included quizzes, bingo, crafts, and music and singalongs. There was a service in the home once a week and one resident went out to the local church. Chair aerobics with music was held once a month. There were two big raised planters in the garden that were going to be planted up by residents. Residents enjoyed the fact that the hairdresser brought in their small dogs when they visited the home twice a week. The dogs remained in the hairdressing salon so that residents could enjoy them during their appointment. The manager told us in the AQAA that he held quarterly residents committee meetings and that they usually discussed meals and activities. The home aimed to have an outside entertainer every month and shared the costs with their sister home. The activity coordinators arranged outings when the weather was warm, for example visits to the fish and chip shop at Brightlingsea and picnics on the beach. A country and western party was due to be held with their sister home at a local church hall and a barbecue was being arranged in the summer. The activity coordinators also spent one to one time time with residents who wished to remain in their rooms and preferred not to join in activities. The majority of residents and relatives who responded to our survey told us that the home usually arranged activities that residents could take part in. Residents we spoke with told us that the food was good and that that they were offered choices at every meal. A resident told us that staff were aware of their dietary needs. The home had a complaints procedure. Residents and relatives who responded to our survey told us that they knew who to speak to if they had any concerns and the majority knew how to make a formal complaint. We had received no complaints about the home since the last inspection. Staff said that they knew what to do if someone had concerns about the home. The home had a safeguarding vulnerable adults and a whistle blowing policy. Staff received safeguarding training. There had been three safeguarding alerts since the last inspection in August 2007. One was not upheld and appropriate action was taken in the other two cases. One resident told us I havent had to raise any concerns. I feel very safe in the home. Staff told us that they had training that was relevant to their role, helped them to understand and meet residents individual needs and kept them up to date with new ways of working. Prior to the inspection a number of overseas staff had their hours reduced due to issues relating to the hours they were able to work on student visas. Agency staff were being employed to cover the additional hours required. On the day of inspection the home had a team leader, two care staff and four agency staff on duty. One resident we Care Homes for Older People Page 5 of 10 spoke with told us I dont like the agency staff because they dont know what you want . They treat you as if you have dementia. (This resident did not have dementia). Another resident told us They could do with more staff sometimes. The manager from the sister home told us that they had revised the duty rotas so that no more than two agency staff were on duty at any one time. They also confirmed that they were currently recruiting additional staff and hoped to be appointing new staff soon. Residents and relatives told us that staff were always or usually available when residents needed them. We inspected parts of the premises. The home was clean and there were no unpleasant odours in the areas we looked at. The majority of residents and relatives told us that the home was usually fresh and clean. Residents rooms were generally homely and personalised with their own belongings. The home was installing liquid soap and paper hand towel dispensers in all residents rooms to enable staff to carry our appropriate infection control procedures. Some of the rooms needed the paint touched up or parts of the room repainted. One relative told us that the maintenance of the home could be improved as the window in one residents room required attention or renewing. Staff told us that a number of the older windows were being replaced in the near future. The manager from the sister home said that they had a new maintenance person who was being given a rolling programme of redecoration to do. The home had a secure garden for residents use and there were tables, chairs and parasols for use in good weather. Residents and relatives told us that the home was well run. The manager had an open door policy and there was evidence that he made changes and improvements to the home as a result of feedback and comments from residents and relatives. The manager carried out a range of audits on a regular basis in order to monitor standards in the home. We looked at the responses from the last survey carried out by the home and the responses were very positive. One relative said The staff are always friendly and helpful. The residents have an excellent diet and staff ensure that they also have an excellent fluid intake. What the care home does well: What they could do better: Residents and relatives told us that they would like fewer agency staff to improve continuity of care. Action was being taken to recruit new staff and to ensure that, where possible, there was a balance between the permanent care staff and agency staff. Additional support and training was being given in care documentation and this needed to Care Homes for Older People Page 6 of 10 be monitored to ensure that the records were kept up to date. Staff were liaising with the GPs to ensure that all medicines given as required had clear instructions for administration and where appropriate a care plan. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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