Care Home: Blenheim Court Nursing Home

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What the care home does well People who use the service`s needs were known to the service prior to admission because at least the manager`s assessments and sometimes the care management assessments were in place. These two assessments ensured that the service have sufficient information. People who use the service benefit from the provision of accurate care plans and were very satisfied with the care and service being delivered.People who use the service and relatives expressed their views, during the inspection; `The care is good`. `Its nice here they look after us very well`. `This one (the service) was by far the best, and would be pleased to come in themselves (relatives) as residents`. `I have never been happier in my whole life`. `This place saved my life, when I came in I was nearly dead, I love it here`. Activities were well organised and people who use the service were able to exercise their rights of choice with the service, therefore this will provide stimulation and enhance their quality of life. The general comments regarding the activities were that; `We enjoy playing our weekly bingo`. `We do all sorts of things, she (activities co-ordinator) is very good`. `The activities are very good`. The manager advised that the service had a `resident`s meeting` and this was a very vocal and active forum. The activities co-ordinator chaired the meeting and took the minutes. The minutes were displayed on the notice board. On reading the minutes, it was clear that the people who use the service led the meeting and several people had had the opportunity to express their views. The general comments regarding the food were that; `The food is very good`. `We can choose what we want.` `The meals are all right`. `The food is good`. People who use the service live in an environment that had been maintained to a good standard to provide a safe, well-maintained environment. The general comments were that; `The home is good`. `I`m comfortable here`. `Its clean and well maintained`. The manager provided evidence that staff had received training, which did reflect on the quality of care being delivered to the people who use the service. The staff recruitment process should provide protection for the people who use the service. An experienced registered manager is in post. This will contributed to the effective organisation and operation of the service.Blenheim Court Nursing HomeDS0000021770.V355789.R01.S.docVersion 5.2Page 7Extensive quality assurance systems were in place that should assist the managers and company to measure the service against expected outcomes. It was recognised that the service was situated in an older building, which creates some problems, for example the layout. However despite this fact there was a clear commitment from the manager and staff to work as a team for the benefit of the people who use the service and the people who use the service who exercised their rights by actively leading their own meetings. This created a warm, friendly and caring atmosphere within the service, which had positive outcomes for people who use the service and was clearly recognised and enjoyed by these people. The expert by experience`s summary was that: Blenheim Court had a good number of staff working on the day of the inspection, the staff and the people who use the service appeared to be happy in their own particular environment, and she came away feeling positive. What has improved since the last inspection? There had been positive action on the requirements listed within the last inspection report. All requirements had been acted upon and resolved. What the care home could do better: Whilst it is accepted that the service undertakes its own assessments of people who may wish to use the service, the service should encourage the Social Services to send their assessments prior to admission. All staff could contribute to completing the activities records. The service should continue to plan and maintain the environment, and monitor the actions of staff, who indirectly cause damage to it. CARE HOMES FOR OLDER PEOPLE Blenheim Court Nursing Home Elm Lane Sheffield South Yorkshire S5 7TW Lead Inspector Mr Ivan Barker Unannounced Inspection 15th January 2008 10:00 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 Blenheim Court Nursing Home DS0000021770.V355789.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. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blenheim Court Nursing Home Address Elm Lane Sheffield South Yorkshire S5 7TW 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) 0114 245 6026 0114 257 7016 blenheimcourt@schealthcare.co.uk Southern Cross Care Homes Limited Post Vacant Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To allow 3 beds for service users aged 55 years and over Date of last inspection 26th February 2007 Brief Description of the Service: Blenheim Court is a nursing home providing care and accommodation for 44 older people. The home is a two-storey building with lift access to the upper level. The home is accessible for wheelchair users. The home has both single and double accommodation. The home is split into two wings consisting of the original building and an extension. The homes gardens are accessible to wheelchair users and there is a patio with seating area. The home is a short distance to local amenities such as shops, pubs and churches. Copies of the last Commission For Social Care Inspection report were kept in the entrance for service users and their families to read. The weekly fees currently charged range from: £356 to £456. This information was provided on the 15th January 2008. Blenheim Court Nursing Home DS0000021770.V355789.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 that the people who use this service experience good quality outcomes. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the ‘key standards’), and the previous requirements. The person present at the inspection was: Julie Wright, manager. Within this site visit, which occurred over a six hour period, the inspector toured the building, examined requirements relating to the previous inspection, case tracked 3 service users (Case tracked means looking at the care and service provided to specific people who use the service living at the home; checking records relating to their health and welfare, care plans and other records; by talking to the specific people who use the service; viewing their personal accommodation as well as communal living areas), and spoke with other people who use the service , and relatives and also 3 staff and examined assessments, care plans, risk assessments, menus, complaint files, staff files and quality monitoring documents. An expert by experience also spoke with people who use the service, relatives and staff and made her own observations of the service. The history of the service was examined prior to the site visit. This included the Self-assessment document, telephone contacts, letters, and notifications. The manager position listed as vacant in a previous page of this report is because the process of registration was still on going when this template was produced. What the service does well: People who use the service’s needs were known to the service prior to admission because at least the manager’s assessments and sometimes the care management assessments were in place. These two assessments ensured that the service have sufficient information. People who use the service benefit from the provision of accurate care plans and were very satisfied with the care and service being delivered. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 6 People who use the service and relatives expressed their views, during the inspection; ‘The care is good’. ‘Its nice here they look after us very well’. ‘This one (the service) was by far the best, and would be pleased to come in themselves (relatives) as residents’. ‘I have never been happier in my whole life’. ‘This place saved my life, when I came in I was nearly dead, I love it here’. Activities were well organised and people who use the service were able to exercise their rights of choice with the service, therefore this will provide stimulation and enhance their quality of life. The general comments regarding the activities were that; ‘We enjoy playing our weekly bingo’. ‘We do all sorts of things, she (activities co-ordinator) is very good’. ‘The activities are very good’. The manager advised that the service had a ‘resident’s meeting’ and this was a very vocal and active forum. The activities co-ordinator chaired the meeting and took the minutes. The minutes were displayed on the notice board. On reading the minutes, it was clear that the people who use the service led the meeting and several people had had the opportunity to express their views. The general comments regarding the food were that; ‘The food is very good’. ‘We can choose what we want.’ ‘The meals are all right’. ‘The food is good’. People who use the service live in an environment that had been maintained to a good standard to provide a safe, well-maintained environment. The general comments were that; ‘The home is good’. ‘I’m comfortable here’. ‘Its clean and well maintained’. The manager provided evidence that staff had received training, which did reflect on the quality of care being delivered to the people who use the service. The staff recruitment process should provide protection for the people who use the service. An experienced registered manager is in post. This will contributed to the effective organisation and operation of the service. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 7 Extensive quality assurance systems were in place that should assist the managers and company to measure the service against expected outcomes. It was recognised that the service was situated in an older building, which creates some problems, for example the layout. However despite this fact there was a clear commitment from the manager and staff to work as a team for the benefit of the people who use the service and the people who use the service who exercised their rights by actively leading their own meetings. This created a warm, friendly and caring atmosphere within the service, which had positive outcomes for people who use the service and was clearly recognised and enjoyed by these people. The expert by experience’s summary was that: Blenheim Court had a good number of staff working on the day of the inspection, the staff and the people who use the service appeared to be happy in their own particular environment, and she came away feeling positive. 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. Blenheim Court Nursing Home DS0000021770.V355789.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 Blenheim Court Nursing Home DS0000021770.V355789.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): Standards 3 and 6. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service’s needs were known to the service prior to admission because at least the manager’s assessments and sometimes the care management assessments were in place. These two assessments ensured that the service have sufficient information. EVIDENCE: On examination of the care management assessments within three care plans, it was established that there were assessments from care management. The manager advised that the care management assessments arrived by fax or by post. However these assessments were not always received prior to the assessment undertaken by the managers of the service or by the person’s admission to the home. It was discussed that the manager should raise this lack of assessments with the Social Services, as will the Commission for Social Care Inspection. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 10 The manager or deputy manager undertook assessments prior to the admission of any persons who wished to use the service. The assessments were comprehensive and detailed the people who use the service’s needs which would assist in providing sufficient information for the staff to decide if the service could met the person’s needs and provided sufficient information for care plans to be drawn up. The manager advised that intermediate care was not provided within the service. Blenheim Court Nursing Home DS0000021770.V355789.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): Standards 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from the provision of accurate care plans and were satisfied with the care and service being delivered. EVIDENCE: On examination of the care plans, from three people who use the service, it was established that all three care plans were up to date. There were daily entries within the care plans. These entries recorded the care delivered on a daily basis, and the plans had been evaluated on a monthly basis. Comprehensive risk assessments were included within the documentation and included moving and handling, nutritional, skin integrity, and other risk factors. These risk assessments had also been reviewed. There was evidence in the care plans that 6 monthly care reviews of the care did take place. This care review consisted of the person who used the service, Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 12 the relatives and a representative from the service. Within the review the person who used the service, and their relative could express their views on the care over the last 6 months and their expectations for the future care and service provision. These reviews were in addition to the reviews by Social Services. This good practice will allow people to express their views, and for all parties to be involved in the care and help to resolve any issues. People who use the service and relatives expressed their views, during the inspection: ‘The care is good’. ‘Its nice here they look after us very well’. The expert by experience’s views and observations were; She spoke to 3 relatives, and without exception they all could not speak highly enough of the standard of care their parents were receiving, and they said they had no problems whatever. They also said “they had experience of care homes with other members of the family, and this one was by far the best, and would be pleased to come in themselves, as residents”. The storage, ordering, administration and disposal of medication procedures were discussed with the manager. The procedures explained by the manager were satisfactory. There was a signature-checking document, which contained the initials as written on the medication administration document and the member of staff’s signature. On examination of the medication administration records it was found that there were no omissions of signatures. All medication records had been signed when being checked in from the pharmacy. Within the small storage room where the drug trolleys were stored, it was observed that the action of chaining the trolleys to the walls was causing a considerable amount of damage. The room was secured with a 5 lever lock with anti saw mechanism, because of the fact that the room had this high level of security when locked, it was agreed that the trolleys do not need to be fastened on the chains. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities were well organised and people who use the service were able to exercise their rights of choice with the service, therefore this will provide stimulation and enhance their quality of life. EVIDENCE: The manager advised that an activities co-ordinator was in post and employed for 30 hours per week. There was a programme of generalised planned social events displayed and included activities within the service and outings. The manager provided evidence, relating to activities from the documentation within the file kept by the activities co-ordinator. These records showed when a person who used the service had participated in an activity or went out into the community. It was agreed that the information within the recording sheets was often sparse and did not reflect all the activities that occurred. It was discussed Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 14 and agreed that the activities sheet was not just the responsibility of the activities co-ordinator to complete, but for all care staff. The manager accepted this point and agreed to raise this point at the next staff meeting. On discussing the activities with the people who use the service, and relatives their opinions were that; ‘We enjoy playing our weekly bingo’. ‘We do all sorts of things, she (activities co-ordinator) is very good’. ‘The activities are very good’. The expert by experience’s views and observations were that: She was very impressed with the activities arranged for the people who use the service by the activities co-ordinator. In the dining room there was a group of women making Easter cards, materials were widely available to them, and they looked to be enjoying themselves immensely. They were very anxious to show her other projects they had been involved in; these included making collages, decorating fans and numerous other attractive items. They went on to tell her about other events organised by the co-ordinator including Bingo, music quizzes, dominoes, draughts, films and singers coming in to entertain. One woman working at the table told her, “I have never been happier in my whole life”; another said, “This place saved my life, when I came in I was nearly dead, I love it here”. At the last inspection there was a requirement to serve hot food. New breakfast bars with accessible electrical points have been created, so that hot food may be served from these points. Regarding the meals, the manager advised that the meal order was taken the previous day. Copies of these were observed in the kitchen. The general comments regarding the food were that; ‘The food is very good’. ‘We can choose what we want.’ The expert by experience’s views and observations were; The meals appear to be well balanced nutritionally, there was a choice of meals at lunch-time, on the day of the inspection there was beef curry or mince beef pie, in the dining room it would appear that the pie was more popular, and it looked very appetising, served with garden peas, mashed potatoes and gravy. People who use the service did have the option of having gravy served on their Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 15 lunch, and some did ask for no potato, and their request was seen to. There was a two weekly rota of menus, and these were displayed on the notice board, with individual daily menus on display in the dining room. Also on the notice board there was a nutritional values graph of the meals. In the two dining rooms, the tables were set with tablecloths and paper serviettes, with artificial flowers on each table. Sugar-free orange was served in plastic tumblers. She noticed a relative was in the dining room feeding a person who used the service, she understand it was his mother, who was very frail and he was giving her a mixture of liquidised food. He appeared to feel quite at ease doing this. Summing up the meal times, the staff were very helpful serving the people who use the service, and they did treat them with the dignity that they deserve. One person commented, “the meals are all right” whilst another said “food is good”. The manager advised that the service had a ‘resident’s meeting’ and this was a very vocal and active forum. The activities co-ordinator chaired the meeting and took the minutes. The minutes were displayed on the notice board. On reading the minutes, it was clear that the people who use the service led the meeting and several people had the opportunity to express their views. The manager explained that any of the people who use the service could attend the meetings and feedback from the meeting was given to her. She also advised that the people who use the service decide who would be ‘invited’ to attend the next meeting. At the last meeting the cook had been ‘invited’. At the next meeting the manager had been ‘invited’. She also advised that it had come out of the meeting that the people who use the service had requested that a large screen be provided for a ‘cinema’ affect and a bar, and these request were currently being explored and hopefully introduced within the next few months. Blenheim Court Nursing Home DS0000021770.V355789.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): Standards 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service had a complaints procedure and it was operating according to the company policy, this provided confidence that complaints were taken seriously and acted upon to address any shortfalls in care or service provision. Safeguarding adults training made aware of their responsibility regarding the protection of vulnerable adults. EVIDENCE: The service had a complaints procedure displayed at the entrance. People who use the service and relative were aware of its location. Copies were also available in the Service User Guide. The complaints file kept by the manager for her investigations was examined. There were two complaints since February 2007, which had been investigated by the company. One was relating to a care issue, the other regarding staff training. Both had been resolved. Regarding safeguarding adults, the safeguarding policies and procedures were available to the staff. Staff had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Blenheim Court Nursing Home DS0000021770.V355789.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): Standards 19 and 26. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in an environment that had been maintained to a good standard to provide a safe, well-maintained environment. EVIDENCE: On touring the building, the home was found to be clean, tidy, generally well maintained and decorated and furbished to a good standard, except for Room 7, which had a damaged wall at the entrance to the room. On observing the practice of the staff and in discussion with the manager, it was established because this room was close to a lounge, staff were using the room as a storage area for wheelchairs. It was the wheelchairs scrapping along the wall, which had caused the damage. Of particular concern was that a person who used the service resided permanently in this room and remained in bed at all Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 18 times, and staff had to squeeze passed the wheelchairs to deliver care to this person. The manager advised that she had recognised this as a problem and a wheelchair storage area was being created this weekend, to alleviate the problem. This was confirmed from discussions with the handyman who had already got some of the material to create the storage. Also numerous areas of the home had minor damaged areas at the base of the doors and doorframes. It was agreed that this was again was possibly caused by wheelchairs, so following redecoration, the fitting of ‘protectors’ might help in reducing some of the damage. The corridor floor on the upper floor within the ‘extension’ and an adjacent bathroom floor had problems with the floorboards, which created a ‘bouncing’ affect, which created an unstable floor on which to walk. The carpet to the corridor was also considerably stained. The manager advised that the floors were to be re-boarded on Friday 18th and Saturday 19th, and new floor covering was to be fitted to the corridor and the bathroom on Monday 21st January. The manager produced an environment refurbishment programme, which was part of her quality audit. All the areas identified within this report were scheduled within the document. Also additional works, which had not been identified as requiring attention, but deemed not to be up to the standard expected by the manager / company was recorded. This clearly demonstrated that the manager / company were aware of the areas requiring refurbishment and had identified these areas and when they were to receive attention as part of the on going refurbishment programme. The manager also advised that had the inspection been one week later then a lot of the refurbishment would have been finished. On examination of the programme it was discussed and agreed that Room 7 should be more of a priority then other areas, within the programme. The manager agreed to review the programme. Positive comments were received from the people who use the service and the relatives regarding the home. The general comments were that; ‘The home is good’. ‘I’m comfortable here’. ‘Its clean and well maintained’. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 19 The people who use the service’s rooms had been personalised and many contained photographs, personal belongings and items of furniture, which the individual or the family had provided. It was recognised that the service was a converted older building with an extension and that the building, did need constant work to maintain it to the required standard. However since the inspection, but prior to the completion of this report the manager contacted us and informed us, in an email, that the work regarding the corridors, bathroom, Room 7 and wheelchair storage had been completed as planned. In view of the fact that there was evidence at the inspection that the work was scheduled and there has been confirmation that the work had been completed then no requirement relating to the environment was listed. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provided evidence that staff had received training, which did reflect on the quality of care being delivered to the people who use the service. The staff recruitment process should provide protection for the people who use the service. EVIDENCE: On examination of the staff rotas and examination of staff on duty, the following was established. Am shift Pm shift Night shift Plus. A manager, a deputy manager, who had 12 hours supernumerary hours, an administrator and an activities co-ordinator. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 21 2 qualified nurses and 7 care staff. 2 qualified nurses and 6 care staff 1 qualified nurse and 4 care staff. Ancillary staff included; domestics, and catering staff. Caring for a present occupancy of 41 people who use the service. A full assessment of the dependency levels of the people who use the service was not undertaken and compared with the indicated staffing levels. However on discussing the dependency of the people who use the service, with the manager, she identified that she did have flexibility within her budget to provide extra staff on a shift to meet the extra needs of the people who use the service should this be needed. On examination of the three staff files, all contained the required documentation, including Criminal Records Bureau and POVA (Protection of Vulnerable Adults) checks. One of the staff files monitored was from a member of staff from ‘overseas’. All relevant documentation had been obtained regarding the member of staff. On examination of the staff training records there were records that indicated the staff had received moving and handling, fire training and other relevant clinical training. The comments from people who use the service and relatives were; ‘The staff are good’. ‘I like the staff’. ‘Very good’. The care staff were commended by several people who use the service for the care they delivered and particular individuals who were praised were, the manager and the activities co-ordinator. The expert by experience’s views and observations were; One member of staff commented, “this was the best home so far, that he had worked in”, and went on to say, “that the training was good and the team click together”. Another member of staff said she had been working here for a few years, and “if there were any problems she would go to the manager or the deputy manager and it would be sorted if they could”. On watching the staff transferring a person in the lounge into a wheelchair, with a hoist, to take her into the dining room, this was done with sensitivity and with care. She also noticed staff knocked on doors before entering a bedroom or bathroom. Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 22 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): Standards 31,33,35 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An experienced registered manager is in post. This will contributed to the effective organisation and operation of the service. Extensive quality assurance systems were in place that should assist the managers and company to measure the service against expected outcomes. EVIDENCE: The manager advised that she had been in post for 8 months and had been the deputy manager prior to her appointment. She had 20 years experience in care and 7 years in management. She had undertaken the ‘fit person’ process in Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 23 January 08 and was now the registered manager. She had completed the Registered Managers Award in December 2007. Regarding service users’ monies there was a credit and debit system in operation. The people who use the service’s records were maintained on computerised system. Regarding Quality Assurance, the manager and operations manager undertake the quality monitoring of the service. The system was robust and included analysis of the care and service provision. Clearly the system was working as issues raised by the managers’ analysis were acted upon and resolved. The information from these documents was forwarded to the head office of the company for analysis. Regulation 26 documentations, which are a record of the registered person’s monthly visits, was complied on a monthly basis, evidence of this was seen at the visit. Regulation 37 notices, which are documents that are sent to the Commission regarding untoward occurrences, including falls, accidents etc; have been received by CSCI (Commission for Social Care Inspection). Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 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 4 13 3 14 4 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 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 Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Blenheim Court Nursing Home DS0000021770.V355789.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Blenheim Court Nursing Home DS0000021770.V355789.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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