Care Home: Bloomfield Care Home

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What the care home does well The home has a loyal and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home appear settled and confident in their surroundings and contribute fully to all aspects of daily life in the home. Interactions with staff on duty are friendly and relaxed. Care plans and associated documents are clear, informative and up to date. Effective systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The manager and staff team are working hard to empower people and encouraging them to maintain independence, autonomy and choice. Safe, effective systems of practice are in place in receiving, storing, administering, and disposing of drugs of controlled drugs which will help protect the health and wellbeing of people living in the home. The home promotes a good quality of life and focuses on maintaining and developing skills, enabling people to be as independent as possible. A range of experiences and opportunities are offered, including regular access to community activities, which is both enjoyable, stimulating and meets individual preferences and expectations. People maintain family contact and staff encourage family and friends to join in with activities and any outings. Recruitment procedures have meant that vacancies have been filled with people that are suited to the job with the right skills, this will also help ensure more continuity of care to the people who use the service. The home promotes staffing levels and skill mix of staff in order to help ensure that people`s needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. The home is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas,exceeds the standards. People benefit from a well run home, under the leadership of an effective management team who have suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. The manager must be commended for the excellent AQAA that she provided us. It indicates a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how the home has listened to people that live there. The home demonstrates a high level of self awareness and recognises the areas that it still needs to improve, and has clearly detailed the innovative ways in which they are planning to do this. The service fully recognises the importance of the AQAA and has used the content to form their own quality assurance. What the care home could do better: The service is well organised and managed by an effective, stable management team that promotes the views and interests of all people who use the service. The service has continued to improve following the last inspection in order to maintain their three star excellent rating. All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. We would like to thank everyone who took part in the inspection, their enthusiasm and support was greatly appreciated. Random inspection report Care homes for older people Name: Address: Bloomfield Care Home Salisbury Road Paulton Bath Bath & N E Somerset BS39 7BD three star excellent 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: Wendy Kirby Date: 1 5 0 6 2 0 1 0 Information about the care home Name of care home: Address: Bloomfield Care Home Salisbury Road Paulton Bath Bath & N E Somerset BS39 7BD 01761417748 01761415814 bloomfield@barchester.com www.barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Joyce Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 102 Number of places (if applicable): Under 65 Over 65 0 102 dementia old age, not falling within any other category Conditions of registration: 102 0 The maximum number of service users who can be accommodated is 102 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender 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) - maximum number of places 40 Date of last inspection Care Homes for Older People Page 2 of 12 Brief description of the care home Bloomfield Care Centre is registered for 102 residents requiring nursing or personal care; included within this is a dementia unit for up to 40 residents. The centre was purpose built in this rural location, which can be accessed by car or bus. Accommodation is provided in single rooms; some have en-suite facilities. Recreational space is provided in nine lounge areas and five dining rooms; there is also a hair salon and therapy room. There is a lift to all areas and a meeting/ conference room is also available. There are two gardens, one with an enclosed area with patio and grass for the safe use adjoining the Dementia Care unit. The other adjoins fields with a patio area and a productive greenhouse, which is enjoyed by all residents. Care Homes for Older People Page 3 of 12 What we found: This was a random inspection conducted by one inspector over approximately five hours. In line with the Care Quality Commissions current methodology this random visit was completed instead of a full key inspection. A key inspection reviews all of the key National Minimum Standards. A random inspection is a more focused, targeted visit and no new rating of a service is given. The previous excellent rating awarded for this service in 2007 remains in place at this current time. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The previous inspection report in 2007 where the home received an excellent rating. The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained detailed useful information about what the home considers it does well and what plans they have for further improvements in the coming year. We have used examples from the AQAA in this report to support our own observations during our visit to the home. We sent surveys Have Your Say to people who live in the home and staff. Comments received from the surveys will be referred to throughout this report. During our visit we spoke with people who live in the home, the manager, and staff members who were on duty. Comments received will be referred to throughout this report. We looked at individual care files, which included pre admission assessments, care plans and risk assessments. We spent time in all communal areas of the home and looked at the bedrooms. These are just some of the positive outcomes for people who use this service that we saw during our visit: Pre admission assessments, are comprehensive covering all activities of daily living, a full health screen and personal history background. The information gathered pre admission should provide a sound benchmark of the persons ability, state of health prior to admission and subsequent needs when they move into the home. The AQAA tells us that, Before admission is agreed all prospective residents are assessed by the General Manager, Deputy Matron or Senior Sister to ensure that we are able to meet his or her needs and also to introduce ourselves if we havent had the opportunity to do so and answer any concerns people may have. This assessment is detailed covering Care Homes for Older People Page 4 of 12 all aspects of daily living in addition to social and psychological needs. Completed assessments are given to relevant nurses to familiarise themselves with the resident prior to admission and are held with the care plan. People wishing to live in the home, family and carers are involved in the pre admission assessment wherever possible and all information is used to determine the suitability of the placement. Where possible the manager also obtains comprehensive assessments and care plans from other health and social care professionals involved, for example, social workers and hospital staff. We spoke with the manager and her deputy who clearly demonstrated the importance of pre admission assessments in order to ensure that the home can meet individuals identified needs. Care plans are completed with regards to health and social needs including, psychological, emotional, and cultural needs which demonstrates that the home takes an holistic approach to the provision of care. The plans are person centered, including personal preferences and like and dislikes. Plans tell staff that people have specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. The AQAA tells us, We have introduced Barchester care plan format very successfully and our care plans as a result are more individual. In particular the MUST tool has proven an excellent method of identifying those at risk of losing weight and those who have lost weight. The care plans reflect action plans to closely monitor those who lose weight and to ensure we do our very best to redress this problem. We have worked hard to ensure our evidence of care given is documented consistently at all times and reflect our care at all times. Regular care reviews take place for people living in the home, which can include family members and care staff wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Staff agreed in their surveys that they had up to date information about individuals needs and confirmed that care plans were reviewed at least monthly unless there were any other significant changes. The AQAA tells us that, At Bloomfield Care Centre we maintain the highest standards of care in all respects. We do this by careful and detailed assessment of a residents needs. Standards of care are monitored continuously both on a daily basis by our trained staff and via internal audits such as our weekly documentation and medication checks for compliance and monthly pressure sore reports. All six surveys received from people living in the home said that they always received the care and support they need, that staff are always available when they need them, that staff listen to what they have to say and that they receive all the medical care they need. We spoke with staff who demonstrated good relationships with individuals and were knowledgeable about the care needs of those living in the home. Comments received from people living in the home included, All the staff are friendly and caring, They look after me well and meet all my needs, I am very happy, and There is a friendly, welcoming attitude of the care staff, they show great kindness towards people and show respect. Policies and procedures for receiving, storing, administering and disposing of controlled Care Homes for Older People Page 5 of 12 medications were examined and discussed. All systems in place are very effective, well managed and audited. Bloomfield is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas, exceeds the standards. Lounges and dining rooms are decorated, furnished and carpeted to a very high standard. People were sitting in these rooms throughout and the day, resting peacefully, reading newspapers, and talking amongst friends. There are a number of aids and adaptations throughout the premises to enable physically disabled people to maximise their independence. This includes wide corridors and pathways, passenger lifts, specialised bathing facilities, grab rails, and assisted toilet facilities. We walked around the inside of the home and viewed some of the bedrooms and bathrooms. People had been supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. Rooms have adjustable beds and good quality matching bedroom suites, soft furnishings, lounge chairs, and a small table. The home has a housekeeper and domestic staff seven days a week. The house was spotless throughout. The home actively promotes individuals to exercise choice and control over the lives they choose to live.There does not appear to be any unnecessary rules and daily routines are flexible within the home. We saw evidence that people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed in discussion with individuals and through observation during our visit. The AQAA tells us, We learn as much as possible about our residents to ensure that we provide them with a lifestyle of their choice. All our residents are free to live their lives as they wish. There are no rules here and residents get up when they wish and retire when they wish without pressure from us. The home operates an open door policy for visitors and people are able to see visitors in the privacy of their own rooms and there are several semi private seating areas around the home and in the gardens. The AQAA states, Visitors are welcome at any time and we organise events to which they are invited to promote a lifestyle as near to normality as possible, for example, the opportunity to enjoy each others company at social events and opportunities to socialise in private surroundings are also provided and encourages. The size and layout of the dining rooms makes it possible for everyone to enjoy the social advantages of dining together. The dining rooms were light and spacious with excellent quality dining furniture, soft furnishing and tables were laid attractively. Staff members supported people that required assistance with eating their meals in a respectful sensitive manner. Staff sat at the same level and assisted them without Care Homes for Older People Page 6 of 12 rushing. We saw jugs of juices, beakers and glasses and these were being handed to people whilst waiting for lunch. Later when we visited people in their rooms we saw that jugs of fluid had also been provided for individual use. The AQAA tells us, Barchester has a passion for promoting all aspects of life within a care environment and this is evident in the emphasis placed upon creating a wonderful dining experience. Our residents enjoy an enviable choice of menu with meals of the highest quality prepared using fresh produce wherever possible prepared in our clean and hygienic kitchen. Feedback from residents is always listened to and actioned. Our dining rooms are spacious and well decorated with well presented settings to enrich this aspect of their lives. Wine is freely available on request. The nutritional needs of our residents are monitored closely and the nurses work with our chefs to ensure this. Our enthusiastic catering team are well supported and advised by our Hospitality Support Team. The manager told us that staffing levels are indicative of needs and the level of care required and confirmed that levels of staff would rise should dependency levels increase. We know that the home also increases the levels of staff at certain busy times of the day to ensure that needs are met. People living in the home and staff agreed that there were enough staff to meet their needs. When there have been staff vacancies permanent staff will often cover extra shifts to provide continuity. The AQAA tells us, At Bloomfield Care Centre we enjoy a stable work force. Many of the staff has been employed for several years, particularly at senior level. We ensure that we have adequate numbers of staff on duty at all times and ensure we maintain a good skill mix of trained, senior carers and experienced carers who can then support our less experienced staff. We have a good bank of staff to call upon. We ensure that they are given shifts on a regular basis so as to remain current and updated to our present residents and to our procedures and working practices. As such we have little need to make use of agency staff. We have a designated member of staff who creates our rosters ensuring that the above criteria are met. We further ensure that we endeavour to maintain adequate numbers of staff to cover annual leave and sickness. The manager believes it is paramount to find suitable staff in order to fulfill the roles and responsibilities expected of them. The home is vigilant in taking their time in this process so that they can find the right person for the job where they have the right skills and attitude to look after and care for people. It is hoped that by taking their time and recruiting the right people for the job will help ensure that staff are committed and remain in the home. People are supported and protected by the homes recruitment policy. We know that the home follows a good recruitment procedure. This will help ensure that people living in the home will be further protected. Records contain completed application forms with a full employment history, two or more written references and Criminal Records Bureau (CRB) disclosures. Staff confirmed that relevant checks had been completed before they started working in the home. The home provides the staff at the home with training and development opportunities tailored to individual needs. The manager and all staff are conscientious in attending training relevant to the care needs of the people they are caring for and those relevant to the roles they perform. Staff surveys agreed that training was relevant to their roles, helped them understand the needs of people, keeps them up to date with new ways of Care Homes for Older People Page 7 of 12 working and gives them enough knowledge about health care and medication. Peoples needs and best interests are central to the management approach in the home. The manager demonstrated good effective leadership and management skills that relate to the aims and purpose of the home. After a lot of hard work and commitment the manager and staff are a stable team that are committed to providing quality of care for the benefit of the people in their care. The staff at the home are very committed to the people living in the home and the roles and responsibilities expected of them. They are empowered by the manager to continually monitor and evaluate the services they provide to people. We received very positive feedback from the staff. Comments included, Management do listen to staff and are very helpful, The home supports residents, visitors and staff very well, I feel we have an approachable manager who is always willing to listen and discuss our views and Bloomfield is a lovely caring home, it is well equipped and it is an enjoyable place to work. I am in a good place. What the care home does well: The home has a loyal and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home appear settled and confident in their surroundings and contribute fully to all aspects of daily life in the home. Interactions with staff on duty are friendly and relaxed. Care plans and associated documents are clear, informative and up to date. Effective systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The manager and staff team are working hard to empower people and encouraging them to maintain independence, autonomy and choice. Safe, effective systems of practice are in place in receiving, storing, administering, and disposing of drugs of controlled drugs which will help protect the health and wellbeing of people living in the home. The home promotes a good quality of life and focuses on maintaining and developing skills, enabling people to be as independent as possible. A range of experiences and opportunities are offered, including regular access to community activities, which is both enjoyable, stimulating and meets individual preferences and expectations. People maintain family contact and staff encourage family and friends to join in with activities and any outings. Recruitment procedures have meant that vacancies have been filled with people that are suited to the job with the right skills, this will also help ensure more continuity of care to the people who use the service. The home promotes staffing levels and skill mix of staff in order to help ensure that peoples needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. The home is well maintained, decorated and furbished to a very high standard, providing a safe, homely, peaceful environment for everyone. The home meets, and in some areas, Care Homes for Older People Page 8 of 12 exceeds the standards. People benefit from a well run home, under the leadership of an effective management team who have suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. The manager must be commended for the excellent AQAA that she provided us. It indicates a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how the home has listened to people that live there. The home demonstrates a high level of self awareness and recognises the areas that it still needs to improve, and has clearly detailed the innovative ways in which they are planning to do this. The service fully recognises the importance of the AQAA and has used the content to form their own quality assurance. What they could do better: 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 9 of 12 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 10 of 12 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 11 of 12 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. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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