Care Home: Blyton Court

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What the care home does well The care home offers a comfortable environment. The home is well maintained. Staffing levels ensure that the needs of residents are met. Staff, feel supported by the homes managers. Residents feel staff are well-trained and are confident that their individual needs are being met by the care home. What has improved since the last inspection? Care records have been reviewed and new systems put in place. These have greatly improved the quality of recording and detail of the information available to staff. The opportunities for staff to take specialised training, has been increased. What the care home could do better: The service continues to provide excelent suport to the people who use the service. we did not identify any need for inprovements at our visit. The registered manager stated that she continue to monitor and review through the QA procedures of the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Blyton Court 3 Laughton Road Blyton Nr Gainsborough Lincs DN21 3LG     The quality rating for this care home is:   three star excellent service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ken Hague     Date: 1 1 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Blyton Court 3 Laughton Road Blyton Nr Gainsborough Lincs DN21 3LG 01427628791 01427628377 blyton.court@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Health & Care Services (UK) Ltd Name of registered manager (if applicable) Miss Anne Jackson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Blyton Court is a two-storey country house with a purpose-built extension. It is situated in the village of Blyton. The village amenities include a post office, village shop, two pubs, a pottery, a Garden Centre and an Ice Cream Parlour, very popular with residents and staff. The village is on a main bus route from Gainsborough to Scunthorpe, with buses stopping right outside the home. Blyton Court provides personal and nursing care for up to twenty-four people of both sexes, from the age of eighteen years, who have a learning disability. There is no upper age limit. The home is currently fully occupied. The accommodation has two units, known as the `House? and the `Court?. It is made up of ten single bedrooms, two of which are ensuite, and eight double bedrooms. The original house accommodates seven residents, the Care Homes for Adults (18-65 years) Page 4 of 27 care home 24 Over 65 0 0 23 1 Brief description of the care home remaining living in the Court. All bedrooms overlook either the garden or the enclosed patio area. The home has its own minibus to enable residents to participate in recreational and leisure activities within the local community and outside the village. Many varied activities are also provided within the home. The home stands in its own grounds. The gardens to the rear and side of the home are well-maintained to provide a tranquil and interesting outdoor area. There is car parking for about twelve staff and visitors at the back of the building. The philosophy of the home is to provide a safe and therapeutic environment for the people who live there. The manager and staff aim to promote independence and ensure the residents? privacy and dignity is maintained. The home has achieved the Investors? in People Award for providing a high quality of care and environment. Fees range from #750 to #900 per week. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means that the people who use the service receive Excelent outcomes. This key inspection was announced any previous information held by the Commission for Social Care Inspection about the home was taken into account. The Commission for Social Care Inspection was replaced from 1st April 2009 by the Care Quality Commission who have published this report. Throughout this report the terms we and us refer to the Care Quality Commission. Before the visit the provider had returned an Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are Care Homes for Adults (18-65 years) Page 6 of 27 meeting standards and their plans for improvement over the next 12 months. We also sent out surveys to residents of which one was returned in time to be included within this report. This was completed by a relative. The residents at present in the home do not communicate in writing. Verbal communication is limited therefore observations had to be used rather than direct communications with individual residents. What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. New residents receive a full comprehensive assessment before being admitted to the care home. The home then confirms in writing to new residents that their needs can be met by the resources of the home. Evidence: The files of three residents were studied they all contained a detailed initial assessment which was well structured and identified the needs of each resident. This assessment had been completed prior to the resident being admitted to the home. All assessments were completed on the same internal documents. Care files were indexed the assessment filed in the same area within each residents care records. The assessments identified social needs and care needs. A detailed risk assessment have been completed for each resident where a risk have been identified the management of that risk was found on both the assessment and the initial care plan. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: All assessments were personalised. Residents needs were recorded in great detail. This included input from the family and the resident. In the sample of assessments viewed there was information obtained from the community health care services and local social services teams. Assessments described the residents wishes in respect of the manner in which they wished help to be provided. Assessments were signed and dated by the assessor and the individual resident or a member of their family. The quality of the records substantiated that the staff carrying out the assessments are well-qualified and skilled in obtaining all information required to ensure the needs of residents are identified and met. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have updated comprehensive care plans. Medication is being administered and stored safely. Staff ensure that the dignity and privacy of residents is maintained Evidence: The care plans for three residents were sampled. Each individual residents file contained a current care plan which had been reviewed every four weeks. Staff stated that they use this plan as a working document. The initial care plan included information obtained at the initial assessment. Care plans contained the social need, personal care needs, and included the wishes of each resident in respect of social activities. The manner in which residents preferred personal care to be provided was recorded. Care plans instruct staff how to meet safely the personal needs of each resident. They give guidance how each task should be carried out and included instructions how staff could ensure that the safety dignity and privacy of the residents is maintained. The equipment and the number of staff required to complete each task safely were found detailed within care plans. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Care records were filed in a consistent manner with a common index inserted at the front of each residents file. Care plans were signed by the resident or a family member and the assessing officer. The information stored within care files enables you to understand very quickly the needs of each individual resident. Care plans described in detail the residents individual needs including their wishes and goals for the future. The registered manager stated personal care plans are discussed with residents and family members and with multi -discipline teams which support the home. They contained the medical history and the current medication being taken by each resident. No residents were self medicating on the day of the site visit. Risk assessments have been carried out which demonstrated that this would be unsafe practice. Each residents care plan contained a description of the choice of activities for each resident. Any allergies or special dietary needs were recorded on the current care plan. The home has an updated medication procedure for the safe administration and storage of medication. Staff confirmed that they had been trained in the administration and storage of medication. No evidence was found in respect of the maladministration of medication at the site visit. There have been no notifications received by the Care Quality Commission in respect of mal-administration of medication. The last pharmacy report was a positive one and contained no recommendations. Staff, were observed to provide care in a sensitive manner. Communications were seen at times to be difficult but staff took time and displayed great patients when communicating with individual residents. Staff, were observed to make sure that the privacy and dignity of residents was maintained. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents, enjoy a diet, and the range of activities that suits their needs and wishes. They benefit from being able to maintain links with local community Evidence: The registered manager stated that each resident has a specific an individual need for stimulation and social activities. The care plans guide staff, how to ensure that social stimulation is provided to all residents. The bulk of activities take place within the care home although some residents to go out into the community for social activities. All residents are taken into the community for organised outings. The AQAA sets out a list of activities offered to all residents. However the individual assessment and care plan specifically looks at these activities taken into account the individual resident skills and abilities and their personal choices in wishes. Staff stated we make sure that every Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: individual resident is provided with social stimulation. They described the choices and wishes of the residents being case tracked and how these were being met by the resources of the care home. The menu which offers choice to all residents while meeting their individual dietary needs as identified in their care plan. The likes and dislikes of residents are recorded on care plans. Staff were able to discuss the dietary needs of the residents been case tracked. The registered manager and staff stated that visitors are free to visit at any reasonable time. Staff and the registered manager stated that they work hard to ensure residents maintain links with their own family and the community. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health care needs are met in the way they personally choose to receive help. The updated medication policy in the care home has been followed. Evidence: The home is supported by multi agency teams within the community health care services and local social services. Details are recorded on individual care records of visits by healthcare professionals and social workers. Residents visit opticians and dentists in the community wherever possible. Individual residents records demonstrated visits by GP and district nurses and CPN. Hospital appointments to see consultants are recorded. The home has an updated medication procedure for the safe administration and storage of medication. No evidence was found of the maladministration of medication. There have been no notifications in respect of maladministration of medication. The last pharmacy report was a positive one and contained no recommendations. Staff, were observed to provide care in a sensitive manner. Communications were Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: seen at times to be difficult but staff took time and displayed great patients when communicating with individual residents. Staff, were observed to make sure that the privacy and dignity of residents was maintained. Observation and discussions with staff showed that they were aware of the need to respect residents privacy. Staff were seen to seek permission from the resident if they wished to enter their bedroom. A member of staff described how she helped one of the residents with their bathing. She stated I take into account the wishes and dignity of the resident when assisting them with bathing and manage this task in a very sensitive manner. The dreams and aspirations of individual residents are recorded on their individual file. The emotional needs of residents are recorded on care records. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to protect residents. Staff, are trained to protect residents from potential abuse. Evidence: The complaints procedure was seen to be displayed in the home. The registered manager stated that an individual copy is given to residents. No complaints have been received by the care home of by the Commission for Social Care Inspection since the last key inspection. The manager stated that she checks the complaint book monthly. Even if there are no complaints recorded she signs and dates the book to demonstrate that she is monitoring complaints. There have been no notifications in the last year which have raised any concerns about the care practice of the care home. Staff stated that adult protection training has been provided which they feel has given them the skills to protect residents from any potential abuse. Training records supported this statement. Staff stated that they would have no difficulty in using a whistle-blowing procedure. However they believed that the managers of the home would take action immediately if anyone raised concerns about the home care practice. Staff stated that they felt the home was a safe place in which to work and could not identify any health and safety issues which would affect the safety of residents. Care Homes for Adults (18-65 years) Page 18 of 27 Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean well maintain care home, which provides safe comfortable accommodation. The up-to-date infection control procedure is followed and a safe environment is maintained Evidence: The registered manager stated that there is an ongoing maintenance program in place. The home was found to be clean tidy and smelt fresh. Bedrooms had been personalised and were decorated to a good standard. All social areas were well maintained furniture have been provided to meet the needs of individual residents. There were no infection control or health and safety issues identified at this inspection. The Garden and Plath areas outside the home were tidy and safe. There are areas where the residents can sit out in safety in the summer months. Off-road parking is provided for visitors. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, are recruited safely using the updated recruitment procedure of the care home. They are trained to meet the needs of residents. Evidence: The staff training plan provided evidence that core and specialised training is provided to staff. The registered manager produced evidence that 70 of staff hold an NVQ level 2 in care or an equivalent qualification. The registered manager stated that supervision and appraisals do take place. Staff confirmed this statement to be correct. Staff stated that staff meetings and residents meetings do take place. However because of the difficulties communicating with some residents one-to-one discussions are regularly held to ensure that residents were happy with the services provided by the home. Recruitment records for staff were seen. There is a procedure in place which ensures the manager obtains of getting a criminal record bureau check (CRB), two written references and Proof of identity before offering new staff employment. The registered manager stated that all new staff are given an induction. Staff confirmed this statement to be correct. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff were able to discuss in detail the needs of the individual residents been case tracked. They described how they helped each individual resident while maintaining their dignity and privacy. Residents were seen to be spoken to in a sensitive manner. Tasks were not rushed or pressurised. Residents receiving personal care or being given their medication were observed to be taken to their own room or a private room to maintain their privacy. Staff stated that the staffing rota is given to them in plenty of time to allow them to maintain their own personal lifestyle. There is no pressure to work additional hours except by choice. Staff stated that they feel well supported by the registered manager and work well as a team. Recruitment records produced evidence that Staff turnover at the home is very low. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this 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 home was well run, with good leadership. The Health and Safety and the well-fare of residents is promoted. Evidence: The inspection commenced at 8am. Staff, were seen to be carrying out their tasks effectively and calmly. Residents were not disturbed or unhappy. The whole home was calm tidy and under control. The registered manager produced any evidence which the inspector requested. She was able to describe the needs and care plans for any resident in detail. Staff stated that the managers of the home are very supportive. Recruitment Records evidenced that the staff turnover is very low. Supervision and appraisals were found to have been carried out in accordance with national guidelines. Care records were of a highquality and are being reviewed frequently. Staff training is being provided which includes specialised training in addition to essential core training. The registered Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: manager has kept the Commission for Social Care Inspection informed of all events which had a potential impact on the safety of residents. No complaints have been received by the home since the last key inspection or by the Commission for Social Care Inspection. No health and safety issues or infection control issues were identified during this inspection. Care Homes for Adults (18-65 years) Page 24 of 27 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 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, Care Homes 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 Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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. 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