Care Home: Dunblane House

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What the care home does well This is a small home that has not changed much over the last eight years, only one new resident has come to live at Dunblane House and that was approximately five years ago. Only one new member of staff has been employed over the last eight years. Therefore staff have a good understanding of the needs and what support is required for people who live here. One staff member wrote in a survey, "I have been here for 18 years and I feel the home is run very well". Surveys returned from people who live and work at Dunblane house were positive in comments on how the home is run and they included, "We promote choice and independence", Also, "Its a lovely place to live". Routines in the home appeared relaxed with people allowed unrestricted access to all areas, helping themselves to drinks in the kitchen and talking to staff and the manager about the day ahead. One person who lives at the home spoken to said, "We all get on well together". Information in the AQAA tells us of the emphasis and commitment to attend training courses, and keep up to date with legislation and information relating to care homes to ensure they continue to develop and provide good care and support to people who live at Dunblane House. One staff member wrote in a survey, "We are trained well and communicate daily to work as a team". Another staff member spoken to said, "If I want to go on a course which would benefit the home and myself they will support me to do it". What has improved since the last inspection? As we walked around the building we noticed the bathroom had been decorated and new fittings installed, also some new furnishings added to bedrooms to ensure people live in pleasant surroundings. Information in the AQAA confirms the new furnishings and bathroom fittings have been completed. "One person who lives at the home said about the bathroom, "Its nice now it has been finished off". What the care home could do better: Safeguarding adults training should be provided for staff who have not received formal training for a number of years to ensure they have an understanding of issues of abuse and any signs to be aware of and how to respond. At the time of the inspection we could not look at a staff recruitment record as the manager was away for the day and they were locked away. Records should be made available any time for inspection purposes. However from discussion it was evident staff had been through a robust recruitment procedure to ensure they were suitable. One staff member said, " I know its a long time ago but all the checks were in place before I came here to work". The owner tells us in the AQAA the process of selecting staff and how the correct checks have to be in place before people start to work at Dunblane House. Key inspection report Care homes for adults (18-65 years) Name: Address: Dunblane House 73 Bloomfield Road Blackpool Lancashire FY1 6JN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Kevan Royston     Date: 2 5 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Dunblane House 73 Bloomfield Road Blackpool Lancashire FY1 6JN 01253316125 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Linda Margaret Parker care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home Dunblane House is a small home registered for four persons with mental health problems. Dunblane House is a large terrace property close to public transport and local amenities in south area of Blackpool. There is a small garden area at the rear of the property with seating facilities. The front provides parking for two vehicles. There are three bedrooms, one is a double and two have en-suite facilities. There are sufficient toilet and bathroom facilities available. The ground floor consists of a lounge and dinning/kitchen area. There is also a conservatory at the rear of the property. There is a Statement of Purpose/Service User Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 Brief description of the care home owners and staff are, and what the resident can expect if he or she decides to live at the home. The fees are £291.00 to £294 per week. There are additional charges for chiropody. 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: two star good 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: This unannounced visit was part of the key inspection process and took place on the 25/08/09. We spoke to people who live at the home, the manager/owner and a member of staff. Care, maintenance, previous inspection reports and other records were looked at as well as a walk around the building. As part of the inspection process we talked to people using the service and asked staff about those people needs. We also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who live at the home were invited to pass their opinions to us if they wish. We received little response from surveys/ questionnaires sent to people who live and work at Dunblane house, for their views on how the home is run. However this is a small family run home with few staff and four residents. Comments we did receive were positive and some are included in this report. Care Homes for Adults (18-65 years) Page 6 of 27 Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. Care Homes for Adults (18-65 years) Page 7 of 27 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 Care Homes for Adults (18-65 years) Page 8 of 27 following this report, you can contact them using the details 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures are clear to ensure the care and support needs of people who live at the home can be met. Evidence: This is a small family run home with only four people who live here and no new admissions for over five years. We looked assessment information for the people who live at Dunblane House and it contained good information before the person moved in from both social services and the managers own assessment. We spoke to the manager/owner about the assessment process and although there has been no admissions for a while, the policy is for plenty of visits, and overnight stays before a decision is made to move in. One staff member spoken to said, If anyone came we would encourage them to come along often to see if we like each other. A person who lives at the home spoken to about the time when he moved in said, I have always liked it here from the start. Social Services assessments and mental health information had been obtained by the manager before people moved in to ensure they have all the information needed to Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: provide the care, support and develop a care plan for each person. There is a brochure available which contains all the information on how the home is run and services and staff information so that potential residents and their families can make an informed choice. Care Homes for Adults (18-65 years) Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported to make decisions,which help them in daily life whilst taking risk into account. Evidence: We looked at care planning records and action staff are taking to provide the support people need to have an independent lifestyle as possible. Care records clearly identified the physical and social needs of people living at Dunblane House to ensure they receive the right care. A staff member spoken to had a good knowledge of what support and care is required to help people who live at the home achieve an independent life as they can. She said, We are a small family home and all are involved in the care of the people who live here. Talking to staff and information in the AQAA confirm staff work closely with the residents to develop a plan of daily life which promotes independence and allows risks to be taken with support and guidance. One staff member wrote in a survey, We promote independence. One person who lives at the home said, I make my own way Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: to work. Records looked at show risk assessments are completed for each person and reviewed on a regular basis and where needed are updated, to ensure risk taking is part of the plan to improve confidence and independence. One staff member said, We encourage the boys to be independent. People who live at the home are involved in decision making within their individual care plan to build confidence. One person who lives at the home said, I enjoy the shop and school work. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Opportunities for development are provided through each individuals daily plan. Meals are managed well and provide a wholesome nutritious diet. Evidence: We looked at what people who live at the home do during the day, activities, education, employment and spoke to staff who confirmed opportunities to take part in the local community is available according to each persons daily programme. One person who lives at the home said, I work part time and enjoy it. Another person when asked about daily activities said, I generally take myself out for a while. Each individual has a daily plan which includes attending day centers, further education and working locally part time ensuring residents have community contact and develop confidence and independence. One staff member wrote in a survey Its important to promote independence and choice. The manager tells us in the AQAA the importance of supporting and encouraging people who live at the home to promote a lifestyle they Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: want and help them achieve their aims. This is a small home and the kitchen area is of a domestic character. We had a look in the kitchen and found lots of of fresh produce, fruit in a basket on the table and fresh vegetables in the fridge. One staff member spoken to said, We try and encourage a healthy diet by providing fresh fruit and vegetables. Comments from people who live at the home about the quality of food included, We generally eat together. Also, The food is good. We looked at records and confirmed food intake is monitored to ensure any issues are picked up on and action taken. People who live at the home are encouraged to keep in touch with family and friends and at the time of the visit a friend was visiting. Families are welcome to come and stay at the home whilst visiting. One member of staff spoken to said, We dont have restrictions on visitors and they are welcome any time. One person we spoke to about contact with friends and family said, I get family visitors now and then. One member of staff said, We are looking to convert a room to a bedroom for family visits and they can stay if they wish. Care Homes for Adults (18-65 years) Page 16 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. Promotion of health is taken seriously and systems are in place to monitor the health of people who live at the home. Evidence: The manager informs us in the AQAA how people who live at the home are encouraged to look after their personal care needs independently with prompting support if needed. One member of staff spoken to said, If need be we help with personal care but every body can look after themselves. We watched during the day a member of staff talking to residents about the daily routines, what plans individuals had for that day and encouraging people to make decisions independently. One person who lives at the home spoken to said, I will go out for a while on my own before tea. One member of staff spoken to said, We all know each others routines with living together for a number of years. Records looked at of people who live at the home and talking to staff confirm health checks including, dental, opticians and other health professionals are involved in the welfare of residents to ensure they remain healthy and any issues are addressed. One staff member wrote, We always put our service users health first. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: We went through the medication procedure with the manager and looked at people we case tracked medication. One resident is self medicating and records looked at confirmed the person had signed to take charge of their own medicines. We found good procedures to follow to ensure medication is handled and given out correctly to ensure people who live at the home are safe. One staff member spoken to said, The three of us who are trained give out medication. Care Homes for Adults (18-65 years) Page 18 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. Procedures for complaints are in place to ensure people feel listened to. Training for staff in Safeguarding adults would help people be aware of any issues that may arise. Evidence: There is a complaints policy and procedure available, all people who live at the home and families have been given copies. No new persons have been admitted to the home for over five years however the policy has been updated by the manager, copies of the complaints policy were available for us to see. One staff member spoken to said, The one complaint by a family member was investigated and dealt with correctly. There has been one complaint since the last inspection investigated by the manager of the home relevant parties involved had been notified of the investigation and outcome which was unsubstantiated. We found from training records and talking to staff safeguarding adults training has been completed by the small staff team however over eight years ago. This should be updated to ensure people are aware of any signs of abuse and able to act to prevent any harm to people living at the home. One staff member spoken to said,We need to update training 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. The building is kept clean and tidy and maintained well. Evidence: We had a walk around the premises and found it to be clean and tidy and looked after to a good standard. The building is a large family home and the furnishings and decoration are homely and ensure people live in comfortable, pleasant surroundings. The manager tells us in the AQAA of improvements such as a new bathroom installed and some new furnishings in bedrooms, also a room has been converted into a bedroom should any family members visiting wish to stay. Further plans to improve the building were discussed with the manager who said, We plan more decoration during the year. One person who lives at Dunblane House spoken to said, Its a family home. The premises are well maintained and any repairs are attended to quickly, a record of repairs is kept and was seen. There is a laundry facility which is situated away from the kitchen and food preparation area. Policies and procedures are in place for the control of infection to protect and safeguard people. 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. Access to training and staff development is good, this helps to develop their skills and competencies. Recruitment records are in place however were not available to look at to ensure all checks had been carried out on staff members, Evidence: There has only been one recent new member of staff employed, the small staff team have worked at Dunblane houes for over ten years The small number of staff have the competencies, experience and have worked together for a number of years to provide the care and support the residents need. One staff member spoken to said, We are a small home and its run as a large family. One person who lives at the home when spoken to about the staff said, Its nice having the same people . 50 of care staff have completed the National Vocational Qualification (NVQ) to level 2 training, which is a recognized qualification in care. This was confirmed through records looked at and speaking to a staff member who said, I have completed my level 4 NVQ. We were unable to look at a staff recruitment records as the manager was away on the day of the visit and access to records were locked away. Recruitment records should be available for inspection to ensure the proper checks have been completed Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: and all are in place before people start to work at the home. However only one member of staff has been employed for over ten years and the manager assured us the proper checks we discussed had been completed prior to the member of staff starting work at the home. 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 is run well with good systems in place for the protection of people who work and live at the home. Evidence: The manager has the necessary skills, wealth of experience and is highly qualified to support staff and people who live at the home and ensure Dunblane House continues to meet it aims and objectives. One person who lives at the home said, We all get on like a family. The senior carer also has a management and care qualification (NVQ to level 4) ensuring the home can be managed and run by competent staff. There are good systems in place to get the views of the small staff team, relatives and people who live at the home on how the home is developing and how they feel the home is run. Informal meetings take place at meal times as this is a small family run home, when they all get together for lunchor tea. One staff member said, Its continuous we all chip in to see if anything needs improving. There is evidence of good contact with families and friends of the people who live at Dunblane House so they can give there opinions on how the home is run. At the time of the visit a friend Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: of a resident had come to visit, we spoke to him and he said, I come a lot here its very nice. Records looked at for people who live at the home we case tracked were found to be comprehensive,well written, easy to follow and up to date, ensuring the information contained was correct and health and social care needs are continuously monitored. Health and safety policies are in place, and records shows procedure in place for recording any accidents, regular checks on fire safety procedures and all equipment checked, ensuring the people who live and work at Dunblane House are kept safe. The manager confirmed in the AQAA checks on aids and equipment have been done. 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 1 23 Staff should complete training around safeguarding adults issues so that they are aware of any signs of abuse taking place and are confident to follow correct procedures and take appropriate action. Recruitment records should be available for inspection to ensure checks are in place before people start to work at the home 2 34 Care Homes for Adults (18-65 years) Page 26 of 27 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. Copyright © (2009) Care Quality Commission (CQC). 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