Blenheim Care Home

Blenheim Care Home is a residential care home registered to provide care and support to up to 31 people. The service is split over two floors which were all accessible by stairs or a lift. At the time of the inspection, there were 28 people living at the service. The service does not provide nursing care.

People’s experience of using this service and what we found

Medicines were managed, stored and administered safely. People were supported to take their medicines safely by staff who had received the appropriate levels of training and had their competency regularly checked. Improvements were needed in the recording of topical creams. We have made a recommendation to the provider to ensure current best practice guidance is followed around the recording of topical creams.

People and their relatives told us they or their loved one felt safe living at Blenheim Care Home. People were relaxed and comfortable with staff who knew them well and supported them in ways they preferred.

Staff understood how to identify and report abuse and were well supported in their roles. Staff received regular team meetings, supervision and annual appraisals and completed a variety of training courses to enable them to carry out their roles competently.

Staff told us they, “Loved their job” and appreciated the open, supportive and friendly approach taken by their manager.

There was a robust risk assessment system in place. Risks to people’s health, safety and well-being were regularly assessed, reviewed and updated. Relatives told us how the service helped people to manage risk. Where appropriate, people and their families were included and involved in their care and support.

Staff were recruited safely. There were enough appropriately trained and experienced staff to support people in ways that suited them.

Cleaning and infection control procedures followed the relevant COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance regarding COVID-19 testing for people, staff and visitors was being followed.

There was a range of quality assurance measures and checks in operation. These included the provider issuing a questionnaire to obtain feedback from people, relatives, staff and health and social care professionals.

There were also audits of various aspects of the service, any shortfalls found were addressed which helped ensure people were safe. Audits helped identify any areas for improvement, this learning was shared with staff and ensured a process of continual improvement was followed.

Health and social care professionals and relatives we spoke with during the inspection, spoke positively of the management and staff team. They commented they were happy with the service and level of care people received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 12 November 2019).

Why we inspected

We received concerns in relation to the management of risks, the care and support people received and the management culture. As a result we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained at good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blenheim Care Home on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation regarding the recording of topical creams.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The service is registered to accommodate up to 31 people and provides care and support for older people. The service is split over two floors which were all accessible by stairs or a lift. There were 27 people using the service at time of inspection.

People’s experience of using this service and what we found

People told us they felt safe living at Blenheim Care Home. The staff demonstrated a good understanding of how to meet people’s individual needs. People’s outcomes were known, and staff worked with people to help achieve these. People were supported and encouraged to maintain their independence and live their lives as fully as possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the home supported this practice.

People were supported to maintain contact with those important to them including family and friends. Staff understood the importance of these contacts for people’s health and well-being. Staff knew people well and what made them individuals.

Staff had a good understanding of their roles and responsibilities and were supported to reflect on their practice and pursue learning opportunities. The staff team worked and got on well together demonstrating team work. They told us they were like one big family.

Quality and safety checks helped ensure people were safe and protected from harm. This meant the home could continually improve. Audits helped identify areas for improvement and this learning was shared with staff through handovers and meetings. The management of the home were respected.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Accommodation is arranged over two floors, with a passenger lift to assist people to get to the upper floor. The home has 27 bedrooms, with all but two having en-suite facilities. The home had two gardens that were designed to accommodate people with mobility issues and provided a safe, secure area for people to enjoy.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

Is the service safe?

People were protected from potential abuse and avoidable harm by staff who were knowledgeable about recognising and reporting different signs of abuse. There were sufficient numbers of appropriately qualified staff available on each shift to ensure people were cared and supported safely. Risks to people were well managed and medicines were stored appropriately and managed effectively. People were protected by the prevention and control of infection.

Is the service effective?

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People had access to a variety of health care professionals who commented positively on the care and support given to people at the home. Staff received quality training which they found effective and useful. Staff were well supported with a clear system of supervision meetings and annual appraisals.

Is the service caring?

People and relatives told us they found the staff to be kind, caring, friendly and patient. Staff spoke knowledgeably about people and showed they knew how people preferred to be given their care and support. People were treated with dignity and respect and supported to make their own choices about how they spent their day. People’s privacy was respected.

Is the service responsive?

People received person centred care from a team of staff who knew them and their health needs well. People’s needs were re-assessed when their health needs changed and relatives were kept informed and included. There was a planned programme of interesting activities that enhanced people’s sense of well-being and prevented social isolation. People knew how to complain if they needed to and there was a clear complaints process available.

Is the service well led?

There was an open, honest, friendly culture and people told us they had confidence in the management team and the staff. People and their relatives were consulted and involved in their care and support. There was a programme of quality checks and audits to ensure the quality of the service was maintained.

Further information is in the detailed findings below

The mental and physical frailty of people living at the home meant that we were only able to speak with two of them. We therefore used a number of different methods to help us understand people’s experiences of living in the home.

We spoke with three relatives for their views about the home and the care and support their relatives received.

Where appropriate we observed the care and support people received. We looked at relevant documents and records. We reviewed a report from the local authority contracts department about the dementia care service provided by the home.

We also observed the day-to-day activities and working practices in the home and we spoke with four care staff about their work in the home.

The home had arrangements in place that ensured the dignity, privacy and independence of people was promoted.

Where possible people or their representatives were able to express their views about what was important to them in relation to their care and treatment.

People received the help, assistance, prompting or supervision they required in accordance with their individualised care plans.

The provider had arrangements in place that ensured people’s nutrition and hydration needs were met; there were enough staff on duty at all times with the skills and experience to meet people’s needs; the quality of the service people received was monitored; and risks to people’s welfare were identified and managed safely.

People’s consent was sought about their care and support when people had capacity to give consent. Where people could not give consent we found that best interest decisions were made on their behalf in line with the Mental Capacity Act 2005. Relatives were involved in these decisions where appropriate.

People’s needs had been assessed and care plans put in place to support them. We found people’s mental health needs and physical needs were addressed appropriately.

Medication was managed safely in the home.

There were robust staff recruitment procedures in place to make sure that suitable people were appointed to work at the home.

Blenheim Care Home had a complaints system in place. Complaints were responded to in line with the home’s policy.