The unannounced inspection took place on 26 August 2015. This was in order to provide a rating
for the service under the Care Act 2014. We were also responding to whistle blowing concerns made to the Care Quality Commission (CQC) about the care provision at the service.
Blackrod House is registered to provide accommodation for up to 30 people. A unit for people with varying stages of dementia is located on the first and second floors, while residential care is provided by the unit on the ground floor. The home is situated on the corner of the main road through the centre of Blackrod, near Bolton. Local shops and amenities are close by.
There was a registered manager at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities)Regulations 2014. This breach related to the provision of safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.
People told us they felt safe living at the home. There was an appropriate safeguarding vulnerable adults policy and procedure in place and staff demonstrated a good working knowledge of this.
The service had emergency plans in place and emergency equipment was well maintained. However there were some environmental risks identified, such as doors propped open, a non-functioning light bulb in an area with no natural light near the top of some stairs and rooms which were situated near the top of some stairs. Although there was a fire door and the lift was adjacent to these rooms the absence of light could have presented a risk to people who used the service who had a level of confusion.
Recruitment of staff was robust, involving appropriate procedures and checks to ensure staff were suitable to work with vulnerable people.
Medicines policies and procedures were in place but medicines were not always given safely.
The home specialised in dementia care, but staff were not able to say what dementia model they were working to. The environment lacked signage and other touches conducive to good dementia care.
Care plans included appropriate information, but were difficult to follow. They had been regularly reviewed to ensure information about care needs was up to date.
The service had a robust induction programme and training for staff was on-going. However, staff would benefit from more in-depth dementia training to ensure people living with dementia had their needs met appropriately.
The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).
People said the staff were caring, but we observed little natural interaction going on throughout the day. Staff concentrated on tasks to be completed rather than chatting with people who used the service.
Regular satisfaction surveys were undertaken to ascertain people’s views of the service and we saw the most recent of these. Most people had made positive comments. Relatives’ meetings provided a forum for people to raise any concerns, put forward suggestions and air their views.
The service had champions amongst the staff for dignity and end of life care. They ensured they kept up to date with information and disseminated it to the other staff members. People’s wishes for the care they wanted when they were nearing the end of life, if they had expressed these, were noted within the care plans.
Personal information within the care plans was inconsistent, so that not all of them were person centred and individualised.
The home worked well with other agencies and there was appropriate documentation and correspondence with regard to other services kept within the care files.
There were a number of activities on offer at the home and the service had a dedicated member of staff to lead activities and trips out. There was a well-equipped sensory/relaxation room and a reminiscence lounge for people to use.
The service had an appropriate complaints policy in place and there was a complaints log which evidenced that complaints were dealt with appropriately.
There was a registered manager in place.The registered manager had little knowledge of what constitutes good dementia care and did not follow the service’s own protocol with regard to infection prevention and control.
Staff supervisions and appraisals were undertaken regularly and staff were encouraged to access training and attend meetings.
Audits were undertaken but there was little evidence of any analysis of the results to facilitate continual improvement to care delivery.
Relatives’ surveys were undertaken regularly to ascertain their views of the service provision.