Blair House

Updated 8 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 13 January 2022 and was announced. We gave the service one days’ notice of the inspection.

Updated 8 February 2022

We inspected the service on 1 December 2017. The inspection was announced. Blair House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service is registered to provide both nursing and personal care for 27 younger adults and older people who have a learning disability. There were 25 people living in the service at the time of our inspection. Most of them had special communication needs and expressed themselves using single words, vocal tones and sign-assisted language. The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service was run by a company who was the registered provider. There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At our last inspection on 3 June 2015 the service was rated overall as being, ‘Good’. However, we found that improvements were needed to ensure that people were fully supported to express their individuality by pursing their hobbies and interests. In addition, we found that people needed to be given more support to readily be able to use the service’s complaints procedure should they need to do so. Furthermore, we found that some care records were not being kept in the right way so that there was a clear account of all of the assistance each person had received. As a result of these shortfalls we rated our domain ‘responsive’ as, ‘Requires Improvement’. At the present inspection we found that these shortfalls had been addressed. Therefore, we rated our domain ‘responsive’ as, ‘Good’.

Also, at our present inspection our overall rating for the service remained as, ’Good’.

There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Most risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, medicines were managed safely. Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service and background checks had been completed before new nurses and care staff had been appointed. People had benefited from the prevention and control of infection and lessons had been learnt when things had gone wrong.

Some areas of the accommodation were not designed, adapted and decorated in a way that met people’s needs and expectation. However, nurses and care staff had been supported to deliver care in line with current best practice guidance. This included supporting people when they became distressed. People received the individual assistance they needed to enjoy their meals and they were helped to eat and drink enough to maintain a balanced diet. In addition, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. Furthermore, people had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support.

People were supported to have maximum choice and control of their lives and nurses and care staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They had also been supported to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. In addition, confidential information was kept private.

People received personalised care that was responsive to their needs. As part of this people had been offered opportunities to pursue their hobbies and interests. People’s concerns and complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a positive culture in the service that was focused upon achieving good outcomes for people. People benefited from there being a robust management framework that helped nurses and care staff to understand their responsibilities so that risks and regulatory requirements were met. In addition, the registered persons had taken various steps to ensure the financial sustainability of the service.

The views of people who lived in the service, relatives and staff had been gathered and acted on to shape any improvements that were made. Furthermore, quality checks had been completed to ensure people benefited from the service being able to quickly put most problems right and to innovate so that people could consistently receive safe care. Good team work was promoted and staff were supported to speak out if they had any concerns about people not being treated in the right way. In addition, the registered persons were actively working in partnership with other agencies to support the development of joined-up care.