Blackley Premier Care

The home had a separate entrance and room that could be used to facilitate essential visits and appointments, for example, by healthcare professionals, while limiting the contact with the rest of the home, staff and residents.

Staff supported residents to receive visits from their relatives outdoors (over the fence) using an appointment system.

Staff and visitors had access to personal protective equipment (PPE) and sanitiser at the entrance of the home. Visitors completed a screening questionnaire and had their temperatures checked on arrival.

The home had an Isolation Policy that described safe practice, guidance and residents’ rights, and an Isolation Plan that set out immediate steps to be taken if a resident tested positive.

The home had a pandemic-specific business continuity plan that was comprehensive and easy to read. It covered what to do in the event of an outbreak, staff loss, manager loss or lockdown, and also covered essential supplies, refuge, utilities, contractors and key contact details.

For residents who become fearful or distressed when staff undertook coronavirus tests wearing full PPE, another staff member familiar to the resident stood at a safe distance (not wearing a mask) to talk through the procedure and reassure the resident.

The home had an infection control champion among its staff group who oversaw infection control practice at the home.

The home planned to create a separate Covid-safe visiting unit in its conservatory as this had a separate entrance and exit.

This was an unannounced inspection that took place on the 31 January 2019.

Blackley Premier Care is a 'care home', people in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Blackley Premier Care is registered to provide accommodation and personal care to 16 people, some of whom are living with dementia. There were 13 people living at the home at the time of our inspection.

At our last inspection on 19 September 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated good.

There was a registered manager in place. 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.

The provider did not have a risk assessment in relation to Legionella. However, we found the provider had completed routine sampling to help control the risks of legionella. Legionella is a type of bacteria that can develop in water systems and cause Legionnaire's disease that can be dangerous, particularly to more vulnerable people such as older adults. The registered manager showed us an email confirming that an external provider would complete this risk assessment in February 2019.

There were procedures in place to protect people from abuse and unsafe care. We saw risk assessments had been developed to help identify ways to minimise the potential risk of harm to people. These had been kept under review and were personalised to meet people's needs.

Staff were kind and caring and treated people with respect. We observed many positive and caring interactions throughout the inspection. Staff knew people's likes and dislikes, which helped them provide individualised care for people.

There were sufficient staff on duty to support people safely. Staff had been recruited safely, appropriately trained and supported.

Staff received induction and on-going training to enable them to meet the needs of people they supported effectively. Staff were supported by way of regular supervision, appraisal and access to management.

People's rights were protected. The registered manager was knowledgeable about their responsibilities under the Mental Capacity Act 2005. People were only deprived of their liberty if this had been authorised by the appropriate body or where applications had been made to do so.

Medicines were managed safely. People received their medicines when needed, and appropriate records had been completed. We saw people had access to healthcare professionals. People told us staff cared for them in the way they wanted and staff met their care needs promptly. Staff referred people to healthcare professionals in a timely way.

The service remained well-led and robust and effective quality assurance systems and processes were in place to assess, monitor and drive improvements in the quality of care people received. People, staff and relatives remained engaged and involved in the service provided. The culture of the service continued to be positive and respected people's equality, diversity and human rights.

The service was previously inspected in June 2014 when it was found to be meeting all the regulatory requirements which were inspected at that time.

Blackley Premier Care is registered to provide accommodation and personal care to 16 people, some of whom are living with dementia, there were 14 people living at the home at the time of our inspection. Blackley Premier Care is located in Blackley and situated near local amenities such as shops, a library and public transport links. There is a passenger lift in place along with facilities for cooking, dining, personal care, relaxing and leisure. The home has two lounges and a dining room. There is a well maintained garden at the rear of the building and sitting out areas around the building.

At the time of the inspection there was a registered manager at Blackley Premier Care. 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.

The registered manager worked flexibly between two homes she was the registered for. During our inspection the registered manager was not available; the full time deputy manager who worked at Blackley Premier Care was available.

The deputy manager engaged positively in the inspection process. The deputy manager was friendly and approachable and operated an open door policy to people using the service, staff and visitors. Throughout the inspection we found Blackley Premier Care to have a warm and relaxed atmosphere and overall people living in the home were happy and content.

Feedback received from people using the service and relatives spoken with was generally complimentary about the standard of care provided.

We found that the home was properly maintained and ensured people's safety was not compromised.

The registered provider had policies and systems in place to manage risks and safeguard people from abuse. Staff were aware of the whistle blowing policy and they told us they would use it if required. Staff told us they were able to speak with the deputy manager if they had a concern.

Staffing levels were structured to meet the needs of the people who used the service. There were sufficient numbers of staff on duty to meet people's needs.

Staff recruitment systems were in place and information about staff had been obtained to make sure staff did not pose a risk to people using the service.

Medicines were ordered, stored, administered and disposed of safely. People using the service had access to a range of individualised and group activities and a choice of wholesome and nutritious meals. Records showed that people also had access to GPs, chiropodists and other health care professionals (subject to individual need).

Staff were supported through induction, regular on-going training, supervision and appraisal. A training plan was in place to support staff learning. Staff told us they were well supported in their roles and responsibilities.

Staff had received training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), and they demonstrated a good understanding of the act and its application. Where people did not have the capacity to make decisions about their care, meetings were held with people, their relatives, and health and social care professionals to help ensure that any decisions were made in the best interests of people using the service.

A process was in place for managing complaints and the home's complaints procedure was displayed so that people had access to this information. People and relatives told us they would raise any concerns with the deputy manager.

Quality assurance systems were in place in assessing, monitoring and improving the quality and safety of services provided. This consisted of surveys and a range of audits that were undertaken twice a year.

We have made recommendations for the enrolment of the care certificate for new staff and the provider to access the best practice guidance to promote the health and wellbeing of people who are living with dementia.

One inspector carried out the inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found.

Is the service safe?

We saw people were being cared for in an environment that was safe and clean.

The people we spoke with who used the service told us they felt safe. One person said 'They always want to help you.'

We saw training records and certificates which showed staff had received training to enable them to meet the needs of the people who used the service. This meant the provider could demonstrate the staff employed to work at the home had the skills and experience needed to support the people living there.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005 (MCA). The aim is to make sure people in care homes and hospitals are looked after in a way which does not restrict their freedom inappropriately. There were no authorisations restricting the freedom of anyone living at the home at the time we visited. Several members of staff had received training about the Mental Capacity Act and Deprivation of Liberty Safeguards so they understood when an application should be made and how to submit one.

Although members of staff had received training in the management of medication we saw one handwritten medication administration record was not countersigned. There was no evidence of any medication errors but a lack of clear records increased the risk of mistakes being made.

We saw quality assurance questionnaires had been circulated to professional visitors. One had commented 'I would be happy to place vulnerable people here.'

Is the service effective?

People's health, social and care needs were assessed with them or their relatives and they were involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. Care plans were reviewed regularly every month.

From the training records we viewed we found staff had received training to enable them to meet the needs of the people who used the service. Discussion with staff and examination of records confirmed a programme of training was in place so all members of staff were kept up to date with current practice.

The people we spoke with told us they were happy with the care they received and said their needs were met. They spoke positively about the care they received and the staff who supported them. From what we saw and from speaking with staff it was clear they had a good understanding of the care and support needs of the people who used the service.

Is the service caring?

People we spoke with told us they liked living at the home. Comments included 'They are always asking if you're satisfied or if you want any changes' and 'Staff listen when I have concerns.'

Feedback we saw in a thank you card from a family member said 'Your care was outstanding, particularly during her final days.'

We saw the staff showed patience and gave encouragement when they were supporting people so people were able to do things at their own pace and were not rushed.

Is the service responsive?

People's needs had been assessed before they moved into the home. The records we saw confirmed people's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People had access to activities which were important to them and had been supported to maintain relationships with their friends and relatives.

We saw people's rooms were spacious, light and clean. People had personalised their rooms with their belongings and furniture. There was a dining area and a lounge and a conservatory was used as a separate 'quiet' area. All of these were clean, spacious and light. The gardens were large but were mainly concrete. We were told there were plans to lay lawns to make the garden more inviting. There were ramped entrances for easy access.

Is the service well-led?

We saw documentary evidence that the service worked well with other agencies and services to make sure people received their care in a joined up way.

From speaking with staff we found they had a good understanding of the home's values. They told us about their roles and responsibilities and they were clear about these. We saw quality assurance processes were in place to make sure the provider monitored the care provided and made improvements where necessary. For example, satisfaction questionnaires had been completed by people who used the service and their families and by professional visitors. We were told the results would be analysed and a report produced although we did not see this.

People using the services of Blackley Premier Care (and their visitors) told us that they were treated well and respectfully by staff, were being cared for and supported properly and that their accommodation was of a good standard. Comments made included:

'All the staff are so kind and ask me what I think about things.'

'I have lived here a long time and know all the staff. They treat me very well and make sure I am safe.'

'I visit here regularly. I have always seen staff to be polite with residents and treat them kindly.'

'They (staff) really do care for me here. The doctor and nurses come when I am ill so I get all the help I need.'

'I think the care you get here is of the best quality. I feel safe and well looked after.'

We found that people were being cared for in a suitable environment by adequate numbers of appropriately trained staff. A suitable system to monitor the quality of the services provided was being operated.