Blenheim House Care Home

Blenheim House Care Home is a residential care home providing accommodation for people who require nursing or personal care to up to 85 people. The service provides support to people living with dementia, older people and younger adults. At the time of our inspection there were 83 people using the service.

Blenheim House Care Home provides accommodation over three floors, bedrooms can be found on each floor and provide en-suite facilities. There are various communal areas including dining rooms, lounges, cinema and a bar. There is level access to extensive well-kept gardens and parking to the front of the premises. The registered manager’s office is located adjacent to the reception area.

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

People were supported by staff who spoke confidently about how they would identify potential abuse and what they would do if abuse was suspected or witnessed. Risk assessments were in place and guidance was available for staff about how they should keep people safe from avoidable harm. Medicines were managed and administered by staff who were trained, and competency checked. The temperature of the medicines fridge was not always recorded in the correct format. Staff were recruited in line with requirements. The provider used a staffing dependency tool and was working to reduce the use of agency staff across the service. We received mixed comments about staffing levels from people, relatives and staff.

Staff spoke positively about the registered manager. The provider operated checks and audits to monitor the quality and safety of care provision in the service. Staff spoke about people in a person-centred way and the provider had identified what actions needed to be taken to ensure a more person-centred service was provided. Statutory notifications were submitted in line with requirements. Lessons were learned when things went wrong, and these were shared organisationally. Staff worked with healthcare professionals to meet people’s needs.

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 service supported this practice.

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 07 January 2020).

Why we inspected

We received concerns in relation to the management of medicines and falls. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

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 the same.

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

Recommendations

We made one recommendation in relation to recording temperatures for the medicines fridge.

Follow up

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

We found the following examples of good practice.

Robust protocols were in place for all visitors to prevent the spread of infection. A designated visiting co-ordinator managed a ‘booking in’ scheme for visitors which assured the numbers of visitors within the home were minimal and staggered. Visitors could enter the homes internal porchway, where there was a hand cleansing station and a supply of fluid repellent masks. The provider requested that all visitors used these masks and not face coverings. Access was granted following stringent questioning regarding contact, travel and symptoms and visitor temperatures were taken. Visitors were invited to wash their hands and use sanitizer gel.

There were two separate garden areas accessed from different areas of the home for socially distanced and time limited garden visits. The service had a designated and purpose built visiting room which was accessed from the outside by visitors and inside for people. It had a full length sealed window with microphones and a hearing loop system. Feedback regarding this room had been positive.

The service developed a designated COVID-19 unit in one of the wings of the home. It was fully self contained and had access and exit points, separate from the main building. There was a stringent protocol to follow for staff use. Guidance for safe donning and doffing of personal protective equipment, management of waste and the delivery of food and equipment was clearly displayed. Staff who worked in this unit were designated to this unit only. There was no use of agency staff within the whole building.

There was clear guidance signage around the home in prominent areas for people and visitors as well as hand washing and sanitizer stations. All staff were seen to be wearing the providers fluid repellent masks. The service had a 14 day isolation protocol in place for new residents or those showing symptoms. There were risk assessments in place for hospital visits and the service used their own transport to minimise the risk of cross contamination.

The head housekeeper was the designated infection control lead. All staff had extra training in COVID-19 and infection prevention and control procedures. There was a stringent cleaning schedule, particularly for communal or visiting areas before and after use and in high touch areas around the home. The service had followed Government and Public Health England guidance and had engaged in all support provided from the Local Authority.

Further information is in the findings below.

Blenheim Care Home is a care home and can accommodate up to 85 people across four separate units, each with separate shared space. One of the units specialises in providing care to people living with dementia.

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

We saw many examples of positive engagement between people and staff. However, there was an over use of endearment terms by staff during conversations with people. The registered manager must take the opportunity to assess the overuse of terms of endearment by staff during conversations and when delivering personal care.

Individual risks were assessed, and action plans were developed on the risk reducing measures. Records were not consistently maintained where there were actions to monitor food and fluid or repositioning.

We recommended the provider seek from a reputable source guidance on the monitoring of food and fluid intake and on record keeping

Care plans overall were person centred and reviewed as people’s needs changed. We found daily reports were generic, but this could be the system that does not allow for more information to be documented.

The registered manager acted on our observations to ensure people were protected from potential harm.

People felt safe living at the home and relatives were confident their family members were safe with the staff. Relatives felt informed about important events.

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 service supported this practice.

People's comments reflected their views of staff being kind and caring. We saw many examples of good interactions with staff. People were asked about their care and relatives said they were invited to reviews. The opinions from people was they felt valued most of the time. People's rights were respected.

There was a full programme of events which included group and one to one activity. People were having virtual reality experiences such as visits to places of interests.

There were systems in place to support staff with their roles and their responsibilities. New staff received an induction when they started their employment at the home. Staff had attended mandatory training set by the provider and there were opportunities for vocational qualifications. One to one supervisions meetings were regular and where staff discussed with their line manager concerns, training and personal development.

People told us the meals were good and choices were available at each mealtime.

There were safe systems of medicine management. People were supported with their ongoing health and there was access to community NHS facilities such as dentists and opticians. Healthcare professionals said there was a visible “management” presence and referrals were timely and appropriate.

People knew the registered manager and the procedures for making complaints, which were taken seriously.

Quality assurance systems were effective. Audits were specific to each unit and action plans were monitored by the registered manager and operations manager. The views of people, relatives and staff were gained using surveys. The registered manager had developed an action plan on developing the service from the feedback 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 requires improvement (published 26 November 2018). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

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.