Archived: Blenheim Care Centre

Updated 17 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 4, 5 and 6 January 2017 and the first day of inspection was unannounced. Before the inspection we reviewed the information we held about the service including notifications and information received from the local authority who had raised concerns following their quality monitoring visit to the service in November 2016. Notifications are for certain changes, events and incidents affecting their service or the people who use it that providers are required to notify us about.

The inspection team consisted of three inspectors, including a pharmacist inspector and a specialist advisor in mental health and dementia care.

During the inspection we viewed a variety of records including 10 people’s care records, the medicine supplies and medicines administration record charts for 15 people, four staff recruitment files, risk assessments for safe working practices, servicing and maintenance records for equipment and the premises, safeguarding and complaints records, minutes of residents, relatives and staff meetings, audit and monitoring reports and policies and procedures.

We used the Short Observational Framework for Inspection (SOFI) during the lunchtime on the first floor. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed the mealtime experience for people and interaction between people using the service and staff on all floors.

We spoke with nine people using the service, six relatives, the nominated individual on behalf of the provider, a peripatetic manager, the manager, the deputy manager, five registered nurses, 10 care staff including two senior carers, the activities coordinator, two catering staff, the maintenance person and one domestic staff member. We also spoke with two visiting healthcare professionals and an independent advocate.

Updated 17 June 2017

The inspection was carried out on 4, 5 and 6 January 2017 and the first day was unannounced. The inspection was undertaken as a result of concerns received from the local authority. The previous inspection took place on 26, 27 and 28 April 2016 and the service was compliant, however we identified the completion of care records needed to improve and the registered manager had identified this for action.

Blenheim Care Centre provides accommodation for a maximum of 64 people. The service has three floors and accommodates people in single rooms each with en suite facilities. The ground floor provides general nursing care for up to 12 older people and 8 people with physical disabilities. The first floor provides personal care for up to 22 older people with dementia care needs. The second floor provides nursing care for up to 22 older people with dementia care needs. Each floor has communal dining, sitting rooms and bathing facilities. At the time of inspection there were 60 people using the service.

The service is required to have a registered manager. 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 previous registered manager had left in September 2016 and a new manager had been in post since 15 November 2016 and was applying for registration with the Care Quality Commission.

Risk assessments had not always been completed. Where risks had been identified, action to minimise them had not always been implemented, so risks to individuals had not been minimised.

Accidents and incidents had been recorded but they had not been investigated or reported to the local authority and there was no evidence they were being monitored to look for trends.

Repairs and replacement of equipment was not always carried out in a timely way, which could pose a risk to people’s safety.

Staff recruitment procedures were in place but were not always being followed to ensure only suitable staff were employed by the service.

The service was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA). DoLS are in place to ensure that people’s freedom is not unduly restricted. Capacity and best interest assessments had not been carried out and consent was not always being sought for care and treatment, which could place people at risk of the service not acting in their best interest.

People’s dietary needs and preferences were not always being identified and met and the quality of the food provision needed to be improved.

Care records did not always reflect people’s individual needs, interests and wishes and there was no evidence that people and their representatives had not been involved in the planning of care.

Processes for auditing and monitoring had not been effective in identifying all shortfalls within the service.

The majority of staff responded well to people’s needs and care and treatment was provided in a way that met people’s individual preferences. People were treated with dignity and respect.

The provider made suitable arrangements to ensure service users were protected against the risks associated with the inappropriate administration of medicines.

Procedures were in place to safeguard people against the risk of abuse and staff understood the importance of keeping people safe and reporting concerns.

Moving and handling equipment was being used safely and correct procedures were being followed when transferring people and moving them around the service.

Staff received training to provide them with the skills and knowledge to care for people effectively.

People’s healthcare needs were identified and they received the input they needed from health and social care professionals.

Some activities took place and work was ongoing to improve the activity provision in the service.

A complaints procedure was in place and people and relatives said they would express any concerns so they could be addressed.

The manager had identified shortfalls and was working with the deputy manager to make improvements at the service.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.