Blenheim Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Most relatives felt their family member was safe living at the home and said they would speak with staff if they had any concerns. We received mixed feedback from people, some told us staff were lovely and took time and listened. Others told us staff spoke over them and were rushed. One person said, “Most of them [the staff] are excellent.” Another person said, “If talking to a staff member, if they [the staff] don’t like what you say they turn their back and walk away.” Our observations showed staff did not always provide person-centred care and support. People’s risks were not always manged effectively, and people were not always listened to. We observed some staff were very caring and respectful and people spoke very highly of the activity coordinator. People and relatives told us the service was clean and did not raise any concerns about infection control. People’s family and friends were free to visit when they wished.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives felt more confident with the new management team. One relative said, “There has been quite a few managers, but there has been big changes since [support manager] has been here.” Another said, “[Manager] has balance she comes in all the time and talks to residents, she’s very positive.” However, not all relative’s felt action was taken appropriately when issues were raised. One relative said, " They [staff and management] just don’t know really what they’re doing.” We also found people's health care needs were not alwasy effectively assessed or reviewed to ensure positive outcomes.

The management team was implementing new practices to continually improve the service ensuring new systems were embedded into practice.

We identified processes were not always followed. However, the management team was aware improvements were required and were implementing more robust processes. These included, safeguarding and analysis of accidents and incidents. Action was being taken to mitigate future risks. For example, liaison with professionals to manage falls and moving and handling risks.

People and relatives told us health care professionals regularly visited the service. We saw evidence in care plans of visits and referrals when required. Relatives confirmed their family member saw their GP and could request a visit if they felt they were unwell. However, we saw that changing needs were not always assessed or rviewed to ensure they were met. Thsi was being addressed by the new management team but requird embedding inot practice.

The manager explained how they monitored care needs to ensure information was shared, reviewed and they carried out root cause analysis and fact finding to ensure lessons were learnt to improve the service. The systems had recently been improved and were being embedded into practice.

The local authority had received concerns about the quality of care and safety of people using the service. However, feedback was the new manager and support manager had improved systems and at recent visits professionals had seen some improvements. A visiting professionals told us, “I have a lot of confidence in the [support manager], they have made improvements, I am glad to see them back.”

Processes were in place to enable a smooth transition between services and to reduce the impact on people. However, these processes were being improved to ensure they were followed to provide a robust system o record, monitor and review care needs so appropriate information was shared between staff and other professionals.

People told us they felt safe and felt they could raise concerns if they needed to. Most relatives felt their family member was safe living at the service and said they would speak with staff if they had any concerns. Relatives told us they were more confident now with the new manager that any concerns raised would be followed up and action taken.

The management team shared information of the action they were taking to ensure people were appropriately supported and safeguarded from abuse and possible harm. There was a commitment from the management team to provide staff with the skills and knowledge to keep people safe from abuse and neglect.

Staff predominantly supported people safely. Staff were aware of safeguarding procedures and reported incidents.

There were effective systems, processes and practices to make sure people were protected from abuse and neglect. The service had policies and procedures in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The service was aware of the need to and had submitted applications for people to assess and authorise that any restrictions in place were in the best interests of the person.

People and/or their relatives told us they were involved in assessing and managing risks. However, we found risks were not always managed effectively. For example, risk of weight loss, tissue viability, moving and handling and continence needs were not managed effectively.

The management team assessed risk to ensure people were appropriately supported. They were aware improvements in documentation were required and were working with staff to embed good practice.

Staff did not always support people safely, peoples changing needs were not always identified. We observed staff following peoples moving and handling care plans, however, people’s needs had changed, and the procedures were not safe.

People had individual risk assessments in place and the care plans detailed actions to be taken. However, staff were not assessing changing needs or documenting effectively, therefore it was not possible to determine if the care plans were being followed. There was no monitoring, review or oversight of the risks.

People were cared for in a safe environment that was designed to meet their needs. People had a range of equipment available to use.

All maintenance checks were completed to ensure safety. Staff said there was enough equipment available to meet people’s needs.

We saw evidence that environmental and equipment checks had been completed. Equipment was available in different areas of the service for staff to access easily. Maintenance of the environment was ongoing at the time of our site visit to ensure it was well maintained and safe.

Environmental safety checks were in place, ensuring the environment and equipment was safe for people to use. This included fire safety, legionnaires and lifting equipment.

There were sufficient staff on duty to meet people’s needs. Staff responded to calls of assistance in a timely way. However, we observed staff at times lacked effective deployment, support and direction. We had mixed feedback from people and relatives. One person said, “Staff always come quickly when you call.” Another said, “There’s not enough staff for a start, I have to wait for assistance, and if staff are doing food they don’t come. I have to wait for the toilet.” A relative said, “More staff should be deployed in the smaller sitting room as they [staff] are mostly in the large sitting room.” The management team were working together to improve leadership and were aware this required

There was a staffing dependency tool used, the staff levels were over and above this. Staff told us there were adequate staff on duty to meet people’s needs. . Staff were visible in communal areas throughout most of the day, Staff received training to ensure they had the skills to meet people's needs.

There were sufficient staff available to support peoples care needs in a timely way. Staff received supervision and support. However, we observed staff did not always follow best practice when supporting people with moving and handling, therefore, training had not been effective. The new management team acted on this immediately and arranged moving and handling training for all staff.

The provider had processes in place to determine staffing levels, which were followed. There was a robust, safe recruitment process in place. Staff received appropriate training and support to fulfil their roles and responsibilities. Effectiveness of training was being reviewed through staff supervision.

People and relatives felt the service was predominantly clean. People were positive about the improvements being made to the environment and said things had improved with the new management.

There was a major maintenance and renewal programme on going to improve the service. The infection control audit tool had been improved and best practice guidance was followed.

We carried out a tour of the service, there was maintenance work ongoing to improve the environment. However, we found areas that were not clean. For example, lounge chair seat covers had strike through and malodorous, storerooms were cluttered, unorganised with items stored on the floor, shower and bath chairs were dirty and stained. We also identified there were no hand washing facilities in the sluice areas

There were systems in place to monitor infection, prevention, and control. However, the audit tool used did not identify some areas that required attention. Improvements were made following our site visit.

Safe systems were in place to ensure people received medicines. However, when people were prescribed medicines to be taken ‘when required’ or with a choice of dose the guidance to support the safe administration was not person centred. This meant staff did not have enough information to tell them when someone may need the medicine or how much to give. We observed staff administering medicines appropriately and safely. Medicines were checked on receipt and disposed of correctly.

There were measures in place to ensure medicines were managed safely. Staff received training and competency assessments.

There were systems for checking that medicines were, received, administered correctly and disposed of. Regular audits were carried out. ‘When required’ protocols were updated following our visit.