Blenheim Court Care Home

We found the following examples of good practice.

As a result of the Coronavirus pandemic additional actions had been taken to further reduce the risk of the spread of infections. Staff were allocated to work in only one of the two units. New procedures had been implemented to restrict access to shared work spaces, such as the kitchen or laundry room.

The premises were clean and well maintained. Cleaning schedules had expanded to address more at-risk areas of the building. For example, high contact areas such as door handles and light switches were regularly cleaned throughout the day. All staff had received recent training in infection control and prevention and their competency in this was regularly checked by managers.

Visits were restricted at the time of this inspection. Relatives and friends were kept informed of any visiting restrictions and the guidelines they were expected to follow.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.

Blenheim Court is a residential care home providing personal and nursing care to 32 people at the time of the inspection. The service can support up to 38 people in one adapted building.

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

Risks to people were assessed and recorded, although these were not always cross-referenced with the recorded needs in people’s care plans staff were knowledgeable about these risks. Systems were in place to safeguard people from abuse and staff were knowledgeable about the signs of abuse. Staffing levels were monitored according to people’s needs and people and staff told us there was sufficient staff. Medicines were administered safely. The home was clean and generally odour-free. Accidents and incidents were recorded and monitored, processes were in place to learn from these to reduce or prevent recurrence. We have made a recommendation that people’s emergency evacuation plans are regularly reviewed.

People’s needs and choices were assessed in line with legislation and guidance. Staff were deployed according to their skills and experience. Staff received appropriate training, supervision and appraisals. People were supported to eat and drink enough to maintain a balanced diet, and people were complimentary about the food. Staff worked with professionals to support people’s well-being and health. Decoration at the home had been considered to support people’s needs. Consent to care was sought and recorded. 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. We have made a recommendation that daily records accurately reflecting the care and support provided.

Observations showed people received kind and considerate care. Staff were attentive to people’s needs. People’s privacy and dignity were respected and promoted.

People received personalised care according to their wishes and preferences. Complaints and concerns were recorded, responded to and monitored. People were supported at their end of life.

The home’s values and vision were used to recruit new staff. There was an open and transparent culture. Systems were in place to ensure quality performance and risks were monitored; care plan audits were a work in progress. People, relatives and staff were involved in the running of the home. The home worked in partnership with community organisations.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 20 October 2018) and there was a breach of regulation relating to good governance of the service. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

Blenheim Court is a ‘care home’. People in care homes receive accommodation and nursing or 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. Blenheim Court is registered to provide accommodation, personal and nursing care for up to 44 older people. Whilst some bedrooms were large enough to accommodate two people, these rooms were all single occupancy rooms and this meant Blenheim Court provided accommodation for up to 35 people. At the time of the inspection there were 30 people living at the home.

Our last inspection at Blenheim Court took place on 8 May 2017. The service was rated requires improvement overall. We found the service was in breach of three of the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014. At this inspection we checked the improvements the registered provider had made and found some improvements had been made but were not were sufficient to meet the requirements of all regulations. We found a continued breach of regulation 17, Good governance. We have subsequently made four recommendations in our report, which means we expect the registered provider to consider our feedback and make reasonable improvements before the next inspection.

There was a manager at the service who had been in post since March 2018. The manager informed us they were applying to be registered with CQC. 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 and associated Regulations about how the service is run.

Most people living at the service told us they felt safe. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. Staff had completed safeguarding adults training and were aware of their responsibilities in protecting people from abuse. We found systems were in place to make sure people received their medicines safely so their health needs were met. On the day of the inspection we found there were sufficient numbers of staff to meet people’s needs and it was evident that staff had been safely recruited. However, people told us they sometimes had to wait for personal care and staff were too busy to chat with them. We made a recommendation about the staffing arrangements at the service.

The service worked collaboratively with external health services to promote people's wellbeing. People’s care records contained detailed information and reflected the care and support being given. Most staff told us they enjoyed working at the service and had received support, training and supervision to help them to carry out their support role effectively. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. We found people’s nutritional needs were met but meal options provided were not always balanced and nutritious.

During the inspection we observed staff treated people with respect and dignity, and staff supported them in a way which met their needs. However, we identified practices which did not promote people’s dignity. We also received mixed feedback about the quality of the activities provided and people said there were limited opportunities for meaningful social opportunities outside of the service.

There were systems in place to monitor and improve the quality of the service provided. We also saw an action plan was in place to drive continuous improvements at the service, which identified actions for completion by who and by when. During the inspection the manager demonstrated she was responsive to our feedback and understood further improvements were needed.

Blenheim Court had been operating for many years. Logini Care Solutions Ltd took over the home and were registered with CQC in May 2016. This is the locations first inspection since the new providers were registered.

There was a manager at the service who had been in post since September 2016. Prior to this the manager had been employed as the deputy manager at the home. The manager informed us they were applying to be registered with CQC. 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 and associated Regulations about how the service is run.

This inspection took place on 8 May 2017 and was unannounced. This meant the people who lived at Blenheim Court and the staff who worked there did not know we were coming. On the day of our inspection there were 35 people living at Blenheim Court.

People spoken with were positive about their experience of living at Blenheim Court. They told us they felt safe and they liked the staff.

Parts of the premises had been left insecure and posed a potential risk to people’s safety.

Sufficient numbers of staff were not provided to ensure people’s needs could be met in a timely way and the manager covered parts of some shifts due to shortage of staff. This reduced time available to dedicate to managerial responsibilities.

We found systems were in place to make sure people received their medicines safely so their health was looked after.

Staff recruitment procedures ensured people’s safety was promoted.

Staff had not been provided with relevant training to make sure they had the right skills and knowledge for their role.

Staff were provided with supervision for their development and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the registered provider’s policies and systems supported this practice.

People had access to a range of health care professionals to help maintain their health. A varied diet was provided, which took into account dietary needs and preferences so people’s health was promoted and choices could be respected.

Staff knew people well and people told us the staff were caring. People’s privacy and dignity were respected and promoted.

A programme of activities was in place so people were provided with a range of leisure opportunities.

People said they could speak with staff if they had any worries or concerns and they would be listened to.

There were some systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to. However, some of these audits were ineffective as risks within the environment had not been identified and minimised.

We found three 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.