Blair Park Residential Care Home

Blair Park Residential care home is a large detached house in a quiet residential area. It provides care and support for up to 47 older people, most of who are living with dementia. At this inspection, there were 31 people living in the service.

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

People told us, “They [staff] do everything you want them to do, so it’s not a problem. And they are very good giving choices.” And “Staff are very good, friendly and brilliant’”

People were protected from the risk of harm as robust safeguarding procedures were in place and staff had a good understanding of their responsibilities. Risks associated with people’s care and wellbeing were safely managed.

We found that staff were adhering to government guidance on Covid-19. We observed staff wearing masks correctly in the service.

Staff were recruited safely, and checks were completed. People were supported by staff with the relevant skills and experience, which enabled them to meet people’s needs. Staff also received appropriate training to enable them to carry out their roles safely. Staffing rotas showed, and we observed there were enough staff deployed 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.

Medicines were safely managed and administered. Staff received appropriate medicine administration training. Staff understood and demonstrated their responsibilities to raise concerns, to record safety incidents, concerns and near misses, and to report them internally and externally, where appropriate.

People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted. The manager had good oversight of the service and the staffing team.

The manager and staff team learnt from incidents that had happened. Any incidents were discussed, and trends and pattern analysed to improve the service.

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 10 July 2017).

Why we inspected

We received concerns in relation to management of the service and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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 Good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see safe and well-led sections of this full report.

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

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.

Visitors were asked about their Lateral Flow Test (LFT) result to ensure they were negative before staff facilitated the visit, temperatures were taken with a standalone automatic temperature taking machine, which further reduces the possibility of transmission. Visitors were also advised to sanitise their hands-on arrival and wear face masks.

Arrangements were in place for visitors to meet in a safe area within and outside the service which minimised the risk of infection spread. The registered manager had opened up the home for visiting based on latest government guidance.

Plans were in place to isolate people with COVID-19 to minimise transmission if required. The service had good supplies of personal protective equipment (PPE) such as masks and hand sanitisers that were readily available at stations throughout the service.

Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and were regularly tested for COVID-19. The building was clean and free from clutter and there were enhanced cleaning practices.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service had a strong, person centred culture and the ethos was that of an extended family. People and their relatives told us the staff were extremely caring, compassionate, attentive and dedicated in the way they supported people. Staff had built positive and caring relationships with people. Interactions between people and staff were affectionate, relaxed and tailored to each person. Staff offered people reassurance and encouragement when supporting them. People were supported to expand their social circle and build friendships through links with the local community, including churches and schools. The management team and staff supported people to feel welcome in the service and to build relationships with the other people who lived there. Staff were exceptionally skilled at demonstrating a caring approach to people with dementia.

People were involved in developing and updating their care plans. People’s care plans were person centred and showed what people could do for themselves and how they preferred to be supported. People were supported to make their own decisions and remain as independent as possible. Staff supported people in the least restrictive way possible. Staff treated people with the utmost dignity and respect. People’s privacy was protected and promoted by all staff. People could have visitors whenever they liked and were supported to maintain relationships with family and friends. There were dedicated activity staff and they offered a wide variety of activities.

People told us they felt safe at the service. Staff recognised different types of abuse and knew who they would report any concerns to, they were confident that the registered manager or deputy manager would address any issues. Risks to people were identified, assessed and plans were put in place which gave staff the guidance needed to manage and minimise the risks. People’s medicines were managed safely and in the way they preferred.

There were enough staff to meet people’s needs and they were recruited safely. Staff told us they were well supported, they had regular one to one meetings with their line manager and had the training required to meet people’s needs. People, staff and relatives told us that the registered manager and deputy manager were approachable and accessible. Everyone working at the service shared the same visions and values, which were to give people excellent care and support them to have the best lives possible.

People had a choice of food and drinks each day which met their dietary and cultural needs. When people were at risk of losing weight they were referred to a nutritionist and any guidance put in place was followed by staff. People had access to healthcare professionals when required and any concerns about people’s health were responded to quickly.

The registered manager asked people for feedback about the service and their care on a regular basis and took action to address any issues raised. People and relatives told us they knew who to speak to if they had a complaint and were confident any issues would be addressed. Both the registered manager and the deputy manager had clear oversight of the service, using regular audits and addressed any issues as they arose. Staff worked in line with policies and systems established in the service to provided people with a high standard of care and support.

Further information is in the detailed findings below.

We found that the service provided a clean environment for people who used the service and there were effective systems in place to reduce the risk and spread of infection.

There were appropriate arrangements in place to manage medicines safely and effectively.

We saw that the premises were designed to provide care in an environment that is suitable for its purpose and adequately maintained.

We saw that records were accurate and appropriate for the management of the service.

We found that people were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records relating to care received were not always maintained.

We found that people felt well cared for and happy at the home. Guidance from healthcare professionals was taken into consideration when care was planned.

We found that the home did not have appropriate processes in place for managing the cleanliness of the service and checks were not always carried out to ensure that communal areas were cleaned regularly.

We looked at how medication was managed by the service and found that there were inappropriate processes for managing topical creams that were prescribed to people who used the service. We also found that other medication errors had occurred which had not been identified by the service.

We looked around the environment and found that there were some areas of the environment which were in need of repair.

We saw that the manager had implemented some audits to monitor the quality of the service. People were able to give their opinions about the service and staff felt able to raise issues or make suggestions about how the service was run.

We looked at records held by the service. We found that they were not always kept up to date and accurate.

Staff were trained in protecting people from abuse. Staff were knowledgeable about what to do if they suspected abuse and knew how to contact other agencies if they needed to.

We looked at how medications were stored, dispensed and recorded. We saw that there were appropriate processes in place for ensuring that medication was administered safely however it was not always recorded accurately.

We saw that there was a complaints procedure available in a communal area of the home. Relative's of people we spoke with told us they were aware of the procedure but had never had a reason to make a complaint.

We looked at care records for people. We saw that some care records were not accurate and did not reflect all of people's needs.