Blair Park Residential Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

There was a real wish to provide a high-quality service to people, one that gave people choice and control and gave them a good sense of well-being. Senior management continuously reviewed the level of the service they provided and took action when care fell below the expected standard. Despite this wish however, we observed instances when care fell below our expected standards.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager and deputy manager had the same drive to move the service forward. They had made a number of changes since our last visit, which included a refurbishment programme to add en-suites to some people’s rooms, extend the outside patio area and create a new dining area as well as communal lounge area. In addition, sensory items and signage had been updated to help orientate people living with dementia. The registered manager told us, “We care a lot about what we do. We can’t change the condition but we can give them happiness and a nice home.” Staff told us they felt supported by management and that the there was a good working culture within the staff team. One staff member said, “We have a really good strong team. If we have any concerns we can raise it as a team. We go to a senior or [deputy] or [registered manager]. Management 100% make you feel comfortable.” However, although there were positive changes to the environment, we found the culture within the service was not always wholly positive. Managers did not always lead by example and as such, much of the care we observed during our visit was task orientated and not person-centred or individualised.

The registered manager said, “We have done a lot of fundraising for the home and relatives want to support our vision of improving. We are setting up a residents/family committee and just need to pick a chair. We are also setting up a dementia group to support relatives and pass on information and updates. We have improved cosmetically and in terms of staffing which was our main focus.” They added, “We want people to have really good care here and a good experience. I introduced drinks bottles for everyone. It has helped increase the amount of fluid people drink and staff can easily monitor their fluids.” These were positive steps to continue to involve people and their family members in the day to day life of Blair Park. On the other hand, the registered manager had not considered how they could ensure the culture within the service was consistently good and staff were following best practice through the introduction of systems or processes to continually monitor staff performance and behaviour.

Management told us they provided a good level of service and were always on the floor and knew people well. Despite these comments one person who had lived at the service for some time said, "Seen [deputy name] once or twice, only seen [registered manager name] once when I moved in" and a relative told us, "I have seen her (the manager) once. That’s the first time I have seen her (the manager). I have seen [deputy name] more."

Although there were arrangements in place to monitor the level of service people received, the systems and processes were not always effective in identifying people's individual needs which may help staff to provide a level of service which enhanced their lives. For example, we heard from one person, "I have a promise of a room downstairs but that’s always just a promise" and another person tell us, "I have asked for a key for my room, but I have never been given one."

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The registered manager said there was an auditing and governance system within the service. They told us some of it was included in their electronic care planning system. The registered manager told us, “There is a matrix on the [care planning] system that logs all this information (themes and trends for accident and incidents).” Yet, we did not see any monitoring of staff performance other than through supervision. This meant day to day practices of staff were not always being reviewed or observed to enable staff to reflect on the care they provided to people.

Regular audits were carried out within the service. These were used to identify any shortfalls or actions required. For example, the registered manager had recently carried out a medicines audit in which they found gaps on people’s medicines administration records. As a result a second checking system was introduced to make sure medicines were signed for when dispensed. Other audits included accidents and incidents, care plans, the environment, staff files and training compliance. However, we found some shortfalls in people’s care plans which had not been picked up by audits. For example, one person who was at high risk of falls and also suffered from depression had no risk assessments in relation to these. Immediately following our visit, the registered manager sent us contemporaneous care plans and risk assessments for the gaps we had identified. There was no audit process which supported the registered manager to identify where care may be undignified or poor practices were being carried out by staff.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.