Blackburn (Florence House)

Safe – This means we looked for evidence that people were protected from abuse and avoidable harm. For this key question we assessed the quality statements relating to; learning culture, safe systems, pathways and transitions, safeguarding, involving people to manage risk, safe and effective staffing and medicines optimisation.

Incidents and accidents had been investigated, policies and guidance to support staff to act on incidents and accidents was available. Safeguarding investigations were ongoing and we received feedback that incidents had reduced recently.

Preadmission and transitional assessments had been completed, but people and relatives were not usually involved. Individual and environmental risks assessments had been undertaken along with safety checks, servicing and emergency planning.

Staff were recruited safely and ongoing supervision and support was in progress. Training had been undertaken, including specific training to support people’s individual needs.

Medicines were generally managed safely, and people received the medicines they needed in the right way.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

For this key question we assessed the quality statements relating to; assessing needs, delivering evidence based care and treatment, supporting people to live healthier lives, monitoring and improving outcomes and consent to care and treatment.

Care plans reflected changes in people’s needs and the involvement of professionals, as well as information about end-of-life care needs, where this was relevant. Assessments were undertaken but not all people and relatives could confirm they had been involved in them. A number of people had lived in the service for a long time. Staff told us they had access to information to provide up to date care to people. One person said, “Care plans are done by managers in the nourish [electronic system]. We have access to care plan and you can update the records.” The provider was working within the principles of the MCA. Staff understood the importance of seeking consent before undertaking any care or activity.

People were offered choices including care and meals. People’s individual needs were considered in relation to their meals. A good arrangement was in place to provide meals, considering cultural and religious practices. Professionals were usually involved with people’s needs where this was required. Information, guidance and policy was available to support staff.

Caring – This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

For this key question we assessed the quality statements relating to; independence, choice and control and responding to people’s immediate needs.

People were treated with kindness and most people were happy with their care. Staff promoted independence and knew how to provide care for people and meet their needs. Staff had access to electronic care records with information about people’s needs, likes and choices. Activities were ongoing in the service and in the community.

Responsive- This means we looked for evidence that the service met people’s needs.

For this key question we assessed the quality statements relating to; person-centred care and equity in experiences and outcomes.

People were supported with their care needs though not all people and relatives had been involved in care planning and reviews. Staff understood people’s needs and how to access the information to support them in their care. Policy and guidance was available to support people with decision making. Care plans had been developed and were available for the staff team on the electronic system. Staff responded to changes in people’s needs. The registered manager discussed actions taken to address a concern raised by two people during our observations.

Well-led – This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

For this key question we assessed the quality statements relating to; capable, compassionate and inclusive leaders, governance, management and sustainability and learning, improvement and innovation.

There was a new registered manager in post and support was ongoing from the senior team. There was a commitment to continue to make improvements in the service. We received positive feedback from professionals about the changes in the service. Staff were mostly positive about the management and the support they provided. One said, “It is really well organised everyone pulls their weight and we work together.” Audits and monitoring were undertaken and an action plan was ongoing to support improvements in the service. Notifications were being submitted to the Care Quality Commission as required.