When we visited the home in September 2011 we had concerns in the five outcome areas we inspected. The registered manager provided an action plan to show improvements would be made. As part of this inspection we looked at how the action taken had led to better outcomes for people living at Blackwells.At this inspection we met six people who lived at the home and we spent time talking with two of them about their life. We spoke to a relative of one person and two of the care staff on the telephone. We spent time with the registered manager and asked external professionals involved with the service for their views.
We found that people's diversity, values and human rights were respected. The care staff we spoke with talked about the people in the home in a caring and
respectful way. They understood that people had different needs and could cope with different pressures due to their learning disability or mental health needs. We saw that care staff offered people choices such as how to spend their day, while care staff also encouraging good daily routines such as bathing and changing clothes.
Systems were in place to involve people in decisions about their lives. One example was that each person had two care staff designated as their keyworkers. This role involved meeting with the person who lived in the home at least monthly to check if they had any concerns, goals or ideas they needed support with.
We saw the feedback surveys that had been returned to the home in January and April 2012. The results were positive. The relative of one person who lived in the home had written, 'I am very satisfied with the overall care and support my relative receives, my relative always seems happy and content when I visit and always has plenty of activities planned'. A consultant psychiatrist who visits monthly had given positive feedback, for example, they had ticked 'consistently high quality performance', and, 'friendly and professional staff'. A visiting health professional had written, 'the manager is very committed to providing an excellent service and works well with other agencies'.
One person's relative told us, 'We visit monthly and we always find our relative clean and well dressed, the care is generally good. There seems to be enough staff on duty'.
We found that people were supported in promoting their independence and community involvement. One person we spoke with told us, 'The staff are great and I get on well with my keyworker. I am going out more, I went to town yesterday and today. I am cooking my own food now using recipe cards and I am doing my laundry now without staff support'.
The registered manager told us that a lot of work had been done to increase the opportunities provided to people to develop life and independence skills. Examples given were food shopping, drink and meal preparation, carrying plates out after a meal, doing personal laundry or dressing unaided. We saw a sample of care plans and daily records that confirmed this new way of working. Care staff gave us positive feedback about how people's needs were met. One told us, 'We now have enough staff to meet people's social needs, the care is personalised and we always meet people's physical care needs. We are definitely working more to develop people's independence skills'.
One person we spoke with told us, 'Yes, I feel safe here and I can lock my bedroom door. I would tell staff the staff if I had any worries'. At the time of our last inspection one person had made a complaint about how they had been treated by a care worker. The registered manager took appropriate action and promptly made a safeguarding alert to the local authority. The care staff we spoke to were aware of their responsibilities and said the culture in the home was one where poor practice would be reported. Safeguarding alerts had been made that demonstrated this.
The registered manager told us that the number of care staff in the team had been increased which made covering for short notice sickness much easier. For a three month trial starting in April 2012 an additional care worker would be on duty at peak times. They felt this would mean each person could be offered an outing each day.
We saw the staff on duty engaging positively with people during our visits. People
seemed relaxed with the care staff and wanted to spend time with them. One person we spoke with told us, 'I like all the staff, they know the things I like to do'.
A community based Speech and Language Therapist told us, 'The staff at Blackwells have been keen to access training on Total Communication, Dysphagia and Singalong signing'. The registered manager showed us a training chart they used to help monitor each worker's training needs. This showed that gaps in training needs had been addressed. Care staff had attended training since our last inspection and other courses were booked or were awaiting the next available date.
One person we spoke to said they felt able to tell care staff and the registered manager if they had any problems. When they had raised a concern in September 2011 the registered manager took this seriously and took appropriate action.
One person's relative told us, 'We feel able to raise any issues but have not had any lately'.