Enter and view: Blenheim House

Healthwatch Wiltshire carried out an unannounced Enter and View visit to Blenheim House, a 53-bed care home in Melksham operated by Majesticare, on 10 June 2016. The purpose of the visit was to observe the quality of care, speak with residents, relatives, and staff, and assess residents’ experiences of living in the home. At the time of the visit, 48 residents lived at the home, which provided residential, dementia, and nursing care. 

Overall, Healthwatch found Blenheim House to be a pleasant, welcoming, and well-maintained home. Residents generally spoke positively about their experiences, describing staff as friendly, caring, and respectful. Many residents said they felt safe, well cared for, and able to raise concerns if needed. Several commented positively on staff attitudes, with one resident saying that staff were always cheerful and enjoyable to be around. 

The home’s environment was viewed positively. The building was attractively presented, with welcoming communal areas, personalised bedrooms, a café, library, cinema, hair salon, and accessible gardens. Residents had opportunities to personalise their rooms, and those living on the dementia floor had memory cabinets containing personal photographs and keepsakes to help support reminiscence and orientation. 

Healthwatch observed that the home generally appeared clean and well maintained. However, on the dementia care floor there was a noticeable smell of stale urine in one area, and some parts of the décor showed signs of wear and tear. The report suggested refreshing decoration on that floor and continuing efforts to address unpleasant odours. 

Residents reported that they were offered choices about their daily routines, including when to get up and where to eat their meals. Most residents enjoyed the food and appreciated being able to choose from menu options or request alternatives. While feedback was largely positive, one resident commented that meals could sometimes be hotter. 

The home offered a broad programme of activities coordinated by dedicated staff. Residents described enjoying gardening, painting, shopping trips, pub outings, and celebrations of birthdays and national events. The home also employed a companion who spent one-to-one time with residents, particularly those without regular visitors or those nearing the end of life. 

Relatives spoke positively about communication with staff and management. They reported being kept informed about changes in residents’ conditions through meetings, telephone calls, and email updates. One relative particularly appreciated being notified promptly after their mother's fall and hospital admission. Families also felt that residents’ changing needs were responded to appropriately, including transfers between dementia and nursing care floors when required. 

Healthwatch observed staff interacting with residents in a caring and respectful manner. Staff reported that the home had experienced a period of instability and high staff turnover but felt that recent improvements in recruitment, communication, and teamwork had led to a more settled environment. Staff valued regular meetings and ongoing training, including dementia care training and clinical skills development. 

Some concerns were identified during the visit. Healthwatch noted that it was relatively easy to enter the building without being challenged, raising questions about entrance security. A small number of residents reported occasional delays in responses to call bells or receiving medication. Some staff expressed concerns about staffing levels during night shifts. The report also suggested that larger clocks and day/date displays could benefit residents, particularly those living with dementia. 

Healthwatch concluded that Blenheim House provided a positive living environment and good-quality care. The report made five recommendations: to review entrance security, continue addressing smells and décor issues on the dementia floor, install clearer clocks and calendars, monitor call bell and medication waiting times, and continue efforts to maintain sufficient staffing levels and strengthen teamworking. 

In its response, the provider stated that action had already been taken to improve entrance security, that work was ongoing to address environmental concerns, and that call bell and medication response times were being monitored electronically. The provider also highlighted ongoing efforts to ensure appropriate staffing levels and welcomed recognition of recent improvements in staff morale and communication.