Inspection on 07/08/07 for Bolealler House

This inspection was carried out on 7th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bolealler House 09/09/09

Bolealler House 18/08/06

Bolealler House 11/11/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Bolealler House Bolealler House Westcott Cullompton Devon EX15 1RJ Lead Inspector Vivien Stephens Unannounced Inspection 7th August 2007 10:30 Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bolealler House Address Bolealler House Westcott Cullompton Devon EX15 1RJ 01884 38275 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) bh.ltd@tiscali.co.uk Bolealler House Limited Anne Maddox Care Home 20 Category(ies) of Learning disability (20), Learning disability over registration, with number 65 years of age (20), Mental disorder, excluding of places learning disability or dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20), Old age, not falling within any other category (20) Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Date of last inspection 18th August 2006 Brief Description of the Service: Bolealler House is owned by Bolealler House Ltd, a subsidiary of Allied Care Ltd. The property consists of a large detached country house with a converted stable block and a further extension, called Angels. It is situated in a rural area between Broadclyst and Cullompton. The main property is a period style house retaining many original and interesting features. The recent extension, Angels, is a stylish and modern house that operates separately from the main house, with its own kitchen, lounge, dining room and bedrooms. There are large grounds and lovely views of the surrounding countryside from many of the rooms. The home provides support and personal care for 20 adults with a learning disability or a mental health problem. The home has transport to enable service users to use local facilities. The inspection report is available in the home for anyone who requests to see a copy. The inspection reports are read out in Residents’ Meetings. All staff are given a copy of the report and asked to sign to confirm they have read it. Fees range from £442.45 to £1,368.91 per week Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Several weeks before this inspection began the home was asked to complete a self assessment questionnaire in order to demonstrate the ways in which they check the quality of the services they provide and how these can be improved. Survey forms were also sent to all of the people living in the home, the staff, relatives, GP’s, care managers and other health and social care professionals who regularly visit the home. 16 responses were received from people living at the home, 15 responses from staff, 2 responses from relatives, 1 response from GP’s and 1 response from care managers. The inspection began at approximately 10.30 am and finished at 6.45pm. 19 people were living in the home on the day of this inspection. 1 person was away on holiday accompanied by a member of staff. During the day a tour of the home took place. We talked to most of the people living in the home, some only briefly. We spoke to four people at length to find out their views about life at Bolealler House. During the day we also looked at the care files for four people and all of the documents relating to their daily care, including medicine administration and accident reports. We also looked at four files of staff who have been recruited in the last year. We saw the records of their induction training. We also looked at the training records for all staff. During the day we spoke to the manager and four staff in order to find out if the home is well run. What the service does well: Although no new people have moved into the home for several years we were assured that good care will be taken before any new person moves in at any time in the future. We heard how the person will be encouraged to visit, stay for a while, and get to know the home in order to be certain that Bolealler is where they want to live. The home will take care to gather sufficient information to be certain that they fully understand the care and support the person needs, and to be certain that they have the right skills to meet those needs. They will also make sure that the person will ‘fit in’, and will be comfortable with everyone living and working in the home. The home has an excellent care planning system in place that places the views and opinions of the people living in the home as the starting point. People are invited to say how they want to lead their lives, what they want to do, and what help they need. From this information the home will then draw up a plan that explains to staff how they will support the person to achieve their goals. The plans cover all areas of health, personal and social care needs, and identify Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 6 any possible risks. The staff have completed daily reports about each person and how they have been supported to do the things they want to do. Bolealler is a lively and happy home. People were busy doing all sorts of different things on the day of our visit. Some were out either on their own, or with staff. One person was out walking in the lanes nearby, one person was out shopping, one person went horse riding, and another person was on holiday with a member of staff. We saw people doing a number of planned activities, including cooking and household tasks, and arts and crafts. People told us about lots of things they enjoy doing, including college classes, meals out, music, games, and art. The people we talked to were proud of their achievements. People told us that they are certain that they can speak out if they have any concerns, and they were confident that the home will listen and act on their concerns. Everyone has been given a copy of the complaints procedure – written using symbols as well as words - and it has also been explained to them. We heard that there is an open atmosphere where people feel comfortable to speak up, safe in the knowledge that their views will be taken seriously. Staff have received training on the protection of vulnerable adults. We saw that the home has taken care when selecting and recruiting new staff to make sure that they are entirely suitable for the job. There is a comprehensive induction procedure lasting for the first three months of employment and this ensures that new staff have the basic skills they need to do the job well. Following this there is a good range of training offered including nationally recognised qualifications in care. The staff we spoke to said they really enjoy their work and praised the home and the company for the way they have been recruited, trained and supported. People told us that the home is well managed. The managers are well liked and people feel confident that the managers are acting in their best interests. We found that the home is safe. All equipment has been well maintained and checked regularly. Staff have been well trained in all aspects of health and safety. Policies and procedures and good systems are in place to ensure staff are aware of potential hazards and what they have to do to prevent people suffering any harm. What has improved since the last inspection? In the last year many improvements have been made throughout the house and grounds. Two maintenance men are employed to keep the home well decorated and maintained. Many areas have been decorated, new windows and doors have been installed in the converted stable block, carpets have been replaced, and the former office has been converted into a lounge for smoking, and a spare bedroom. The garden has been improved with paths, gravelled driveway and ornate fish pond. All areas of the home appeared bright, clean and homely. Everyone has a good sized single bedroom that has been Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 7 decorated and furnished according to their individual tastes, interests and choices. Good systems are in place to continuously check and improve standards. We were told that people are encouraged to speak up about all aspects of day to day live in the home. There are a variety of ways of listening to people including group meetings, staff supervision, individual reviews of care plans, and questionnaires sent to everyone living, working or involved in the home. There was good evidence to show what has been done to address any points raised. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may be thinking about moving into Bolealler House can be confident that they will be given as much information and time as they need to help them get to know home and decide if it is where they want to live. The home won’t admit new people unless they are certain they can meet the person’s needs. EVIDENCE: All of the people living at Bolealler at the time of this inspection had been living there for many years. Anne Maddox explained the process they will take in the future before any new person moves in. This process will be careful, with plenty of opportunities for the person to visit and get to know the home before they decide to move in, including overnight stays if possible. They have detailed assessment documents that guide them to gather information about all aspects of the person and the ways in which they will need support. They also gather information from family or carers, social workers or health professionals in order to gain a clear understanding of the person and the assistance they will need in order to lead their lives as they wish. The home has a detailed Statement of Purpose giving a wide range of written information about the home with some photographs. Anne Maddox said they Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 10 would read the document to the person if they were unable to read. She also talked about alternative formats for this information if necessary. She said that as they haven’t had anyone move in for several years they haven’t drawn up any alternative formats for information about the home, but said they would consider this if necessary. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People can lead their lives as they wish, as set out and agreed with them in their individual plan of care. The staff help people to speak out about things that matter to them, and listen and act on the things they say. EVIDENCE: Four care plan files were seen during this visit (these are known as ‘lifestyle plans’). There is a section for the people who live in the home to complete (with assistance where necessary) where they can talk about the things they want to do, the goals they want to achieve, and how they want to staff to support them. This information has been used to help the home develop a detailed care plan explaining how each aspect of the person’s care needs will be met. The plans cover health and personal care needs, likes and dislikes, nutritional needs, and daily activities, and show how the home has sought guidance and treatment from relevant health and social care professionals. The plans explain what the person is able to do for themselves and show how Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 12 the home will continue to help them remain independent, or how they will help them gain new skills. During the visit people talked to us about their daily lives, and how they make decisions about what they do each day. They gave examples of many ways in which they lead busy lives, and have friends and relationships with support and help from staff help as and where they request. They were aware of their care plans and said the staff help them to be as independent as possible. There was good evidence to show that the home has helped people to take responsible risks, where possible finding ways of reducing those risks where possible, while at the same time respecting the right of each person to lead their lives as they wish. The care plans have been reviewed at least annually in conjunction with the person concerned, their family or representative (if they want them to be involved) and any relevant health or social care professionals. On the notice board in the main kitchen there was a notice to say there will be a resident’s meeting the following Thursday. The meetings allow people to express their views about all aspects of the day-to-day running of the home. Anne Maddox also gave examples of other ways in which the people living in the home are consulted and involved, including the recruitment of new staff. Their views are sought on colour schemes in the home, new furniture and equipment, and group activities. Survey forms are sent out at least annually to everyone living in the home to seek their views on a wide range of aspects about the accommodation and care provided. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides support and encouragement to people to enable them to lead stimulating and fulfilling lives. People enjoy a healthy and balanced diet. EVIDENCE: Bolealler is a lively home, with people out and about, doing a wide range of different things each day. During the day we heard many examples of how people have achieved some of the goals they wanted to reach, including weight loss and leading healthier lifestyles, meeting new friends, and becoming happier and more confident in their lives. This was also confirmed by some relatives who contacted us. We saw lots of evidence of how people participate fully in the local community. Some attend church regularly. They all enjoy meals out at a nearby pub on a fairly regular basis. Some attend a local drop-in centre. One person was seen walking in the lanes nearby. He told us how much he loves going out for walks Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 14 every day. Another person returned smiling from a horse riding lesson during the morning. Another person said they like to go into Cullompton on their own several times a week. One person follows a local Speedway team. Everyone living in the home has a bus pass and is able to catch a local bus that will take them either to Exeter or Cullompton. Transport is also provided by the home’s minibus. Several people talked about college and educational courses they have attended, including art, literacy and numeracy skills. We saw certificates of courses they had attended and qualifications they had achieved. One person enjoys needlework and the staff have been gathering information about courses this person may be interested in. Some people have had jobs in the local community in the past, and several currently have paid jobs in the home, including office tasks, cleaning, gardening and maintenance. An arts and crafts instructor regularly visits the home. On the afternoon of this inspection the instructor worked with a group of people to create colourful decorations. People also told us about some of the things they enjoy doing when they are at home. During the warmer weather they like sitting in the garden, or having barbeques. Every week they have a bingo session – this was clearly very popular. Most people have televisions, videos and music equipment in their rooms and told us how they use their rooms as bed-sitting rooms as they wish. People talked about some of the holidays they have had, or were about to have this year. Destinations include Cornwall, Exmouth, Blackpool, and Spain. We heard about how people have met new friends, and how they have been helped to keep in touch with friends and family by visits, phone calls or letters. One relative told us “I have been particularly impressed by the willingness to transport ‘X’ to and from home. This is much appreciated in view of my increasing age! They are excellent at fostering her independence.” At lunchtime we sat and shared a meal with the people in the main dining room. The choices offered included chicken curry, fish or sausages and mashed potatoes and peas, or a vegetarian alternative. A variety of yoghurts were offered for pudding. The weekly menus are displayed around the home, and we heard about how people have been fully consulted over the content of the menus, and how they can always have a meal that meets their likes and dislikes and dietary needs. We were told that the main meal has been changed from midday, to the evening, and back to midday following these consultation sessions. One person was seen eating the main meal in the evening – this was clearly their individual choice. A large bowl with a good variety of fresh fruit was placed on the dining table and we heard how people are encouraged to eat healthily. They home has recently sought advice from a nutritionist on the menus. New tablecloths have been purchased to help mealtimes feel ‘special’. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People receive sensitive and personalised support from well-trained staff who recognise and understand their personal and health care needs. EVIDENCE: All bedrooms are single occupancy, with the exception of a flat in one part of the home occupied by a couple. All doors are lockable and the staff were seen respecting people’s privacy by knocking on bedroom doors before entering. If people need assistance with personal or health care tasks the care plans provide guidance on how these tasks should be carried out in order to maintain privacy and dignity. People talked about the times they get up or go to bed, and how the staff respect their wishes. We also heard how, at times, people who may get up very late in the morning or may want to watch television into the early hours of the morning are given sensitive guidance by staff if this lifestyle affects their health, or upsets other people living in the home. People talked about shopping trips for clothes, and the things they enjoy wearing. We also heard about the support offered by staff to encourage people to take a pride in their appearance, including hairstyles. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 16 People have received advice and treatment from a number of relevant health care professionals in the last year. We saw evidence of a recent visit to the home from an optician, and how people have regular dental checks and treatment. We heard about staff asking people about the support they want for doctors and hospital appointments, and how staff will stay with people overnight if necessary if they have to go into hospital. We also heard about how the staff have recognised the signs of possible illnesses and have sought medical advice appropriately. While people living in the home mainly have good mobility, the staff have recognised where some people are beginning to experience difficulties and have provided aids and equipment as necessary. On the day of this inspection a bath hoist was delivered. In the evening we watched as the teatime medicines were administered. Two staff always work together to ensure this task is carried out safely. The medicines are stored securely at all times, including any that need to be kept cool. The home uses a monitored dosage system provided by a local pharmacist that the home feels gives them a safe and easy to use system that suits their particular needs. Staff have received training on the safe administration of medicines, and this has included checks to ensure they are competent and have understood the content of the training. Records of medicines administered have been completed efficiently to show the medicines received into the home and administered. The home has drawn up an additional record that provided good evidence of regular spot checks and audits of the medicines, ensuring that the correct amounts of medicines are held and no errors have been made. Creams and lotions are correctly recorded, and show the dates opened. The company has policies and procedures in place to guide staff on safe procedures for medicine storage, administration and disposal. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People know that they can speak out if they have any concerns, and can be confident that the home will listen and take action to ensure they are safe and their concerns are addressed. EVIDENCE: All of the people who responded to this inspection by completing a survey form said they would tell the manager if they had any concerns or complaints. They said they have recently been given a form that tells them how to make a complaint. This form uses symbols as well as words, and has been explained to them by the staff. In the last year no complaints have been recorded by the home, or by the Commission. During this inspection we spoke to staff and to people living in the home about how complaints or concerns are dealt with . They all said that if they were worried about anything, or if they saw or heard anything they were uncomfortable about they would speak out, and they felt confident these would be dealt with promptly and correctly. People reassured us that they have had no cause for concern or complaint in the last year and told us there is a very open and happy atmosphere in the home where people felt able to speak out freely about any matter they feel is important to them. People also felt confident that, if necessary, they could talk to senior managers of Allied Care Ltd who would ensure that correct procedures are followed. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 18 All staff have received training on the protection of vulnerable adults. Policies and procedures are in place covering all aspects of alerting and acting upon suspicions of abuse. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a bright, comfortable, clean and well maintained home. EVIDENCE: In the last year many improvements have been made to the property. New windows and doors have been installed in the converted stable block, a new gravel drive has been laid, the former office has been converted to a spare bedroom and a smoking lounge, new stair and hall carpets have been laid, and improvements to the garden have included an ornamental fish pond. Two fulltime maintenance people are employed. In a tour of the home all areas were found to be bright, clean, comfortable and homely. There is an annual programme of redecoration for the house. Most bedroom carpets were in good condition but in just a couple of rooms the carpets were faded and worn. Anne Maddox said that when each bedroom is redecorated new carpets are fitted as necessary, and those remaining carpets will be replaced in the next few months. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 20 Several people wanted to show off their rooms and it was evident that they are proud of their home and clearly appreciate the way it has been improved in the last year. People have been consulted on the colour scheme they want in their rooms. Pictures, posters, ornaments, televisions and music equipment have helped to create highly individual and personalised bedrooms. All bedrooms are of a good size, and are single occupancy. A couple living in the home have their own flat with bedroom, bathroom, kitchen and living room. Bathrooms, shower rooms and toilets around the home are bright, modern, clean and attractive. The kitchen is well equipped with a range of commercial stainless steel equipment and fittings. All areas of the home were found to be clean and free from any odours. There is a cleaning rota posted in the kitchen and there are good systems in place to ensure all routine tasks such as defrosting freezers are carried out regularly. People living in the home help with cleaning tasks – one person was seen vacuuming the stairs and he said he enjoys helping out around the house. Staff have received training on health and safety and infection control, and policies and procedures are in place to ensure that all areas of the home are clean and safe. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are supported by a committed and competent staff team who have been carefully selected and trained. EVIDENCE: On the day of this inspection the manager and assistant manager were on duty plus 5 care workers. 2 maintenance men were also working in the home. 19 people were living in the home (1 vacancy). One person was away on holiday, accompanied by a member of staff. Anne Maddox said they are planning to recruit a third maintenance person and also a cook/chef. The people we spoke to said they felt the staffing levels were ‘about right’. They said the current staffing levels provided sufficient staff to work individually of with small groups of people, and enabled people to go out and about and do the things they want to do. The manager said the ethos of the home is one of ‘a big happy family’. During our visit the staff were seen to have a relaxed, happy and confident manner when working with the people living in the home. There was lots of lively Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 22 discussion around the dining table at meal times. Staff were seen giving equal attention to everyone, and were sensitive to individual needs. Records seen during our visit showed that new staff undertake a very thorough induction programme that lasts for the first three months of their employment and provides them with basic information about all aspects of their work. They are then encouraged to go on and achieve nationally recognised qualifications (known as NVQ’s). On the day of this inspection an NVQ assessor was visiting the home to work with the assistant manager who was in the process of gaining the Registered Managers’ Award and NVQ level 4. We looked at the files of four staff recruited in the last year. These provided clear evidence to show that the home has taken care to select only people who are suitable for the job. Application forms have been completed, at least two satisfactory references have been received, and criminal records checks have been taken up before a new person has been confirmed in post. The files contained copies of training certificates that demonstrated a good range of training has been provided. The staff we spoke to said they thoroughly enjoy their work. One person said she couldn’t think of doing anything else. They said there is a good atmosphere within the home, and plenty of opportunity to discuss issues. Staff meetings are held monthly. 15 staff completed a survey form before this inspection began. All of the responses were positive and showed that they have been recruited, trained, supervised and supported satisfactorily. The staff told us about some of the things they feel the home does very well “Service users’ needs are met at all times and cared for to a high standard.” “Both manager and under manager participate with staff in evening activities for the service users.” (The home) “looks after everybody. I am very happy working here.” “Everything – happy service users, good atmosphere, enjoy working here.” “The care home does well at motivating the service users, making sure that they go out and about if they want to. The care home also makes sure the service users are happy with their meals – if not they are offered an alternative, but try to encourage them to eat healthily.” Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People live in a safe and well managed home where their views will be listed to and acted upon to ensure that standards are constantly improving. EVIDENCE: Anne Maddox has gained a nationally recognised qualification known as the Registered Managers’ Award and NVQ level 4. The Assistant Manager is also in the process of obtaining these qualifications. Anne Maddox has had many years of relevant experience. She is well supported by other managers employed by Allied Care Ltd and senior managers within the company. She praised the excellent support she receives from the company, and their high standards of training and management. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 24 The company has a comprehensive Quality Assurance System that seeks the views of everyone involved in the home in order to constantly improve the facilities and services provided. Survey forms are regularly sent out to everyone living and working in the home (a pile of forms were seen in the office that were just about to be sent out). Residents’ Meetings, staff meetings, monthly visits to the home by a representative of Allied Care Ltd, and good communication with families and visitors all contribute towards the quality assurance systems. During the inspection we looked at the records relating to health and safety in the home. The fire log book showed that the fire system has been regularly maintained and tested. Staff have received a range of training on fire safety at regular intervals. The accident book has been well maintained. Staff have received training on all health and safety related topics. Information provided by the home before this inspection took place showed that they have a wide range of policies and procedures in place covering all health and safety related topics. Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 4 3 x LIFESTYLES Standard No Score 11 4 12 3 13 4 14 4 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 4 X 4 X X 3 x Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bolealler House DS0000064992.V343678.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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