CARE HOMES FOR OLDER PEOPLE
Boniface House Spratton Road Brixworth Northants NN6 9DS Lead Inspector
Mrs Pat Harte Unannounced Inspection 2nd August 2006 10:00 X10015.doc Version 1.40 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 Boniface House DS0000034646.V306138.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 Older People. 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. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Boniface House Address Spratton Road Brixworth Northants NN6 9DS 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) 01604 883800 01604 883805 www.northamptonshire.gov.uk Northamptonshire County Council Mrs Jennifer Ruth Marks Care Home 46 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (44), of places Physical disability over 65 years of age (2) Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. 4. 5. No person falling within the OP category can be admitted where there are already 44 people of OP category already in the home. No person falling within the DE(E) category can be admitted where there are already 23 people of DE(E) category already in the home. No person falling within the PD (E) category can be admitted where there are already 2 people of PD (E) category already in the home. To be able to accommodate three named service users who have needs within the MD (E) category. Total number of service users in the home must not exceed 46. Date of last inspection 26th October 2005 Brief Description of the Service: Boniface House is a Care Home providing personal care for up to 46 Residents over the age of 65 years with up to 23 places for People with Dementia and 2 places for People with Physical Disabilities, a specific condition of registration allows the Home to continue to provide care for 3 people with Mental Disorders. The Home provides permanent places only. The Home is owned by Northamptonshire County Council and managed by Mrs. J. Marks. The Home is situated in the village of Brixworth some six miles from Northampton, is close to local shops and a Library and can be accessed by Public Transport. The premises are designed to provide 6 self-contained units for 7 or 8 Residents; each unit has its own lounge/dining room, bedrooms, toilets and bathing areas and a kitchenette. All Residents have single room accommodation and secure garden areas lead off each unit. There is an additional central lounge area by the main entrance, which includes a small bar. Charges range between £95.45p to £347.00 per week, Residents are assessed to pay according to their means. Extra charges are made for Hairdressing, Chiropody, Toiletries and Newspapers. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took half a day and consisted of a full review of the inspection record, the service history record including notifications of complaints, accidents, events and incidents made to the CSCI, the pre inspection information submitted by the Manager and correspondence and contacts between the Commission and the Home. The information was collated and analysed to form a plan of inspection focusing on the outcomes for Residents. The primary method of inspection used was ‘case tracking’ which involved selecting three Residents and tracking the care they receive through review of their records and talking with them and the care staff. In addition six Residents, six staff and five Relatives were spoken with and care practices were observed. Selected areas of the premises were viewed and a selection of records were inspected. Discussions were held with the Registered Manager. The Inspection took place during the morning and afternoon over a period of 6 hours and was carried out on an unannounced basis What the service does well:
There is a stable staff group who continue to demonstrate their commitment to the well being of their Residents. Staff turnover is low and this means that familiar staff are on hand to provide care for the Residents. Residents spoke very highly of the staff group commenting that they were very caring, helpful and on hand to quickly respond to their needs. Residents commented and observations confirmed that relationships between themselves and the staff group were very good. The information given to all prospective Residents has been updated and Residents felt it gave them good descriptions and accurate information on the Home and the services provided. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 6 The assessment process ensures that all prospective Residents are visited and a thorough assessment carried out ensuring that the needs of anyone admitted to the Home will be met in full. The process includes a thorough identification of any risk areas that may make Residents vulnerable. Staff ensure that Residents are fully involved in their care planning, including Residents with Dementia, and that respect is shown to their wishes and preferences on how the care is to be provided. The care planning process takes account of any cultural or religious needs so that arrangements can be made to respect and uphold Residents wishes or lifestyles. Residents’ healthcare needs are carefully monitored and they are enabled to see their relevant medical professionals promptly and in private. Specialist Professionals such as the Continence and Falls Advisers are called in to give staff advice on how best to support their Residents in these areas. Residents confirmed that they are aware of the complaints procedure and are confident to raise any issues or concerns with staff or the Manager. There has been one complaint since the last inspection and records showed that this was investigated carefully and resolved. Routines were relaxed and flexible and Residents had choice in how and where they wished to spend their time. Residents’ comments included “I can get up and go to bed as I please” “ I can spend my time where I wish.” “I enjoy the activities but I don’t have to join in if I don’t wish to.” Observations confirmed that staff took care to protect Residents’ dignity and privacy by ensuring personal care tasks were carried out in private. Residents commented that staff took care to ease any embarrassment and make them comfortable when intimate tasks such as bathing were carried out. Residents’ records showed that they were encouraged to remain as independent as possible and do things for themselves. Care plan instructions reminded staff that Resident’s with Dementia must be consulted, involved in and assisted to make decisions for themselves. Residents’ comments on the food provision were very positive. They felt that they were provided with a good range of meals, choices were available and the catering staff were fully aware of their dietary needs and likes and dislikes. The serving of the midday meal was efficient and Residents were given help, by staff, to eat their meals. Records showed that weight is monitored and staff note daily nutritional intake to ensure any problems are quickly identified. Residents’ religious persuasions are respected and arrangements are made for them to receive visits from their relevant clergy in order that they may fulfil their religious observances. Residents are provided with a safe and comfortable environment and have freedom of movement including into safe garden areas. The communal area at
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 7 the front of the Home continues to be a place where Residents from all the units can gather together. The systems for safekeeping Residents’ moneys, where necessary, were well maintained and receipts for items or services purchased by staff on behalf of Residents were carefully maintained. What has improved since the last inspection? 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. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good information is made available to prospective Residents on the Home’s services and facilities, the assessment process is thorough and effective ensuring that the needs of Residents admitted to the Home can be met in full. EVIDENCE: We looked at the information given to Residents on the Home’s services and the process of assessment to see that this was thorough in identifying Peoples’ needs and ensured that those needs could be met. Residents confirmed that they had been given the Service User Guide. They felt this contained accurate and good information on the services and facilities and how to raise any issues or concerns. The information in the Guide and the Statement of Purpose, which describes the aims and objectives for the service, has recently been reviewed and updated. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 10 The assessment process was discussed with the Manager and three assessment records were viewed. The process ensures that the Manager or senior staff visit all prospective Residents and carry through an assessment to ensure that their needs can be met in full. The Manager showed, through discussions, that staff took account of each individuals needs and balanced these with the dependency levels of people already living in the Home identified needs can be met in full. Admissions are not made where there is any doubt that the needs can be met or where it is felt that the staffing levels would not be sufficient to manage addition high dependency needs. The assessment records were thorough and holistic and took account of all areas of need including Residents emotional and psychological care needs. Historical information had been gathered from Residents, Families and relevant professionals to broaden the understanding of the needs. Care had been taken to establish the Residents’ wishes in relation to routines, food likes and dislikes, their hobbies and interests and their preferences for their support. Care had also been taken to identify if there were any cultural or religious needs where special arrangements may have to be made. Recognised assessment tools are used to assess any risk areas such as skin and nutritional needs. Where Residents have Dementia an assessment of their mental abilities, awareness and understanding is carried through. Assessments of physical care needs identify any aids or equipment that may be needed for individuals. Residents records showed that they had been given contracts detailing the terms and conditions of their placement. Information on charges are forwarded to them following a financial assessment by the County Council and information on extra charges is made available to them in the Service Users Guide. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to take acceptable risks, make decisions about their lives and are assured that the staff group know their needs, aspirations and goals. EVIDENCE: We looked at care planning processes to ensure that staff were given instruction and guidance on how to meet Service Users’ needs. Three Residents care plans were inspected. The records showed a holistic approach to recording the needs and providing staff with good levels of instruction and guidance on how the care is to be carried through. Residents commented that they felt were respected and valued as individuals by the staff group. The plans showed that account is taken of Residents wishes in relation to their personal lifestyle routines. Tasks that they could undertake for themselves were detailed showing that they were encouraged to maintain as much control
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 12 over their lives and be as independence as possible. Where Residents needed assistance the care plans gave step-by-step guidance to staff and reminded them to monitor for any adverse outcomes. For example a Resident was at risk from falls at night, as she would forget to summon help if she got up. Instructions had been put in place to ensure that she was monitored through the night to eliminate the risk. In another instance step by step guidance was given on the management of a Resident’s physical care needs, the guidance reminded staff to ensure her privacy and gave clear guidance on the movement and handling techniques to be used to ensure her comfort. Records showed that good use is made of historical information to help staff understand and provide support for Resident’s with Dementia. For example information on past interests, events and people of importance to individual Residents are documented and may be cross referenced to the care plans to help staff provide emotional support and understand what may be important to Residents who are confused. Strategies are in place to help Residents whose behaviours may cause risk to them or others. For example help was given to one Resident with managing her meals as she had lost her skills and could cause distress to other residents at meal times. Care was taken to ensure another Resident was taken out when she wished. Discussions with the Manager and staff and observations of practice showed that attention has been paid to developing effective communication methods. Care plans detailed the need to speak clearly, explain carefully and give time for Residents respond. Staff showed that they took care and time to assist Residents and could use other methods such as picture referencing or getting Residents to write things down so they could express choice and make their wishes and opinions known. The care plan records showed that Residents are constantly monitored and where changes in need are identified new instructions are provided for staff. Where no changes have occurred there is a system for reviewing the plans on a monthly basis. Health care records were very detailed. They showed that health care professionals were routinely involved with Resident’s health care and that staff were quick to respond to any changes and request visits from the relevant medical practitioners. Procedures were in place for the management of medication. Storage was appropriate. The required records for incoming, administration and disposal of medication were in good order. Observations confirmed that Medication was safely and appropriately administered. Assessments are carried out to determine whether Residents can safely continue to manage or part manage their own medication if at all possible. Residents who are able to manage their medication are provided with safe storage arrangements and staff monitor any change in abilities.
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 13 Observations confirmed that Staff ensure the protection of Residents privacy and dignity and carry through personal care tasks in private. Residents felt that staff knew their care needs very well and provided them with good support and encouragement. One Resident spoke of staff helping her to find her way about as she was very forgetful and easily got lost. Another Resident spoke of the fact that staff allowed her to do things for herself and only supported where necessary, this was very important to her and allowed her independence. Residents’ records showed that staff made every effort to secure their wishes in relation to death and funeral arrangements. Care can be provided for Residents who are ill or dying so long as their needs can be met and the relevant medical professionals are involved with their care. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service Residents are enabled to exercise control and choice in the way they wish to lead their lives and are provided with good activity programmes in keeping with their interests. EVIDENCE: We looked at routines and the activities programmes to ensure that Residents were able to live relaxed and fulfilled lives reflecting their personal preferences. Residents stated that routines were relaxed and flexible. They commented and observations confirmed that they were free to decide on how and where they wished to spend their time. They said that timings such as getting up and going to bed were wholly in accordance with their wishes. Residents were satisfied with the activity programme. Activities are provided on both a group and individual basis and include games, craftwork, quizzes and general entertainment. A recently introduce cookery activity has proved particularly popular. There is a café in the local library, adjacent to the Home, which Residents are encouraged to visit to develop and maintain local community links. Several Residents are able to go and choose their own library
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 15 books and many are able to visit the local shops just across the road. Risk assessments are carried out to ensure the safety of individual Residents going out alone and staff can escort those who need support. Residents commented and observations confirmed that staff spend time talking with them both on a group and individual basis. Staff are stationed in the various units and good use is made of the late morning time, following elevenses and up to lunch time staff are on hand to do activities, read newspapers to their Residents and have quizzes or games. The activity programme for Residents with Dementia has been developed. Staff use historical information to ensure that Residents are encouraged to carry through previous hobbies and interests as well as participating in new ones. Quizzes are designed with reminiscence in mind so that these Residents can get the full benefit of joining in and recalling past events and ways of life. There is an open visiting policy. Residents confirmed that they were enabled to receive their visitors in private if they wished. Visiting Relatives spoke of always being made welcome and extended hospitality. They stated that staff made time to discuss their Resident’s care needs and commented that they were kept well informed of any changes or concerns. On the day of inspection it was a Residents birthday and family and friends had come along to the Home to celebrate. There was a real family feel as other Residents and Staff were invited to join in the celebration. Residents were satisfied with the food provision. They felt that staff respected their dietary needs and individual likes and dislikes and they stated that they were provided with a good range of choice. One Resident said that you would not have a bigger variety anywhere and another commented that staff went out of their way to tempt her appetite by offering alternatives. Observations of the mid day meal confirmed that the meal was nicely presented, efficiently served and that staff were on hand to assist Residents where necessary. Care is taken to monitor Residents weight and appetites to ensure any nutritional concerns are identified and action taken swiftly. During the morning of the inspection there was a power cut. The Manager and catering staff responded immediately to look at contingency plans to provide for the lunchtime meal. Fortunately the power supply was quickly re-instated however the event had highlighted a problem. A safety valve has been fitted to the gas supply so that in the event of a power failure the gas is cut off. This means that the gas cookers could not be used to heat food or to boil water. A recent power failure caused by a storm left the staff without any means to heat food or boil water for five hours necessitating a take away meal to be bought and calor gas heaters obtained to make drinks. The County Council should Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 16 review whether it is possible to override the gas cut out so the gas cookers can be used in such circumstances. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 17 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are effective systems in place to ensure complaints are listened to, investigated and acted upon and to ensure that Residents are protected from abuse. EVIDENCE: Residents confirmed that they had been given the complaints procedure, which is also displayed in the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. There has been one complaint since the last inspection concerning the deterioration of a Residents health and the delay in obtaining the Resident’s belongings after discharge from the Home. The complaint was investigated by the Manager and was unfounded. However the records showed that the comments of the Relative were listened to and instructions were given to staff on ensuring good communication. Residents are registered on the electoral roll and are given assistance to exercise their voting rights by postal votes or visiting the local polling stations. Robust procedures for the Protection of Vulnerable Adults are in place. Staff have been provided with training in recognising the areas of abuse and the reporting procedures. Two notifications have been made since the last inspection concerning two staff members’ attitude. The incidents were reported
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 18 to the relevant authorities and were fully investigated. Whilst both instances were not deemed to be abuse the staff concerned received further training on how to improve their communication skills. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 19 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: We looked at the premises to ensure that they were suitable for the Residents needs and offered them a comfortable and safe environment. The premises were in good order, clean, warm, safe, comfortable and well maintained. Standards of domestic and hygiene maintenance were viewed as very good. Residents stated that cleaning routines were carefully organised to ensure no disruption to their preferred routines. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 20 The Residents’ bedrooms viewed showed that they were encouraged and enabled to personalise them as they wished and have their furnishings and belongings around them. Residents have access to garden areas that are safe, secure and suitable for those with dementia. Aids and equipment are provided and include track hoists in the toilet areas of two of the units. The provision of this equipment enables physically disabled Residents to access the toilets and provides a safe method of movement and handling. Other specialist movement and handling equipment has also been made available in accordance with individual Residents’ needs. The Home has on going programme of maintenance and redecoration. Since the last inspection attention has been paid to redecoration of Resident’s bedrooms. The home has a Handyman who swiftly carries out minor repairs. Residents confirmed their satisfaction with the facilities stating that their individual units were comfortable and homely. They are provided with a general communal area at the front of the Home, which includes a bar. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 21 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust and sufficient numbers of competent care staff are deployed to meet the Residents needs. EVIDENCE: We looked at staff recruitment procedures and staff training to ensure Residents were in safe and competent hands. The rotas showed that a minimum of six care staff are deployed on daytime shifts and 3 night carers provide night care. In addition a senior staff member, a Residential Care Supervisor, is on duty on leading all daytime shifts and providing guidance and support for staff. The Manager mainly works office weekdays hours. Staff stated that they were always able to contact her or other County Council representatives for advice or in an emergency out of office hours. Day care staff are deployed to each of the six units, where it is necessary for two care staff to carry through the care staff members from other low dependency units give assistance. The deployment of regular staff provides consistency and continuity of care especially enabling Residents with Dementia to become familiar with and recognise their staff group.
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 22 In addition to the care staff, domestic and catering staff are employed together with a Handyman. The ancillary staff provision ensures that care staff are not diverted from their care duties. Two staff members’ records were viewed and showed that recruitment practice was good and protected Residents. The necessary Criminal Records Bureau Checks had been undertaken and references obtained. Records showed that new staff were provided with an induction programme, which is linked to the Sector Skill Council’s recommended guidelines and was carried through within the recommended timeframes. Residents spoken with said that the all the staff, including ancillary staff, were very kind, committed and caring. They felt that care needs were promptly attended to. Observations showed that staff constantly monitored their Residents and responded promptly to their needs, relationships between the staff and Residents were viewed as excellent. Staff spoken with expressed positive comments on the training provided. They stated that they were encouraged to undertake National Vocational Qualifications. Currently about 75 of the staff group have obtained an NVQ. The Manager ensures that she keeps the Staff training plan under review and ensures that staff receive regular updates. A staff induction programme is in place for new staff Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 23 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Management of the Home is effective and in the best interests of the Residents. Safe systems are in place for the management of Residents monies and items held for safekeeping. EVIDENCE: We looked at the overall management of the Home and Health and Safety to ensure that the Home was effectively managed and Service Users were not at risk. The Manager demonstrated her ongoing commitment to maintaining the required Regulations and Standards and ensuring the Home is run in the best interests of her Residents. This is demonstrated by the fact that no requirements have been made in this report.
Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 24 The Manager evidenced that she involves the Residents in the running of their home. Residents said that the Manager was readily available to them and was in contact with them on a daily basis. In addition regular Residents meetings are held and these have been adjusted so that the Manager meets with small groups to ensure that all Residents have a voice. It was clear from the records and Residents comments that their opinions, comments and wishes are listened to and acted upon and that any issues raised are looked at and resolved. The Manager has undertaken surveys with the Residents, Relatives and stakeholders, such as Doctors, Nurses, Chiropodists, Hairdressers and other visiting professionals, to gain their opinions of the services. The results have been collated and published and have been made available to all in the information notice board at the entrance to the Home. Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. Formal staff supervision is undertaken bi monthly. The Home’s policies and procedures were all revised last year and are now in place to guide staff. Visit reports made by the County Council’s representatives show that the Home is visited monthly with quality areas reviewed and Residents comments sought. The systems for the safekeeping, where necessary, of Residents moneys were in good order. Two records inspected showed that receipts were carefully maintained for any purchases made by staff on a Resident’s behalf or charges incurred for services such as Hairdressing and Chiropody. There is an internal auditing and reconciliation system to ensure the accuracy of the individual accounts and balances. The approach to general health and safety was assessed as excellent. Fire records were well maintained indicating that the fire systems were regularly checked in accordance with the guidance given by the Fire Officer. Accident records were well maintained and showed that every accident or incident was analysed and action was taken to prevent similar occurrences. Staff are provided with training in Health and Safety. The Home was safe no hazards were observed. Boniface House DS0000034646.V306138.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 3 4 Boniface House DS0000034646.V306138.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. 1 Refer to Standard OP15 Good Practice Recommendations The County Council should take action to review the gas supply to the Home to ensure that in the event of a power cut the cookers remain able to be used. Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI Boniface House DS0000034646.V306138.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
