Inspection on 26/10/05 for Boniface House

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Boniface House 02/08/06

Boniface House 08/04/05

Boniface House 18/11/04

Boniface House 10/05/04

Boniface House 09/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Boniface House Spratton Road Brixworth Northants NN6 9DS Lead Inspector Mrs Pat Harte Unannounced Inspection 26th October 2005 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.V260648.R01.S.doc Version 5.0 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.V260648.R01.S.doc Version 5.0 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 (15), Old age, registration, with number not falling within any other category (46), of places Physical disability over 65 years of age (2) Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 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 46 people of OP category already in the home. No person falling within the DE(E) category can be admitted where there are already 15 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 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 15 places for People with Dementia and 2 places for People with Physical Disabilities. 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. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 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 one hour and consisted of a review of the last Inspection report and the Home’s service history including notifications and events. The primary method of inspection used was ‘case tracking’ which involved selecting two Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition six staff and twelve Residents were spoken with to obtain their views. A partial tour of the premises took place, a selection of records was inspected and observations made on care practices. The previous requirements were reviewed. Discussions were held with the Manager and staff on duty. The Inspection took place during the late morning and afternoon over a period of six hours and was carried out on an unannounced basis What the service does well: The Home has a committed staff group. Residents spoken to felt that their relationships with staff were very good and that staff provided them with good care and support and valued and respected them as individuals. Routines are relaxed and flexible and Residents confirmed that they are enabled to continue with their normal routines, exercise control over their lives and maintain their independence as much as possible. Residents’ health care needs are taken very seriously and a proactive approach is taken to refer any concerns to the relevant Medical Professionals. Meals are varied, well balanced, of good quality and nicely presented. Residents stated that they are given a good choice of options in the daily menu and account is taken of their likes and dislikes and special diets. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 6 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.V260648.R01.S.doc Version 5.0 Page 7 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.V260648.R01.S.doc Version 5.0 Page 8 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 Prospective Residents are provided with information to enable them to make informed choice regarding their placement. The pre-admission assessment is thorough and effective in ensuring that the needs of people admitted to the home can be met. EVIDENCE: The admission process ensures that all prospective Residents are visited and assessed by staff from the Home to identify their individual needs and ensure that these can be met. Residents and their relatives have opportunities to visit the Home prior to their admission and are given written information on the services and facilities. Residents spoken with felt that staff were well briefed on their needs and the care to be provided. Staff spoken with felt that they were given good information on their Residents needs, routines and wishes. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 9 Individual records are kept for each of the Residents and inspection of a new Resident’s records showed that the assessment process has been revised to ensure a good level of detail on the individual’s needs. Life history information is gathered for all Residents. Particular emphasis is now placed on the gathering of this information relating to those Residents with Dementia. Staff confirmed that the information assists their understanding of needs and ensures effective communication and interaction. Specific and recognised assessment tools are used to identify needs and risks as part of the assessment process. Residents are provided with written contracts with copies maintained in their records. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 10 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 Revised care plans provide staff with a good level of instruction on physical care needs however further work is needed to ensure clear guidance and instruction on the support required for Residents with Dementia, including strategies for the management of behaviours. EVIDENCE: About 40 of Residents care plans have been reviewed and updated to a new format. Two Residents care plans were inspected. The records showed a holistic approach in relation to physical and personal care needs. The level of instruction and guidance given to staff has been increased on how the care is to be carried through and includes guidance on the emotional support to be provided. The plans showed that account is taken of Residents wishes in relation to how the care is to be carried through and details the tasks that Residents’ could undertake for themselves. Residents felt that they were encouraged to retain as much control over their lives and maintain their independence as much as Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 11 possible. Residents commented that they felt were respected and valued as individuals by the staff group. The Home has developed two units with dedicated provision for Residents with Dementia. Staff are specifically deployed to all the units and this provides continuity and consistency of care for all Residents of care particularly to those Residents with Dementia. Residents were very positive in their comments and appreciated this development. They felt that they were able to develop fuller relationships with the staff and that staff were continuously on hand to provide assistance. Attention has been paid to ensuring information gathering on Life Histories for Residents in general with specific attention given to those Residents with Dementia. The development of care planning for Residents with Dementia is on going. Some cross referencing from the Life Histories was made on individual care plans but more of the information could be used to develop written guidance and instruction for staff on strategies for the management of behaviours. One plan viewed identified behaviour management issues with a Resident who was disturbed at night and subsequently disturbed others by going into their rooms. It is acknowledged that the advice of relevant Medical Professionals was sought and night checks were carried through. However there were no clear strategies to alert staff to the Resident’s movements and support her through her confusion. Discussions with the Manager and staff and observations of practice showed that attention has been paid to developing effective communication methods. Examples of this are picture referencing and written communication to assist Residents with speech difficulties to express choice and make their wishes and opinions known. Health care records were detailed and a proactive approach to monitor for changes with prompt referrals made to medical professionals. Residents stated that staff were quick to react to any changes and ensure that they were able to see their General Practitioners quickly. 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 following the midday meal. Observations confirmed that Staff ensure the protection of Residents privacy and dignity when carrying through personal care. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 12 Care is taken to identify and record Residents wishes in relation to the arrangements to be made after their deaths. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 13 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 Residents are enabled to maintain their independence as much as possible and exercise control and choice in the way they wish to lead their lives. The Home provides Residents with a range of activities including meaningful activities for those Residents with Dementia. EVIDENCE: Residents felt routines were relaxed and flexible and that their preferences on rising and going to bed times were respected. They felt that they were free to decide on how and where they wished to spend their time and that they were encouraged to maintain their independence as much as possible. The Home’s activities programme has been reviewed and a member of staff appointed as an Activity Co-ordinator with responsibility for designing and monitoring programmes. Records of the various unit activities are maintained. Residents commented that the range of activities had increased on both a group and individual basis. Group activities include Quizzes, film and Karaoke evenings. Residents stated that they are kept well informed of the programmes with notices placed in their units and staff remind them of the daily events. They are free to choose whether or not they wish to participate. They also confirmed Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 14 that staff assisted them in their individual interests and hobbies and made time to sit and talk with them. The deployment of specific staff to the units has proved invaluable in developing the programmes and attention has been paid to developing suitable activities for Residents with Dementia. For example staff now join with their Residents at coffee time and tea times to promote social interaction and carry through activities. In one lounge lively interest was taken in discussing the latest news. In another lounge Residents, led by a staff member, were discussing the changing customs of the Halloween celebrations and making comparisons to the customs of past times. The Home has an open visiting policy and Residents confirmed that they were enabled to receive their visitors in private if they wished. They stated that their visitors were always made welcome and extended hospitality. Residents felt that the food provision was good, that they had choice and their special and likes and dislikes were catered for and respected. They confirmed that they are asked to comment and offer suggestions on the menu and changes are made accordingly. The midday meal was efficiently served and nicely presented. Staff helped Residents with their meals where necessary. Some Resident’s chose to take their meal in their rooms or in the lounge areas. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 15 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 & 18 Systems are in place to protect Residents from abuse, to ensure that complaints are listened to and acted upon and that their rights are protected. EVIDENCE: Residents confirmed that they had been given the Home’s 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. No complaints have been received by the CSCI in the last year. Robust procedures for the Protection of Vulnerable Adults are in place. Staff demonstrated, through discussions, their full understanding of the reporting procedures. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 16 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 The Home was safely maintained, well kept, warm and comfortable. Suitable equipment has been provided to enable physically disabled Residents to access toilet areas. EVIDENCE: 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. Residents are enabled to personalise their rooms as they wish and have their furnishings and belongings around them. Residents have access to garden areas that are safe, secure and suitable for Residents with Dementia. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 17 Two track hoists have been fitted 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. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 18 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 Sufficient numbers of staff are deployed to meet the needs of the Residents. EVIDENCE: Staffing levels have been reviewed and increased. The rotas showed that six care staff are deployed on daytime shifts and 3 night carers provide night care. 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. A designated Residential Care Supervisor or senior night Carer have responsibility for leading each shift. 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. 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. Staff spoken with expressed positive comments on the training provided. They stated that they were encouraged to undertake National Vocational Qualifications and by Christmas of this year 50 of the staff group are expected to have achieved a qualification. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 19 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 & 38 The Management of the Home is effective and the home is run in the best interests of the Residents. The records for the management of Residents monies were not appropriately maintained with receipts for items purchased by staff on Residents behalves or for hairdressing payments. EVIDENCE: 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 and supervision. Residents felt the Manager was readily available to them. They commented that regular Residents meetings were held and that the Manager consulted with them and sought their individual views and opinions. Residents felt that they had trust and confidence in both the Manager and the staff group as a whole and that the Home was run in their best interests. Relationships between staff and Residents were observed to be very good. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 20 The systems for safekeeping and management, where necessary, of Residents moneys have been reviewed and records of all transactions were well maintained. However receipts were not routinely obtained items purchased on behalf of Residents or for hairdressing services. The Manager agreed to give this matter her urgent attention. Due attention was paid to Health and Safety and staff receive training and updates in this area. The Fire records showed regular monitoring of the fire systems in line with the Fire Officer’s recommendations. Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 21 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 X X 3 Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 22 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 Boniface House DS0000034646.V260648.R01.S.doc Version 5.0 Page 23 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. 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