Inspection on 08/04/05 for Boniface House

This inspection was carried out on 8th April 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 26/10/05

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 Pat Harte Unannounced 8th April 2005 at 10.15 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 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Boniface House Address Spratton Road Brixworth Northants NN6 9DS 01604 883800 01604 883805 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Philip Jones, Northampton County Council Oxford House, West Villa Road, Wellingborough, Northants, NN8 4JR Mrs Jennifer Ruth Marks Care Home 46 2 Category(ies) of PD(E) Physical Disability over 65yrs Both registration, with number OP Old age Both 46 of places DE(E) Dementia - over 65 Both 15 BONIFACE HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 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 18/11/04 Brief Description of the Service: Bonfiface House is a Care Home providing personal care for up to 46 Residents over the age of 65 years some of who may have additional needs relating to Dementia or Physical DIsabilities. The Home provides permenant places only.The Home is owned by Northamptontonshire County Council and is situated in the village of Brixworth some six miles from Northampton. The Home 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, toilets and bathing areas and a kitchenette. All Residents have single room accomodation and individual garden areas lead off each unit. There is a central lounge area and also a central garden area. The Home has a main kitchen catering for all the main meals. The Home has a laundry catering for the needs of all Residents. Facilities include a small bar leading off the entrance reception area. here gardens leading off all the individual units are large gardens to the rear of the premises. BONIFACE HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and took place over 5 hours. Five staff, nine Residents and two visiting relatives were spoken with. Written comments were also received from twenty-seven relatives and 27 Residents. A partial tour of the premises took place and staff; care and other records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Care planning for Residents with Dementia must be improved to ensure that staff know what to do for each Resident and how to support them. The activities programme must be improved especially for Residents with Dementia. The toilet areas must be improved to allow a hoist to be used. Staffing levels must be increased in the afternoons to ensure all the units are monitored and staff are available to meet Residents needs. BONIFACE HOUSE Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. BONIFACE HOUSE Version 1.10 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 Standards Statutory Requirements Identified During the Inspection BONIFACE HOUSE Version 1.10 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 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 ensure their needs can be met. Residents and their relatives have opportunities to visit the Home and are given 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. Individual records are kept for each of the Residents and inspection of the records showed that the assessment process has been revised, specific assessment tools are used to identify needs and risk and needs are carefully documented. BONIFACE HOUSE Version 1.10 Page 9 Residents are provided with contracts. The contracts have been reviewed to increase the level of information and are to be re-issued shortly. BONIFACE HOUSE Version 1.10 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 standard(s) 7,8, 9,10. Progress has been made on documenting Residents physical and health care needs and providing detailed instructions for staff. Further development of the care plans for Residents with Dementia is needed to provided guidance and instruction for staff. EVIDENCE: Individual plans of care are available for all Residents. Good progress has been made in developing the plans to reflect health and personal care needs. The level of instruction provided to staff on how the care is to be carried through has been increased. Staff spoken with felt that the plans now offered detailed guidance in these areas. Dementia Care plans are still limited, whilst needs are identified and personal life histories are gathered to aid understanding of the individuals needs, instructions for staff are still limited. The approach to Dementia care is still fragmented, as the Home does not have specialised Dementia care units with trained staff concentrated in specific areas to meet specialised needs. There is a risk that Residents with Dementia can be isolated, that their needs are not being met in full and that they may be put at risk through a lack of supervision and monitoring particularly in the afternoons when staffing levels drop and units are left unattended. BONIFACE HOUSE Version 1.10 Page 11 Health care records were detailed and a proactive approach is made to referrals to medical professionals. Two relatives spoken felt that staff had reacted well in referring their relative for further investigation by medical professionals. Service Users felt that they were treated as individuals and were respected by staff. Staff ensured that their privacy and dignity was protected when personal care was carried through. BONIFACE HOUSE Version 1.10 Page 12 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 standard(s) 12, 13, 15. The meals in the Home are good offering choice, variety and catering for special dietary needs and individual likes and dislikes. The activities programme is limited, particularly for people with dementia. EVIDENCE: A number of Residents were spoken to and everyone who commented on the food said it was good, they had choice and their special and likes and dislikes were catered for and respected. Residents 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. 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. Whilst an activities programme is provided no activities were taking place during the Inspection. The programme is limited to group activities and Residents commented that staff had little time to provide for individual interests or just sit and talk with them. There is little in the way of individual activities for people with dementia and group activities were confined to “Reminiscence”. The Home has an open visiting policy. Visiting Relatives commented that they were made welcome, extended hospitality and that staff made time to discuss BONIFACE HOUSE Version 1.10 Page 13 their Residents needs, health and progress with them. Residents confirmed that they were enabled to receive their visitors in private if they wished. BONIFACE HOUSE Version 1.10 Page 14 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 standard(s) 16, 17, 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. The Home has a procedure for the Protection of Vulnerable Adults. Staff spoken with had received training on Elder Abuse and showed that they would react quickly and appropriately to any allegations. Senior staff have responsibility for the reporting procedures to the Authorities. Residents are supported to vote and postal votes are obtained. BONIFACE HOUSE Version 1.10 Page 15 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The Home was safely maintained, well kept, warm and comfortable. The Toilet areas are too small for the use of a hoist and therefore the choice and dignity of disabled Residents is compromised. EVIDENCE: Since the last Inspection there has been considerable renewal of furniture and carpets and some redecoration work. The Home is comfortably furnished to a good standard and is safely maintained. A new specialised Parker bath has been installed to enable the hoist to be used. All the toilet areas in the Home are very cramped and a hoist cannot be used. Residents needing hoisting have no choice but to use commodes in their rooms. BONIFACE HOUSE Version 1.10 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30. Procedures for the recruitment of staff were robust and provided safeguards to offer protection to people living in the Home. The deployment and number of staff available in the afternoons is not sufficient and there is a risk to Users when the Units are left without staff. Training for staff on Dementia remains insufficient. EVIDENCE: Residents spoken with said that the staff were very kind, committed and caring. The Home’s Statement of purpose refers to staffing levels as being maintained by 6 Care assistants on daytime shifts with additional staff being brought in where necessary. However the numbers of care staff drops to 3 in the afternoons between the hours of 1.45 to 4pm. Staff are very busy at this time and are not able to supervise and monitor all the Units. Residents with Dementia are accommodated throughout the Home and not in specific units. There were times where staff were occupied in other areas and the Residents were not supervised or monitored. The sample of two staff members records inspected showed that the necessary checks and references had been obtained. A sample of staff training records confirmed that staff receive induction and ongoing training and regular updates. Training on specialist areas is provided but there are still limitations on Dementia care training. BONIFACE HOUSE Version 1.10 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36, 38 There is an effective and proactive Management structure in place that is accessible and responsive to the needs of both the Residents and staff. EVIDENCE: Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues and guide them in practice. Supervisions systems were in place to ensure that staff receive guidance and support. Residents felt the Manager was readily available to them. They commented that regular Residents meetings were held and that the Manager also sought their individual views. Residents felt that their opinions were listened to, valued and acted upon and that they had trust and confidence in the staff group as a whole. Changes have been made to the running of the Home as a direct result of their comments. BONIFACE HOUSE Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 x x x 3 3 3 BONIFACE HOUSE Version 1.10 Page 19 No Are there any outstanding requirements from the last inspection? 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. 1. Standard 21 Regulation 23(2)(a) &(j) 18 (1)(a) & 12(1)(a) 15(1) 16(2)(n) Requirement Timescale for action 20.5.2005 2. 27 3. 4. 7 12.2. An action plan must be submitted detailing proposals to alter the Toilet facilities to enable the use of a hoist. Staffing levels must be increased 20.5.2005 to reflect the levels stated in the Statement of Purpose and to meet the needs of the Residents. Dementia Care plans must be 30.7.2005 developed and put in place for all Residents with Dementia. Attention must be given to 30.7.2005 providing suitable and meaningful activities for Resident s with Dementia. 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 Good Practice Recommendations BONIFACE HOUSE Version 1.10 Page 20 Commission for Social Care Inspection Newland House, First Floor Cambell 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 Version 1.10 Page 21 - 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. 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