Inspection on 17/01/06 for Boscobel

This inspection was carried out on 17th January 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Boscobel 18/01/08

Boscobel 26/02/07

Boscobel 11/10/05

Boscobel 09/03/05

Boscobel 09/12/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Boscobel 1 Preston Road Southport Merseyside PR9 9EG Lead Inspector Miss Orla Murphy Unannounced Inspection 17th January 2006 3:30 Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 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 Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 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. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Boscobel Address 1 Preston Road Southport Merseyside PR9 9EG 01704 537611 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) Mr Derek Ellison Mrs M Ellison Mrs Marjorie Ismay Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 20 LD One named out of category service user, Physical Disability (PD), as defined in letter dated 19/04/90. 11th October 2005. Date of last inspection Brief Description of the Service: Boscobel provides personal care and accommodation for up to 20 adults with a learning disability, one of whom also has a physical disability. The home is owned by private individuals, Mr & Mrs Ellison and is managed by Mrs M Ismay. The property is a detached four-storey house in a wide, tree-lined street. There is ample parking available outside the home and some on its grounds. Accommodation is available on three floors. There is a large garden to the rear of the property. The home has close access to public transport links to Southport town centre, Lancashire & Liverpool. Southport town centre is approximately ten minutes bus journey from the area. The Promenade is also nearby. There are local shops & facilities nearby, with a wider range available in the town centre. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was unannounced and neither residents nor staff knew the Inspector was coming. The last inspection report was examined and some requirements needed to be followed up on this visit. The Inspection was the second in the home’s required visits, which are 2 inspection visits per year. 3 residents and three staff were spoken to at the inspection. Two residents were “case tracked”. Case tracking means that the Inspector concentrates on the care given and experiences of one or more residents to get an idea of what is like to live there and how that person’s needs are being met. Case tracking also shows the inspector where needs aren’t being met. A variety of records (care plans, medical notes, complaints records, assessments, reviews, medication sheets, meeting minutes, menus, timetables, risk assessments and significant events) were examined. What the service does well: Boscobel Management and staff have always responded well to the minimum standards and advice to raise standards. The service continues to do well in areas such as resident consultation and involvement. Historically, this was an area that the home did not do well, but great improvements have been made since 2002, and residents meetings are now very empowering for those that live there. Staff discuss day-to-day issues with residents at these meetings but they also involve residents in policy issues, informing them of issues in care and the home’s management, which affect them. The result is that residents are very informed, for example, about complaints, what to do if they are worried about abuse, managing money and health & safety. Staff have involved residents in making their own DVD’s (for friends & family) and other projects. Residents have continued to say in all inspections that they really enjoy living at Boscobel. There is a very positive atmosphere in the home and staff have been observed always being patient, kind and positive with residents. Staff supervisions have been introduced and are being continued. Each resident has an Essential Lifestyle Plan, which are positive, and user led. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 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. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 7 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 Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None This standard was met at the last inspection. EVIDENCE: This standard was met at the last inspection. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Residents are supported to take risks as part of their lifestyle. EVIDENCE: The risk assessments of the resident case tracked were examined. Risk assessments were in place for the resident’s health, wellbeing, vulnerability, mobility and the environment. These were all detailed & relevant and were regularly reviewed. They were also linked to the resident’s Essential Lifestyle Plan (ELP). Residents meetings discuss topics of relevance regularly, including what to do if scared or abuse ids seen and these continued discussions empower residents to be more informed and subsequently more in control of their wellbeing. It was evident that taking calculated risks are promoted by the home to enhance the independence of the resident. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,16 & 17. Resident take part in the local community. Resident’s rights and responsibilities are respected. Residents are happy with the variety of food and enjoy the meals provided to them. EVIDENCE: Activities have improved over recent inspections. The ageing population of the home means that many residents have expressed a wish not to go out in the evenings, preferring to retire to their rooms. The Managers must ensure this is clearly recorded in their plan to demonstrate the resident’s choice & preference. Some residents have day services to attend, and visit family/friends locally. Daily records showed some residents have been shopping, walks, church, trips out & meals out. Records showed a good level of positive language used about resident’s activities/welfare. Residents are listened to by staff, and this was observed during the inspection both within day-to-day tasks seen and in records. For example, two residents have expressed a wish to share a bedroom. Though this is contrary to the minimum standards for vacant rooms, the Managers were advised that if this is the residents wish it should be recorded and agreed Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 11 with the resident and their representatives. Once this documentation is in place, the room share can go ahead. The home has a rotating menu, which was seen and is satisfactory. All residents spoken to said they liked the meals & food and if they don’t like the meal choice they can have something else. Residents recently requested to take salad off the menu during winter months, as it was too cold. The evening meal was observed during the inspection and staff supporting older residents to eat were seen to do so with respect and dignity. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Resident’s health needs are met. EVIDENCE: The Essential Plan and assessment of the resident case tracked recorded the support that that resident needs for health and personal care. This included hygiene & health routines, and the person’s preferences when being supported. Staff help residents with medical observation on a day-to-day basis as some may not be able to verbally communicate pain/discomfort, and staff attend all health appointments with them. Detailed records were seen outlining all health visits/appointments, their outcome and treatment planned. Treatment received was also recorded. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22. Residents feel listened to and that their concerns are acted upon. EVIDENCE: There have been no complaints regarding the service direct to CSCI and the homes complaint record was examined and showed no complaints had been received by the home. Residents have monthly meetings where, amongst other topics, they discuss important issues such as Abuse, Fire Safety and complaints procedures. These plus other topics are rotated so residents are reminded regularly about what to do. This was very evident when talking to residents. They are fully aware of complaints, what is right and wrong, that they should always tell someone they trust if they are afraid, angry or being hurt. One of the residents case tracked said, “ We talked about abuse in the meetings and I know its wrong for anyone to hurt me or make me scared. I’d tell ***** (staff) or you (Inspector) straight away because it would have to be stopped.” They also said “If I don’t like some things or I’m cross with staff I talk to them about it”. When asked if they felt it would be dealt with they said, “Yes, they explain stuff and if they could they would help me”. This shows how staff have worked hard to empower residents and how the importance of complaints and raising concerns is not just left with staff but residents are informed enough to be confident and speak up. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Residents live in a comfortable home. EVIDENCE: The home is located in a quiet residential area set in its own grounds. Ample parking is available on the street outside the home and some parking is available in the grounds. Accommodation is over 3 floors with the top 2 floors being unsuitable for those with mobility problems. The dining area has been redecorated in recent months. The business plan for 2005/06 was seen and this detailed planned improvements to areas in the home. All shared areas of the home seen were clean, well furnished and comfortable. Bedrooms seen are personalised and suited to each residents taste and preferences. All residents spoken to said they liked their bedrooms and the communal areas. All residents were seen accessing the home freely and comfortably. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Residents are supported by competent staff, in sufficient numbers. EVIDENCE: Statutory training is carried out on a yearly planned rolling basis. Records were examined to determine what training has been attended and the planned schedule showed that the plan is in place to address areas such as Health & Safety, Manual Handling, Cardio Pulmonary Resuscitation, Infection Control, First Aid, POVA, Food Hygiene and Fire Awareness. Staff were observed working well with residents, treating them with dignity & affection, and all residents spoken to during this and previous inspections felt their needs were met. The staff rota was examined for a 2-week period. This showed that staffing meets the requirements set by the previous regulating authority. There are three staff on duty at all times during the day. 2 staff are on duty at night. The Manager & Deputy Manager are in the home Monday to Friday in addition to the staffing numbers outlined. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 42. Residents live in a well run home. Resident’s health & safety is protected and promoted. EVIDENCE: The home’s Manager and Deputy have worked hard since the introduction of the National Minimum Standards in 2002 to ensure the service improved and met these standards. It is evident that great improvements have been made in areas such as records, care planning, resident consultation, empowerment, providing evidence and staff attitudes. The whole team must be commended for the improvements made but the leadership of the home has enabled a shift in attitude and commitment so that residents are the focus of the service. The progress made has been extremely positive and the team are committed to a quality service for residents. All staff training is up to date including booked scheduled training courses seen. Cleaning materials and other hazardous substances are kept locked away in accordance with Health & Safety legislation. Regular safety audits are undertaken & records kept in the home. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 17 The homes gas & electrical safety checks were seen & were up to date and satisfactory. All other safety checks were up to date and satisfactory. Fire drills are up to date. Residents discuss fire procedures regularly in their residents meetings and as a result told the Inspector (at previous inspections) where to go if the alarm went off and all understood that they must leave the building if the alarm goes off. Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 18 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 X 2 X 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 4 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 2 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X 3 X X X X 3 X Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 19 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 YA13 Regulation 12 Requirement Residents that do not wish to take part in external activities should have this clearly incorporated into their plan. Timescale for action 01/04/06 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 Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Boscobel DS0000005357.V279216.R01.S.doc Version 5.1 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. 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. 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