Inspection on 01/02/06 for Boston House

This inspection was carried out on 1st February 2006.

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

Boston House 20/07/09

Boston House 22/05/07

Boston House 22/08/05

Boston House 01/03/05

Boston House 02/11/04

Boston House 08/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Boston House Broadway Street Hathershaw Oldham OL8 1XR Lead Inspector Sandra Bennett Unannounced Inspection 1st February 2006 09:00 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 Boston House DS0000035134.V276914.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 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. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Boston House Address Broadway Street Hathershaw Oldham OL8 1XR 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) 0161 911 3769 0161 665 1039 Oldham M.B.C. Mrs Patricia Judge Care Home 29 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (14) Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 25 OP, up to 14 PD(E) and up to 5 DE(E). A manager, working a minimum of 30 hours each week, must be in place at all times who has the qualifications, skills and experience necessary for managing the home and who is registered, or has an application for registration pending, with the Commission for Social Care. The ratio of care staff to service users must be determined according to the assessed needs of service users and staffing levels must be regularly reviewed to reflect service users` changing needs. 22nd August 2005 3. Date of last inspection Brief Description of the Service: Boston House is a purpose built Local Authority Home, situated three miles from Oldham town centre and close to local amenities and public transport. There are only nine permanent beds remaining with others being allocated to short stay and intermediate care. The home is divided into three units, each unit having a lounge, kitchen and dining area with bedrooms situated off the units. The intermediate unit has a specially adapted kitchen and equipment for rehabilitation purposes. All bedrooms are single occupancy and are above the minimum space requirements. There are no en-suite facilities, however there are numerous toilets and bathrooms situated close to service users bedrooms and lounges. Four rooms have doors into adjoining rooms, which can be converted into doubles for service users to share if they wish. The home provides appropriate aids and adaptations in order to maintain service users independence. Boston House has level access throughout the building onto secure garden areas. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unscheduled inspection time was spent talking to three service users in private, other discussions took place with a groups of service users. The care for three service users was looked at in detail looking at their experience of the home from the time if their admission to the present day. Records of care were examined; staff duty rotas, financial and medication records were also looked at. Service user, relative and health professional’s questionnaires were left for completion on the previous inspection some, which have been recently received. Comments from service users were all positive with one relative saying “this is the best home that I have seen for the care provided”, another said they were happy with care and was always kept informed of any problems or progress. What the service does well: What has improved since the last inspection? Aspects of the rear garden area have been improved for the safety for residents when walking outdoors. A pleasant seating area is provided. The manager reported that other areas of the garden were also listed for improvement. Each wing has had new televisions, DVD’s and video recorders. Some have televisions with large screens, which service users said they liked because they can see them better. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 6 A new medic bath has been provided for those service users with a physical disability. A domestic style washing machine has been added to the intermediate unit for rehabilitation purposes. This allows service users to continue to do their personal laundry if they wish. 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. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 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 Boston House DS0000035134.V276914.R01.S.doc Version 5.1 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, 3, 6. Service users are provided with information on facilities and services allowing an informed choice to be made. A detailed assessment ensures that service users needs are met. Access to health care professionals and a multidisciplinary approach ensures the needs of service users receiving intermediate care are met. EVIDENCE: There is a service user guide in each of the service users bedrooms for reference. This is especially useful for those service users on the short stay and intermediate units due to the high rate of admissions and discharges. Detailed assessments are obtained on all service users admitted into the home, which is then reflected in care planning. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 9 The intermediate unit provide a step down approach form hospital for a period of six weeks after which a review is held when a longer period of stay may be granted in exceptionally circumstances. Service users have access to health care professionals to promote mobility and independence. Multidisciplinary reviews are held weekly to assess their progress. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 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. Care plans matched service users assessments ensuring their needs are met. Inconsistencies were found in the administration of medication which may pose a risk to service users. EVIDENCE: On admission to the home, service users on the intermediate units come under the care of the homes nominated GP. This GP liaises with consultants and the service users own GP on discharge. The exception to this is the nine permanent service users who retain their own GP within the district boundaries. Those service users on short stay retain their own GP. Case files from the intermediate care and transitional units reflect input from district nurse, physiotherapists, and occupational therapists. Service users on the short stay unit receive regular reviews from social workers. Reviews of permanent service users take place by the home on a monthly basis with a social work review yearly or when required. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 11 Care plans and risk assessments were comprehensive and reflected service users assessed needs. Nutritional requirements, personal preferences and selfimage were also documented. Service users on the intermediate care unit undertake home visits accompanied by professionals and family to assess their coping skills at home. Service users comments included “ the physiotherapists have really got me going “ and “they have done marvellous for me here”. A relative commented saying, “ I visit at different times throughout the week and have noted that staff are always caring and the home is spotlessly clean”. The manager provided examples of a pilot scheme to promote service user involvement which included service users writing their own comments on care planning and progress notes with their views on expected outcomes. Examination of medication records and administration found inconsistencies in recording. Examples - one medication had been signed for and not given, medication administered was not recorded on recordkeeping sheets and prescribed creams had not been recorded when applied. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 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 the following standard(s): 15. Meals times were well-managed and provided service users with a choice of food. EVIDENCE: All the above standards were examined on the previous inspection. The inspector spent time discussing with service users their experiences while being in the home and the quality of food provided. Some of their comments were as follows; “It is just like being in an hotel here”, “this is a well managed home” and “staff treat us very well.” Other comments made related to how pleased service users were that their clothes were soon returned from the laundry and always came back in good order. Menus were displayed on each of the wings and food served is from individual trolleys, with service users being asked individually on the choice and portion of food they would like. One service user commented that food is always good and there is too much for them some times. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 13 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. The home operates an effective complaints procedure. Service users are confident they can talk to staff. Staff training in the protection of vulnerable adults provides protection for service users. EVIDENCE: Service users were aware of the home’s complaints procedure, all were confident that any problems they might have would be acted on immediately by the a management team before a complaint was raised. Staff interviewed were aware of the home’s prevention of adult abuse policy and action they would be required to take if such an event should be witnessed. Training is provided in the protection of vulnerable adults. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 14 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, 26. The home presents has being appropriately maintained, safe clean and tidy throughout. A good standard of homely accommodation is provided for the comfort of service users. EVIDENCE: All the above standards were examined on the previous inspection. This is an overview of the inspector’s findings and observations through out the day. Worked had commenced on garden areas to the rear of the home providing a safer environment. The manger reported that other areas of the garden had been allocated for an upgrade. A new medic-bath for service users with physically disabilities had been installed and a walk in shower had replaced one bathroom. All were equipped to a high specification. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 15 The intermediate care unit had been provided with a domestic washing machine for rehabilitation purposes allowing those service users who wish to continue to do their own laundry. The home provided a high standard of domestic accommodation for service users that, is clean tidy and free from odours. A selection of service user rooms were inspected on each unit and were homely some of which had been provided with new furniture. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 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 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, 30. Staffing levels are maintained in line with service users assessment of need ensuring the needs of service users are met. Staff training is given a high profile, which is reflected in the care delivery the service users receive. EVIDENCE: Staffing levels in the home were appropriate to meet the needs of service users. Staff training is given a high profile in the home leaving them feeling confident in their role. Examples of staff training, which is undertaken alongside NVQ training, are Stoma care, protection of vulnerable adults, equality and diversity, dementia care and health and safety. Oldham Social Services training department provides staff training. Several staff had worked in the home for a number of years promoting continuity of care for service users. Service user spoke highly of the care and consideration given by staff. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 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 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. Effective leader ship and management provide an open and inclusive atmosphere through consultation with service users. EVIDENCE: The manager has over 20 years experience in care and management. They hold a Certificate in Social Services and NVQ4 in management and have continued their professional development by ongoing training in relation to the service users needs. There is a good communication system in the home with the views of service users and staff being considered on a regular basis. There was evidence of service users on the intermediate unit completing satisfaction questionnaires weekly together with an exit questionnaire. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 18 Service users on the long stay unit receive questionnaires on a three monthly basis. Quality of care practice monitoring is undertaken monthly. Regular staff meetings and shift handovers ensure staff are kept informed on all matters affecting the running of the home and service users care. Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 19 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 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 20 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. 1 Standard OP9 Regulation 13 Requirement The registered person must ensure that medication is administered and recorded has prescribed. All service users medication must be recorded on medication sheets, any additions must be signed and dated by the person completing them. Timescale for action 01/02/06 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 Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs. OL7 0QD 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 Boston House DS0000035134.V276914.R01.S.doc Version 5.1 Page 22 - 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!