Inspection on 30/08/06 for Boughton Manor Care Home

This inspection was carried out on 30th August 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 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

Boughton Manor Care Home 18/10/05

Boughton Manor Care Home 16/03/05

Boughton Manor Care Home 29/09/04

Boughton Manor Care Home 16/02/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOMES FOR OLDER PEOPLE Boughton Manor Care Home Church Road Boughton Newark Nottinghamshire NG22 9JX Lead Inspector Vanessa Gent Key Unannounced Inspection 9th August 2006 09:30 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 Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boughton Manor Care Home Address Church Road Boughton Newark Nottinghamshire NG22 9JX 01623 860436 01623 835968 boughton.manor@craegmoor.co.uk www.craegmoor.co.uk Craegmoor Healthcare 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) Margaret Aileen Blower Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (40) Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 resident 58 years and above Date of last inspection 18/10/05 Brief Description of the Service: Boughton Manor is an old convent which has been converted and extended. It is owned and run by a large care home group. It houses up to thirty-five residents of both sexes, over the age of 65 years, who suffer from dementiatype related illness. The home is situated in the village of Boughton, next door to the church, on the outskirts of the village of Ollerton. The facilities in Ollerton include a superstore, shops, pubs, churches, library, a college with swimming pool and a community centre. There are amenities in the local village within a mile. These include shops, pub, garage and police station within half a mile. The home is on a bus route to the towns of Mansfield and Worksop, the nearest bus stop about 500 yards from the care home entrance. The two-storey home consists of twenty-three single and six double bedrooms, none of which are en suite. Communally, there are two large lounges which also incorporate dining areas. There are five bathrooms, three of which have toilets in them, and six toilets. There is also a jacuzzi which is used by three residents. One room has been made into a sensory room and can be used to provide a calming area as well as activities. The care home is surrounded by gardens extending to several acres and is accessible to wheelchairs. There are approximately fifteen car parking spaces for visitors and staff. The philosophy of care is that the manager and staff do what is in the best interest of the residents at all times, giving the best quality of care and enhancing their quality of life as much as possible. The fees range from £474 to £1193. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home as part of a key inspection. It started at 15.00 and lasted 4¾ hours. Information already held on file was used to plan the visit. On the day of the visit, thirty-one residents were living in the home. The main method of inspection used is called ‘case-tracking’, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Four residents’ survey forms were received. All were positive about the level and quality of care given. All said that staff always listen to what residents say, and that meals are excellent. One comment made was, “I cannot praise the management and staff enough for how much care they put into looking after me. Taking time to sit and talk.” There were no negative comments made. The visit focused on whether key standards and requirements from previous inspections had been met and how the residents, relatives and staff feel about the service provided. Three residents’ assessments and care plans were examined. This is to ensure the health, safety and welfare of the residents is checked and that residents are allowed dignity, autonomy and choice. A partial tour of the home was made and a sample of other records examined. The inspector spoke with five of the seven staff on duty, at least thirteen of the thirty-one residents, including those being case-tracked, and three relatives. The manager was present throughout this visit and spent time discussing many issues that arise in the running of a care home. What the service does well: The home is run by a competent, confident manager and supported by a staff team who are well-trained and thoughtfully support the residents. It provides a comfortable and homely place for the residents. Everyone the inspector spoke with said there is always a happy atmosphere and that the staff treat the residents with respect and dignity. The home is a pleasant, clean environment. Visitors are encouraged to join in the home’s activities if they so wish. Relatives who visit almost daily and assist their relative with their meals, say staff are always attentive, caring, kind and available to meet the residents’ needs and wishes. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 6 The staff provide daily activities, that are tailored to the needs, wishes and age of the residents. 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. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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 Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Any decision for a resident to come and live at the home may be made without having full information about what the home can offer. No-one is admitted to the home without a full assessment of their needs. EVIDENCE: The statement of purpose and service user guide are very brief. They record the minimum of information about the home. Prospective residents and their families may not be able to make an informed decision about wanting to live at the home unless more information is provided. The manager said she would email the Regional manager to ask for advice on this aspect, to have more details about the service provided included. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 9 Pre-admission assessments are now undertaken using a new form which is more relevant to the ‘client-group’ that is accommodated at the home. Those seen in the residents who were case-tracked are comprehensive. They are used, along with the assessments from whoever funds the resident, to form the basis of the care plans. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are well-prepared documents that are kept up-to-date. Residents’ healthcare needs and their respect and dignity are maintained by kind, caring well-trained staff. EVIDENCE: The care plans examined are comprehensive statements of the needs, lives and wishes of each resident. They contain life histories, risk and health assessments and describe in detail how the care of the resident should be managed. Re-arranging the order of the contents of the care plans would make for easier reading. Care plans and risk assessments are reviewed one-to-three monthly as necessary. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 11 Two relatives said that they are fully aware of the contents of the care plans, were involved with setting them up and in their regular reviews. They said that staff keep them fully informed about any medical or health issues. The residents’ health needs are observed, monitored and recorded by the nursing and care staff. Staff liaise with other healthcare professionals over specific areas of the residents’ health, such as psycho-geriatrician, speech and language therapists, continence advisors and the community tissue viability nurse. The medication procedures seen and checked are adequate to safeguard the residents. The home’s supplying pharmacist gives regular update training for the nurses and basic training for the carers, so that they know the effects and side-effects of the drugs that are administered. The pharmacist also provides a regular inspecting service to ensure that the home’s medication practices stay in order. A relative said, “If the medicines are refused, the staff go away and will try again later, always keeping calm.” The inspector saw and relatives confirm that staff treat the residents with respect. Staff ensure that residents, especially those who are unaware of their behaviour, retain their dignity at all times. A relative said that when the resident is very sick, staff have “treated the resident and them with dignity and respect”. “They are all excellent and the manager too.” Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All aspects of the daily life and activities of the residents are thoughtfully and caringly carried out. The staff provide a quality, calm and happy life within the residents’ limitations. EVIDENCE: Activities are provided, both individually and communally. Staff describe how they manage one-to-one sessions with the residents. Relatives confirm that staff are very good with the residents. They sit with them, chatting, laughing, calming and keeping them occupied. This happens often, as confirmed by relatives who visit frequently and at different times and on most days. Of the four resident surveys received, all of which were completed by relatives, two say that there are always plenty of activities; one said there usually is and one said there sometimes is. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 13 Relatives said they are always made welcome. They are invited to join the home’s activities and have recently “enjoyed the Summer Fair which was very nicely done”. Some residents are funded to receive one-to-one caring during their waking hours. The staff with these residents were seen to be attentive, calm and always alert to the residents’ movements and wishes. It is the resident’s wishes that dictate where the resident and staff go and what they do. The provision of good, nutritious food was assessed at the previous inspection as being more than adequate. Relatives and a resident confirm that the food is excellent, in quantity and quality. The relatives say that staff attend to helping residents with their food in a dignified and unhurried manner. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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 the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents and relatives are listened to and know that any complaints or concerns would be taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: An up-to-date complaints policy is displayed publicly. No complaints have been received by the home or the commission in the past twelve months. No relatives expressed any concerns about the care or environment to the inspector or in the resident surveys. Indeed, relatives have only praise and compliments to say about the staff and manager. Relatives say that staff and the manager are very open in including them and keeping them informed of all aspects of the resident’s care and condition at all times. A relative said, “We can’t fault the quality and level of care. [The resident] is calmer here and always nice and clean, well-fed and given plenty of fluids. We have no problems or concerns.” Policies and procedures are in place and training has taken place to enable staff to protect residents from harm. (See also the Section on Training.) Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The decorations in most areas let the home down in its ability to provide an otherwise comfortable, clean, calm environment to help the residents feel ‘at home’. Most measures, except for the temperature of water at the outlets, keep the residents safe and secure from harm. EVIDENCE: The lounge and dining areas are large, airy and clean. They are spacious enough for staff to help the residents with their daily needs and allow space for people to wander in safely and in comfort. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 16 The home has not had a major decorating programme for many years. Much of the decoration is ‘tired’, grubby with knocks, scratches and wallpaper tears and ‘dated’ in appearance. Communally, the two lounge-cum-dining rooms are spacious and allow for staff to attend to the needs of the residents and for residents to wander round in safety and comfort. The gardens, set in several acres of ground, surround the home. They provide a tranquil outdoor area for residents and are wheelchair accessible. The car park has about fifteen spaces for visitors and staff. The water temperature, in the resident’s sinks of those who were case-tracked, is over 49°C: too hot for safe use by residents, many of whom are not aware of any risk or danger and may have fragile skin. The manager showed the inspector a new form that she has received that will be used by the handyman from the Monday after the visit. He will then regularly monitor, adjust and control the water temperatures from all outlets. Relatives said that the home is kept clean, tidy and hygienic at all times. They said that any mess made at meal or any other times, is cleaned up straight away. The Environmental Health Officer visited the home after the last inspection to advise on aspects of health and safety. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are in safe hands with well-trained and caring staff to ensure their comfort and well-being at all times. EVIDENCE: The staff duty rotas indicate that there is a good ratio of staff on duty, taking into account the high dependency levels of the current thirty-one residents and the layout of the building. Relatives say “the staff are brilliant; wonderful; will do anything for you”; that “they sit or walk round with the residents, chatting, listening”; that “nothing is too much trouble”; that “there always seems to be enough staff on duty. They come straight away when they needed and there are always plenty of staff in the lounges.” “And the activities organiser does crafts and things too.” All four resident surveys said that staff were always available when you need them. Staff say they get on well together and are well-supported in their duties. They “like coming to work” and “I’m really enjoying it”. An activities organiser works Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 18 with the staff to provide for the residents’ social, physical and emotional needs. Overseas staff employed at the home are well-integrated into the staff team. Staff have meetings but the inspector did not ascertain how regular these are or whether staff can and do voice their opinions and wishes at them. All aspects of basic care and necessary training are covered thoroughly in the induction of new staff. They shadow and work with senior staff for several weeks, depending on their previous experience, to ensure that they care for the residents safely, competently and confidently. Staff say they receive a good amount of training and feel able to deliver a good quality of care to the residents. The manager keeps an electronic record of staff training to monitor that they are always up-to-date. Certificates are available to show the staff training done externally to the home. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run by a manager who is well qualified, well thought of and supported by the company which owns the home. She ensures that the residents’ best interests, health, welfare and finances are safe-guarded and maintained at all times. EVIDENCE: The manager is a nurse trained in mental health and she has achieved her Registered Manager’s Award. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 20 She is highly respected by residents, relatives and staff alike. Staff say that since she became manager, the home has gone from strength to strength. They say she is supportive. “You can go to her with anything and she will listen.” Relatives say she is “wonderful”, “just great”. She has a clear rapport with the residents, who are obviously fond of her. The regional manager visits monthly and reports of their findings, and these will be supplied to the commission office in future. Resident survey questionnaires go out from head office directly; the manager has no input into this. The manager monitors monthly the occurrence of any falls or accidents. Residents’ finances are handled by relatives or guardians. The staff manage only the personal allowances to pay for small expenses such as hair, chiropody, etc. Receipts are kept and two signatures are obtained for each transaction. Staff receive supervision but the manager states she is struggling to do them all as regularly as advised. It was suggested that other senior staff be trained and the responsibility be shared. The manager does not work totally extra to the staff ‘on the floor’ – only half her hours are for administration. She finds it difficult to maintain the records, auditing, reviewing of care plans and other paperwork that are a manager’s responsibility. Health and safety measures are in place and the maintenance file was briefly seen, although this was not inspected fully at this time. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 2 3 X X X X 2 3 STAFFING Standard No Score 27 4 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 X 3 Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 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. 1. 2. Standard OP19 OP25 Regulation 23(2) 23(2) Requirement The home must be kept in a reasonable state of decoration for the comfort of the residents. The water temperatures in the residents’ rooms must be maintained at a temperature safe for the residents to use without risk of harm. Timescale for action 30/11/06 06/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations The statement of purpose and service user guide should be adequate to inform prospective residents fully of what the home has to offer. Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Boughton Manor Care Home DS0000024632.V303813.R01.S.doc Version 5.2 Page 24 - 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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