Inspection on 21/11/05 for Boulevard House

This inspection was carried out on 21st November 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Boulevard House 17/07/06

Boulevard House 20/09/05

Boulevard House 20/12/04

Boulevard House 21/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Boulevard House 1 The Boulevard Mablethorpe Lincs LN12 2AD Lead Inspector Mr Ken Hague Unannounced In 21st November 2005 10:00 Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 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 Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Boulevard House Address 1 The Boulevard Mablethorpe Lincs LN12 2AD 01507 473228 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) Boulevard Care Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Situated in Mablethorpe in a residential area close to the centre of the resort, beach and local facilities, Boulevard House has been converted from a former domestic and hotel premises to the present accommodation. The home is registered for 15 service users with learning disabilities. Although it has 4 rooms registered to occupy 2 people, all but one is at present occupied on a single occupancy basis. The home’s service user guide states that the home aims to provide a caring environment for individuals to reach their optimum potential intellectually and socially in small supported living accommodation. The home is owned by Boulevard Care. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 ½ hours. A tour of the building took place and care records were inspected. The main method of inspection used is called ‘case-tracking’; this involved selecting two residents and tracking the care they received through the checking of their records, discussion with the residents, care staff and observation of practices. A sample of care records and policies and procedures were examined. The Acting Manager of Boulevard House was present throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 6 The home has no registered manager in post. She is preparing an application to the Commission for Social Care Inspection to become the registered manager. The home needs to review its training plan to ensure that all staff receive appropriate training in the administration of medication and the identification and management of potential abuse situations. 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. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 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 Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 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): 1,2,4,&5 The home provides all new residents with information which enables them to make an informed choice whether the home can meet their individual needs. The individual aspirations and needs of residents are recorded on their care plans. The home encourages all new residents to visit the home prior to making long-term decisions. All residents are given a copy of the contract or statement of the terms and conditions for their Stay at the care home. EVIDENCE: The home has a statement of purpose, which sets out the resources of the care home and is available to all residents. This document meets the National Minimum Standards. Care records provided evidence that the individual aspirations and needs of the residents are identified at the initial assessment and transferred onto care plans. A resident’s care records and discussions with the acting manager provided evidence that they had visited the home several times before making a decision to stay. Individual residents files seen at this inspection all contained copies of the terms and conditions for the residents stay at the care home. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 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): 6,7&9 Resident’s care plans are written after the initial assessment has been made and all their needs identified. The care plan resulting from this assessment reflects the wishes and choices of the resident .The care plans are review with the residents at a frequency set out in the National Minimum Standards. EVIDENCE: Three residents files were inspected, and all had been updated since the last inspection. They provided evidence that staff review the care needs of residents in accordance with the National Minimum Standards. They were presented in a format which was easy to follow and written in plain English. The wishes, choices and goals of each individual resident is recorded on their care plan. There was evidence of residents being involved in the writing of their own individual care plan. The resident and the member of staff who carried out the assessment had dated and signed the care plan. Staff stated all of the goals for individual residents are recorded in their file. A long discussion was held with the acting manager regarding a resident admitted since the last inspection. The assessment for this resident was detailed it included the identification of possible risk. The risk assessment set out management strategies to reduce or remove the identified risk. The care Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 10 plan detailed his health care needs including the details of community health services support in the home. The quality of the records enabled the reader to understand the needs of this resident very quickly. There was evidence of his needs been reviewed since he was admitted to the home. The acting manager and a second member of staff were able to describe and discuss his care plan. They were able to describe the personality of the resident and his choice and wishes in respect of the manner in which he wanted his support to be provided. His care plan exceeded the National Minimum Standards. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 11 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): 12,13,16 & 17 Residents are encouraged to take part in activities of their choice some activities being taken within the local community. The home makes all friends and family welcome. Residents are actively involved in the decision making process of the home. The home offers a wholesome and appealing menu choice is offered special diets are being catered for. EVIDENCE: Residents attend the Orby day Centre which offers activities including social and personal skill training. The acting manager stated that the day centre is to close for a period of time. Plans have been made to replace activities provided at Orby with alternative ones within the care home. She stated that these will be organised to ensure that the individual needs of each resident are met. Residents confirmed that the activities recorded on the care plans were being provided by the home. They stated their satisfaction with the day centre they attended at Orby. The home arranges for residents to go out into the community to take part in local activities or join in social events at other boulevard care homes in the area. Residents stated their satisfaction with the menu and quality of food being provided by the care home The menu demonstrates evidence of choice being offered to residents. Residents are Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 12 encouraged to prepare a snack for themselves under supervision to retain their social skills. All residents take part in a cleaning rota for the kitchen and take responsibility for the cleaning of their own bedrooms. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 13 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): 18 &19 The health needs of service users are met, with good liaison with healthcare services. Medication storage and administration systems are satisfactory. EVIDENCE: The care records contain information regarding the resident’s choice in relation to the manner in which personal care should be provided. Residents stated that they felt all staff respected their privacy and dignity. The acting manager stated that the home liaison with community health services. The care records demonstrated that eye care, foot care and dental care are being provided for all residents. The details of visits and appointments for hospitals, dentist, opticians and visits from chiropodist were recorded on the individual resident’s files. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 14 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): The home has robust procedures for handling complaints and allegations of adult abuse, but staff were clear on the action to take in the event of this occurring. EVIDENCE: There is information for residents and their relatives about how to make a complaint displayed in the home. Residents said they felt confident that they could raise any concerns with the management of the home. The home holds regular residents meetings to discuss the services provided by the care home. A resident stated “this is my opportunity to express my opinion or ask questions regarding how the home is being run”. The home has a copy of the Lincolnshire Adult Protection procedures within the homes procedure manual. This is cross-referenced with the home abuse policy. Staff interviewed were not however able to confirm the details of the Lincolnshire County Council abuse procedure. One member of staff interviewed had not received any training in a recognition and prevention of abuse in the last year. Residents said that they felt safe in the home. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 15 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 & 30 The standard of the environment within this home is good, providing service users with a comfortable and homely place to stay. EVIDENCE: A tour was made of the care home. All areas of the home were found to be clean and smelt fresh. Ongoing maintenance is being carried out. Bedrooms rooms were decorated to a good standard. A bedrooms viewed at the request of a resident was found to meet the National Minimum Standards in relation to the provision of facilities and equipment. The room viewed had been personalised by the individual resident. All residents seen during this inspection confirmed their satisfaction with the environment of the care home and their own individual bedroom. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 16 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): 32,34,35 & 36 The home ensures that appropriate staff are recruited and employed by the home. There are always sufficient numbers and skill mix of staff on duty. The staff training provided does not cover all essential core training. EVIDENCE: There have been no members of staff recruited since the last inspection. The acting manager confirmed that the recruitment policy of the home continues to be followed. Staff and residents expressed their satisfaction with staffing hours allocated to the care home. Staff stated they felt able to carry out their task safely with the training provided by the company. However one member of staff interviewed stated that she had not received training in the recognition and management of abuse. In addition she had not been provided with a refresher course in the administration of medication for over two years. A competent person not directly employed by the company should provide this training on a yearly basis. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 17 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): 38 & 42 The home is well run, with good leadership and guidance for staff. recordkeeping is of a high standard, and the health and safety and welfare of resident is promoted. EVIDENCE: There was an acting manager in post at the time of this inspection. She was also providing management support to number 3 the Boulevard, which is a second care home, owned by the company. This was due to the registered manager of that home being on long-term sick leave. Staff stated that she is very supportive and approachable. In formal interviews staff stated that appraisals and supervision are being provided in accordance with the National Minimum Standards. The procedures manual also contains a health and safety and an infection control policy. Staff confirmed that they were aware of these policies during the formal interviews. There were no health and safety issues identified at this inspection. Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 x 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Boulevard House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 4 x x x 3 x DS0000002329.V265152.R01.S.doc Version 5.0 Page 19 yes 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 YA35 Regulation 18-1 (c) Requirement Staff must be provided with training in the administration of medication and the recognition and management of abuse. Timescale for action 27/02/06 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 Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Boulevard House DS0000002329.V265152.R01.S.doc Version 5.0 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. 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!