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Inspection on 23/05/05 for Boultham Park House

Also see our care home review for Boultham Park House for more information

This inspection was carried out on 23rd May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service users with whom the inspector spoke were very positive about the staff and the standards of care overall. Comments included: "The staff are excellent, very kind and helpful". "I wouldn`t want to be anywhere else, I`m quite satisfied". "You could better the food but not the staff". The care staff are a well supervised and trained team who throughout the visit were observed to be attentive and polite when speaking with residents. The visiting community nurses confirmed that staff appropriately followed any given instruction or advice relating to residents nursing needs. The home is well managed and supervised and the records are clearly written and stored. The organisation continues to invest in each aspect of the service.

What has improved since the last inspection?

Improvements have been made regarding the supervision of staff within the home. The homes policies and procedures and risk assessments have been reviewed and updated as required.

What the care home could do better:

The homes care records must demonstrate fully how the daily living and recreational needs of service users are met. Training overall is good although staff must attend training regarding infection control and health and safety awareness. General health and safety within the home is of a good standard although window restrictors must be fitted to all uptairs windows.

CARE HOMES FOR OLDER PEOPLE Boultham Park House Rookery Lane Lincoln Lincolnshire LN6 7PH Lead Inspector David Bacon Unannounced 23 May 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Boultham Park House Address Rookery Lane Lincoln Lincolnshire LN6 7PH 01522 681500 01522 696399 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Orders of St Johns Care Trust Mrs Jaqueline Luke Care Home 36 Category(ies) of DE Dementia (2) Both registration, with number OP Old Age (34) Both of places Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 2 (DE) Dementia aged 58 years or over. Date of last inspection Brief Description of the Service: Boultham Park House is a 2-storey building located on the outskirts of Lincoln and is situated at the end of a small lane, behind residential housing and shops. The home is set in well-maintained gardens and a car park situated at the front of the premises. The rear of the property overlooks Boultham Park and its lake. The home is close to local facilities and a short bus ride from the City Centre. The home is registered to provide personal care for up to 36 service users, 34 of these being over 65 years and 2 having specific mental health needs. Accommodation is provided in 32 single and 2 double bedrooms situated on the ground and first floor. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3.5 hours, it was unannounced and was carried out by one inspector. A tour of the premises was conducted, service users care records and staff records were inspected. The inspectors spoke with the acting manager, five service users, one relative and two visiting community nurses. What the service does well: What has improved since the last inspection? Improvements have been made regarding the supervision of staff within the home. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 6 The homes policies and procedures and risk assessments have been reviewed and updated as required. 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. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 There are satisfactory policies and procedures in place for the introduction of residents to the home. Information is provided to prospective service users to enable individuals to make informed choices about admission to the home. EVIDENCE: Boultham Park House has a service users guide and a statement of purpose, which detail the services provided by the home and its terms and conditions. These documents are made available to prospective service users prior to admission. Three service users personal files were seen, which contained pre-admission assessments and a copy of the letter sent to the service user confirming that the home was able to meet their needs. Individually signed terms and conditions of residence contracts were maintained on each of the service users files inspected. The service users with whom the inspector spoke confirmed that they were satisfied with the admission process and that they were initially invited to visit the home without having an appointment prior to admission. Service users Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 9 comments regarding the admission process included: “Yes, I was certainly made welcome”. “The staff made the move much easier, they appreciate what you are going through”. “We were all made welcome, they were very good”. Admission policies and procedures are in place giving guidance to staff, which are discussed as part of the induction process. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10, 11 The homes care plans and risk assessments are well maintained and provide staff with the required information to meet service users care needs. Service users health needs and privacy and dignity is promoted and met. EVIDENCE: A care plan and risk assessment is completed for each service user, these clearly detail individuals care needs and document how these are met. Care records are generally updated on a daily basis and reviewed each month or as changes occur. These are signed by service users, or their representatives where possible. The five service users and one representative confirmed that staff provide the care needed and that supporting health services are utilised as required, which are recorded within service users care records. Services users confirmed that their privacy is maintained and they were complimentary about the care provided. Comments included: “The standard of the care here is good, without question”. “The staff are well trained and do a very good job”. “You couldn’t improve the care here”. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 11 Policies and procedures regarding the organisations care philosophies and practices are in place, giving guidance to staff. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 Service users are supported to express their views regarding the care they receive, life within the home, and to maintain and develop community links as they prefer. The homes variety of activities is limited although enjoyed by service users. The food and drink available is varied, plentiful and of good quality and the home aims to meet service users preferences. EVIDENCE: Service users with whom the inspector spoke confirmed that they were able to spend their time as they like and to maintain/develop interests or relationships. Information regarding the homes care philosophies and the promotion of service users rights are included in the statement of purpose. Each resident is consulted about their likes and dislikes and they have the opportunity to express their views and offer ideas at the residents meetings of which records are maintained. The home provides information to service users detailing how they may contact external agencies, e.g. advocates. A limited variety of activities is made available to service users although the manager is in the process of addressing this. Service users were partially Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 13 satisfied with the homes provision of activities although all stated that they would like for there to me more to do in the home. The home meal records documented that a varied selection of foods was provided and that food safety precautions are continuously undertaken. The service users spoken with confirmed that a choice of foods was always available and that food was plentiful. Some service users were not fully satisfied with the taste and presentation of all foods provided although no specific comments or suggestions were made. The acting manager said she would ensure that service users are further consulted with in the aim of improving overall levels of satisfaction. Other service users with whom the inspector spoke were satisfied with the homes provision of meals. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected during this visit. EVIDENCE: Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25, 26 The standard of the physical environment is good, with the organisation ensuring the maintenance of each area of the home. All private and communal space is suitable for the residents, homely and comfortable. Service users are able to personalise their own accommodation as they prefer. EVIDENCE: The home is well furnished and decorated and the standard of the environment and its facilities are appropriate to the needs of residents. Maintenance programmes are in place. Domestic staff keep the home clean and odour free and health and safety policies and procedures give guidance to staff. Each radiator is covered and water temperature restrictors are fitted to water outlets to minimise the risk of burns or scalding. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 16 The bathrooms areas are well maintained and equipped with aids and adaptations of which are serviced and staff receive training. During the visit one hoist had been identified to be repaired although other hoists were available. The inspection of ten service users rooms identified that rooms are personalised and contained personal effects. Service users were satisfied with the physical environment. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 There are sufficient staff to allow them to care for the residents. Robust recruitment procedures are in place and the staff are trained, competent and they receive induction when starting at the home. EVIDENCE: The service users commented that their care needs were met and that there was generally sufficient numbers of staff deployed in the home, which was further evidenced through inspection of the home rota. The staff files viewed contained all of the required records to demonstrate that appropriate recruitment procedures had been followed. The staff receive a comprehensive induction and a rolling programme of training is in place and records maintained although the acting manager confirmed that some training regarding health and safety and infection control is required. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36, 37, 38 The written and verbal communication systems in the home are adequate. Systems are in place to ensure that staff are appropriately supervised and working consistently as a team. Quality assurance procedures are in place for service users. EVIDENCE: Staff are supervised and records of these are maintained. Health and safety policies and procedures are in place, giving guidance to staff. Risk assessments have been completed for all service users and systems are in place to minimise risks to residents prone to wandering. This includes the fitting of door alarms to external doorways although window restrictors must be fitted to all upstairs windows. Quality assurance monitoring systems are in place and the service users spoken with confirmed that they felt supported to express their views Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 19 regarding the home, through attending residents meetings, completing satisfaction questionnaires and individually. The homes fire logs were viewed, which documented that regular checks are carried out relating to fire safety systems. Fire training and drills are carried out as per fire safety regulations. The Commission for Social Care Inspection has received reports (regulation 26) from a representative of the Proprietor, who visit the home on a regular basis to ensure the smooth running of the home. Data protection and access to records policies are in place and made available to service users. Individual records and home records were well maintained overall and secure. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x x 3 3 2 Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 21 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 12 Regulation 15 and 16 (2) (n) Requirement Timescale for action 31/07/05 2. 3. 30 38 18 (1) (c) (i) 13 (4) (a) The registered person shall prepare a plan as to how the service users needs in respect of health and welfare are to be met. Therefore, it is required that care records demonstrate fully how the daily living and recreational needs of service users are met. Staff must attend training 31/07/05 regarding infection control and health and safety awareness. Window restrictors must be fitted 31/07/05 to all uptairs windows. 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 15 Good Practice Recommendations It is recommended that the home cook communicates with service users in the aim of improving overall levels of satisfaction regarding meals. Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection CSCI, 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 Boultham Park House C53 C04 S2330 Boultham Park V228963 230505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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