Inspection on 15/12/05 for The Boltons

This inspection was carried out on 15th December 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.

Other inspections for this house

The Boltons 30/03/09

The Boltons 02/11/06

The Boltons 17/06/05

The Boltons 18/01/05

The Boltons 03/08/04

The Boltons 19/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Boltons 4 College Road Reading Berkshire RG6 1QB Lead Inspector Sally Newman Unannounced Inspection 15th December 2005 10:00 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 DS0000011122.V264250.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 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. DS0000011122.V264250.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Boltons Address 4 College Road Reading Berkshire RG6 1QB 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) 0118 9261712 0118 9261712 Mr Vijaye Juggurnauth Mrs Premila Juggurnauth Mr Vijaye Juggurnauth Care Home 18 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (2), Old age, of places not falling within any other category (16) DS0000011122.V264250.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th June 2005 Brief Description of the Service: The Boltons is a small residential care home for older people situated in a residential area close to Palmer Park in Reading. The Registered manager has owned and managed the home for the last 16 years. The age and design of the Victorian building make it unsuitable for residents with mobility restrictions, despite the lift to the first floor. An extension has been added which has given a number of rooms large en-suite bathrooms. There is one shared room within the home.The home provides care for service users with a range of multicultural needs. DS0000011122.V264250.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which was conducted over the course of 4 ¼ hours over a morning and lunch time period. 10 service users were spoken to of which 2 were spoken to in private. Discussion took place with the management and staff were briefly spoken to. A range of records were seen. This home provides a good standard of care which is appreciated by service users. The home has tried to provide a healthy menu in light of recommendations made by a dietician who was commissioned by the home. In addition, efforts have been made to provide varied activities for service users. What the service does well: What has improved since the last inspection? What they could do better: DS0000011122.V264250.R01.S.doc Version 5.0 Page 6 The management should encourage greater take up of NVQ training amongst the staff team. To ensure that service users are provided with as many choices as possible. 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. DS0000011122.V264250.R01.S.doc Version 5.0 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 DS0000011122.V264250.R01.S.doc Version 5.0 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): No standards were assessed under this heading on this occasion. EVIDENCE: DS0000011122.V264250.R01.S.doc Version 5.0 Page 9 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): 9 & 10 Service users 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. EVIDENCE: Evidence was provided from discussion with management and perusal of medication records. No service user currently in the home self medicates. All staff who administer medication receive both external and internal training and a range of certificates were provided to support this. A standard Monitored Dosage System is used for all service users which minimises the potential for errors. The chemist uses by the home provides a 3 monthly visit to the home by a pharmacist to assess the arrangements for medication within the home. Service users spoken to indicated that staff are respectful and that their right to privacy is respected. Some service users prefer to spend time in their rooms and although they are encouraged to join in with group activities including meals their right to choose time spent on their own is respected. DS0000011122.V264250.R01.S.doc Version 5.0 Page 10 DS0000011122.V264250.R01.S.doc Version 5.0 Page 11 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): 14 & 15 Service users are helped to exercise choice and control over their lives most of the time. Service users receive a balanced diet in convivial surroundings. EVIDENCE: Evidence was obtained by talking to service users, from observations and from discussion with management. Service users always choose food preferences at mealtimes and some are able to choose when to go out but must rely upon staff availability. Staff should ensure that they take every opportunity to provide service users with everyday choices. The food provided in the home was praised by the majority of service users. The cook advised that she often discusses food preferences with service users and makes changes to the menu as necessary. These discussions tend to be informal and not part of formal meetings. A dietician was commissioned approximately a year ago and her recommendations have been largely incorporated into the homes menus. The inspector was advised that 4 staff are due to attend a course addressing health and nutritional needs of older people which will further enhance the skills and knowledge of staff. DS0000011122.V264250.R01.S.doc Version 5.0 Page 12 DS0000011122.V264250.R01.S.doc Version 5.0 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): 18 Service users are protected from abuse. EVIDENCE: All staff have received training on adult protection issues and regular updates are provided on a rolling programme. The management team demonstrated a clear understanding of the course of action to be taken should an allegation or suspicion of abuse was taking place. DS0000011122.V264250.R01.S.doc Version 5.0 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 Service users live in a safe, well-maintained environment. EVIDENCE: Various areas of the home were seen by inspector during the course of the inspection. The home is maintained in a clean and hygienic fashion. Records confirmed that the home is well maintained with health and safety checks including fire checks being undertaken on a regular basis. DS0000011122.V264250.R01.S.doc Version 5.0 Page 15 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): 29 & 30 Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: A sample of the most recently employed staff records were seen and were found to contain all the required documentation and checks. The home has registered with a local training agency which provides some free training. This has helped the homes training programme and staff were now able to access a range of training including dementia, activities for people with dementia, reminiscing and safe-lone working. Currently 3 staff are undertaking NVQ 3 training and 1 is completing NVQ 4 training. The management acknowledged that they do have difficulty in persuading some of their more mature staff to undertake NVQ’s. However, they will continue to provide opportunities for staff to undertaken professional training and will consider making it a condition of employment. DS0000011122.V264250.R01.S.doc Version 5.0 Page 16 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): 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 responsibilities fully. The home is run in the best interests of the service users. Service users’ financial interests are safeguarded. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The manager has now achieved NVQ 4 and the Registered Managers Award. He spends considerable time in the home ensuring that the level of service DS0000011122.V264250.R01.S.doc Version 5.0 Page 17 provided is of a high standard. He is highly regarded by service users and their relatives. Although the home does not run residents meetings on regular basis the management feel that the combination of the time they spend in the home and its relatively small size enables them to be very aware of personal interests and preferences. Certainly in discussions with the management team a high level of knowledge regarding service users needs, preferences and interests was demonstrated. The home’s policy regarding service users money is that they do not manage any ones money unless on a temporary basis only. They were managing one service users’ money whilst waiting for the local social service department to make arrangements for the Court of Protection to take over. One other service user was supported by an Age Concern advocate who regularly provided cash to the home for the use of the service user. Documentation seen was comprehensive and provided safeguards for the handling of these two service users money. The health and safety of service users and staff are safeguarded by the policies and procedures operating in the home and by staff training. In addition, regular health and safety checks are undertaken including a comprehensive range of fire safety checks. All significant risks in relation to the home and to individual service users is assessed and a management plan is in place. DS0000011122.V264250.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 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 DS0000011122.V264250.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action 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 DS0000011122.V264250.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 DS0000011122.V264250.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!