Inspection on 02/11/06 for The Boltons

This inspection was carried out on 2nd November 2006.

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

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

Other inspections for this house

The Boltons 30/03/09

The Boltons 15/12/05

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 Robert Dawes Unannounced Inspection 2nd November 2006 10:15 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 The Boltons DS0000011122.V317966.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. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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 djuggurnauth@hotmail.com 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) The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 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 multi-cultural needs. Fees: Single room-£315-£500. Double room-£301-£375. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection assessed information obtained from an unannounced site visit which took place during the day on the 2nd November 2006, a preinspection questionnaire returned by the registered provider and six questionnaires returned out of ten sent to service users. During the site visit the inspector spoke with a group of service users and three service users individually; interviewed the manager, deputy manager and two members of staff; toured the premises; looked at records; case tracked; and observed the interaction between service users and staff. Twenty-one standards were assessed during the site visit of which one was exceeded and twenty were met. One recommendation was made. What the service does well: What has improved since the last inspection? A new garden bench and chairs have been bought for the garden. New chairs have been bought for the dining room and lounge. A new call bell system has been installed which monitors the time taken to respond to the calls and gives service users the opportunity to use mobile handsets. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. The Boltons DS0000011122.V317966.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 The Boltons DS0000011122.V317966.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is good. No service user moves into the home without having his/her needs assessed and been assured that they will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comprehensive needs assessments were seen on all the files looked at by the inspector. All the service users’ surveys returned said they had received enough information about the home before they moved in. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. Service users’ health, personal and social care needs are set out in an individual plan of care; their health care needs are fully met; staff follow the medication procedures; and service users are treated with respect and their right to privacy is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the service users’ files looked at by the inspector had detailed individual plans and were reviewed at least once a month. Service users’ files showed; service users’ sight and teeth are checked at regular intervals; weight, bowel movements and incidence of pressure sores are recorded; and health professionals are involved when required. Service users said they are very pleased with the way the home looks after their health. Service users’ surveys all said they receive the medical support they needed. A lady comes to the home every week to take exercise sessions. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 10 All staff who administer medication receive appropriate training. Administration records were in order. Medication policies and procedures were in place. No controlled drugs are kept on the premises. Service users said staff are respectful and treat them well. Staff were observed to knock before entering service users’ rooms and treated them in a respectful manner. Service users were wearing their own clothes and looked clean and presentable. Service users can have phones in their rooms or use the home’s cordless phone. Several service users have their own mobile phones. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is good. Service users are offered a range of leisure activities; they exercise choice in relation to routines of daily living; and have opportunities to practice their religious faiths. Relatives and friends can visit at any reasonable time. Service users are offered a balanced diet, which is suited to individual requirements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are offered a range of leisure and social activities, such as card games, jigsaws, reading material, bingo, reminiscing sessions and old time music sessions. A service user showed me her crochet work and another her knitting which staff encourage and assist them to do. A musician provides entertainment once a week and a local Church choir sings for the service users on occasions. At Christmas, a party and entertainment takes place. Service users who are able are taken for walks to local shops. A big screen television and large print books from the mobile library are provided for service users who are partially sighted. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 12 Service users’ religious needs are catered for through; Catholic priests and lay ministers bringing communion to Catholic service users; a Church of England service every Sunday in the home; and service users of other religious faiths being taken to local places of worship. Four of the six service users’ surveys said there are always activities arranged by the home that they can take part in; one said usually; and one said sometimes, activities are limited and in house. Service users said relatives and friends can come at any time and are made to feel welcome by the staff. Service users’ files contained individual lifestyle choices and preferences. Service users are asked if they wish to join in any activity; are given a choice of meals at mealtimes; can stay in their rooms or join the others in the lounge; can go out of the home when they wish and it is safe for them to do so; can bring personal possessions with them; and have access to personal records. Service users said they feel they can choose what they want to do. Service users spoken with said the meals are very good, they can eat their meals in their rooms and they have regular drinks during the day. All the service users’ surveys said they always or usually like the meals at the home. Fresh fruit was seen to be available for service users. The service users are offered an alternative if they do not like the main meal and are asked what they would like to eat for supper and breakfast. Cultural needs are catered for, i.e. a Chinese lady has Chinese food except on Sundays when she enjoys the roast chicken or beef. One service user survey said the menu was very limited and lacked variety. The manager said he has tried to introduce alternative meals but service users didn’t like them. Choices of meals are discussed individually and at service users’ meetings. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. Service users know how to make a complaint and confident they will be acted upon. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said they would go to the manager if they have a complaint. He is very approachable. All the service users’ surveys said they always or usually know who to speak to if they are unhappy. Five of the six service users’ surveys said they know how to make a complaint. The complaints leaflet is on the notice board and in the service users’ guide. Neither the Commission nor the home have received any complaints since the last inspection. Staff are aware of the vulnerable adults and whistle blowing procedures. They receive vulnerable adults training. The manager frequently reminds staff of how to respond to unexplained bruises. Staff are not allowed to receive financial or personal gifts from service users. The Commission has received no allegations of abuse since the last inspection. One service user has been assessed as being at risk if she goes out of the home on her own. The inspector recommended an agreement to that effect and guidance on how the staff will prevent the service user from leaving the home are signed by the service user, relative and care manager. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 14 The Boltons DS0000011122.V317966.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is good. Service users live in a safe, well-maintained and clean environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is comfortable, homely, safe, accessible and well maintained. The manager is planning to add en-suite facilities to six of the bedrooms. On the day of the site visit the home was clean and hygienic. Five of the six service users’ surveys returned said the home is always fresh and clean. One said the home was not as clean as it could be and the garden could be made more attractive. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. Service users; needs are met by the numbers and skill mix of staff. 50 of staff have a NVQ 2 or above in care. The home operates a thorough recruitment procedure. Staff are trained and competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two carers are on duty during the day with an extra member of staff on duty during busy periods, which is usually the manager or the deputy manager. At night one carer is on duty with back up when required from a member of staff on ‘sleep in’ duty, which again is usually the manager or the deputy manager. The home also employs a sessional gardener plus a cleaner and cook on weekdays. Agency staff are never employed. Several of the carers are from the same ethnic backgrounds as some of the service users, which enable these service users to communicate in their first language. The service users’ surveys showed that five out of the six returned considered that staff listened and acted on what they said; all six considered they receive the care and support they needed; and all said staff are always or usually available when you need them. Comments made ranged from being very pleased with the standard of care to dissatisfaction with the number of staff on duty used to coping with the elderly The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 17 Service users informed the inspector that staff are patient, kind, very nice people and help you a lot. Staff considered there were sufficient staff on duty to respond satisfactorily to the service users’ needs. 50 of staff have achieved a NVQ 2 or above in care. Records showed the home operates thorough recruitment procedures. The home operates a comprehensive training programme, which covers all the necessary basic knowledge and skills required for staff to undertake their work. It also offers staff additional training opportunities to undertake additional responsibilities, such as administering medication, and to gain a better understanding of service users’ conditions and needs, i.e. dementia, incontinence control, infection prevention etc. Staff said they receive sufficient training to undertake their work and have refresher training in key areas of work. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38. Quality in this outcome area is good. Service users live in a home which is managed by a competent and experienced person. The home is run in the best interests of service users. Service users’ financial interests are safeguarded. The health, safety and welfare of service users are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager/proprietor has achieved NVQ 4 and the Registered Managers Award. He spends considerable time in the home ensuring that the level of service provided is of a high standard. Staff said he is approachable, supportive and clear in how service users should be cared for. The manager The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 19 demonstrated a very good understanding of the service users’ conditions and needs. Satisfaction questionnaires are sent to service users and their relatives/advocates every year. A business plan is then produced from the findings of the questionnaires returned together with information obtained from service users’ meetings, which have taken place twice this year, individual discussions with service users and general assessments of the premises and the running of the home. The home does not manage the finances of any of the service users. The personal money of two service users is looked after by the home. Receipts and records are kept of all transactions. These records are audited by the Social Services Receivership Department at regular intervals. Records showed that all necessary checks and inspections take place to ensure the health and safety of service users are promoted and protected. Appropriate health and safety policies and procedures and risk assessments are in place. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 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 The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 21 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. 1 Refer to Standard OP18 Good Practice Recommendations An agreement and guidance on how the staff will prevent a service user from leaving the home are signed by the service user, relative and care manager. The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 The Boltons DS0000011122.V317966.R01.S.doc Version 5.2 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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