Care Home: Boniface House

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Inspecting for better lives Key inspection report Care homes for older people Name: Address: Boniface House Spratton Road Brixworth Northants NN6 9DS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Irene Miller     Date: 2 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Boniface House Spratton Road Brixworth Northants NN6 9DS 01604883800 01604883805 jmarks@northamptonshire.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northamptonshire County Council care home 46 Number of places (if applicable): Under 65 Over 65 23 44 2 dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 No person falling within the DE(E) category can be admitted where there are already 23 people of DE(E) category already in the home. No person falling within the OP category can be admitted where there are already 44 people of OP category already in the home. No person falling within the PD(E) category can be admitted where there are already 2 people of PD(E) category already in the home. To be able to accommodate three named service users who have needs within the MD(E) category. Total number of service users in the home must not exceed 46. Date of last inspection Brief description of the care home Boniface House is a Care Home providing personal care for up to 46 Residents over the age of 65 years with up to 23 places for People with Dementia and 2 places for People Care Homes for Older People Page 4 of 26 Brief description of the care home with Physical Disabilities, a specific condition of registration allows the Home to continue to provide care for 3 people with Mental Disorders. The Home provides permanent places only. The Home is owned by Northamptonshire County Council and managed by Mrs. J. Marks. The Home is situated in the village of Brixworth some six miles from Northampton, is close to local shops and a Library and can be accessed by Public Transport. The premises are designed to provide 6 self-contained units for 7 or 8 Residents; each unit has its own lounge/dining room, bedrooms, toilets and bathing areas and a kitchenette. All Residents have single room accommodation and secure garden areas lead off each unit. There is an additional central lounge area by the main entrance, which includes a small bar. Charges range between #95.45p to #347.00 per week, Residents are assessed to pay according to their means. Extra charges are made for Hairdressing, Chiropody, Toiletries and Newspapers. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of all inspections undertaken by the Commission for Social Care Inspection (CSCI) are based upon seeking the outcomes for people using the service and their views of the services provided. This visit was unannounced and involved one regulation inspector and we also used an expert by experience who spent time with people using the service, staff and visitors. We focused on the key standards under the National Minimum Standards and the Care Standards Act 2001 for homes providing care for older people. The care records of three people were sample checked which involved looking at their individual care plans (a care plan sets out how the home aims to meet the personal, Care Homes for Older People Page 6 of 26 healthcare, social and spiritual needs of the people using the service), we looked at risk assessments and other care records to establish how the home works with health and social care professionals to meet the needs of the people using the service. People using the service were consulted on how they view the care provided at the home, and discussions with staff gave an insight into the support and training provided at the home. Observations of care practices and discussions with people using the service gave an indication on the quality of the service provided at Boniface House. The expert by experience was able to speak with five people two female and three male and one member of the care staff. Overall the expert by experience was impressed with this home. There were a few small problems but all in all this was wellrun and which was as homely as much as a Care Home can be. Records in relation to the homes maintenance, management and quality assurance systems and staff recruitment and training were viewed. Prior to this visit the Commission for Social Care Inspection sent out to the provider an Annual Quality Assurance Assessment (AQAA) this document allows the provider to supply us with information on how they view their own performance. This gives the provider the opportunity to state what they do well, what they could do better and their plans for future improvements. The AQAA was returned to the Commission for Social Care Inspection (CSCI) within the timescale set, and gave an insight into the management and quality assurance systems in place. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Full information on the range of services and facilities is provided for people considering moving into the home to enable choice to be excercised. Evidence: The homes statement of purpose and service users guides were available within the front entrance of the home, these documents provide details on the homes aims and objectives, services and facilities. Pre admission assessments were available within the care plans viewed which identified the needs of people considering to move into the home, this ensures that people are only admitted once it is established the their full range of needs can be met by the home. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people using the service are fully met. Evidence: We looked at the care of three people using the service within all of the care plans viewed there was records of assessments in place to include pressure area care, falls, nutrition, and diabetic care. Within the pressure area care assessments there was information on the frequency of people requiring to be turned and repositioned in bed, the type of pressure area relieving equipment in use. Within the nutritional assessments there was records of peoples weight gains and losses being monitored and of food supplements and thickeners for drinks being provided. There was records of falls risk assessment in place and where assessed as high risk Care Homes for Older People Page 12 of 26 Evidence: falls monitoring charts were in use with the aim of establishing the possible cause of the falls. The care plans detailed the personal preferences and level of support required, such as the gender of staff who provide support with personal care, the care plan for one person had details of catheter care which detailed the frequency of catheter changes and bathing routines. Moving and Handling assessments were in place that detailed the equipment required for people with limited mobility. We looked at the medication storage and administration systems to include controlled drugs in use all were managed in accordance with the homes medication policy. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines of daily living activities are flexible and varied to suit the needs and expectations of people using the service. Evidence: Within the care plans viewed there were records of people participating in in house activities and pursuing their hobbies and interests outside of the home. There was records of people going out shopping, to the local pub, one person regularly goes to the Cobblers and the Saints matches. The home organises social activities and events on the day of the visit a group of people were taking part in a weekly music and movement activity people appeared to be getting enjoyment out of this activity. Two staff had recently attended training on providing activities for people with dementia and the home had purchased several books and a DVD that gave information on how to provide activities to stimulate the memory. The home holds regular coffee mornings, and has close links the Christian Fellowship Church who visit the home to conduct religious services, and with local schools who Care Homes for Older People Page 14 of 26 Evidence: visit the home on special occasions such as Easter and Christmas. A bar which is fully licenced is available within the home, and a mobile shop is available. One person spoken with had nothing but praise about the home. Saying they been at the home 5 years, that there was a good choice of food and it was decent quality. This person said they have a cooked breakfast on a Monday morning and otherwise cereals/toast etc which they were happy with. People spoken with confirmed there was no visitor restriction that there was plenty of activities going on. One person said that Christmas was particularly happy there and everyone is given a present. One person spoken with had nothing but praise about the home. Saying they been at the home 5 years, saying that there was a good choice of food of decent quality. This person said they have a cooked breakfast on a Monday morning and otherwise cereals/toast etc which they were happy with. People spoken with confirmed there was no visitor restriction and that there was plenty of activities going on. One person said that Christmas was particularly happy there and everyone is given a present. One person spoken with had nothing but praise about the home. Saying they been at the home 5 years, that there was a good choice of food and it was decent quality. This person said they have a cooked breakfast on a Monday morning and otherwise cereals/toast etc which they were happy with. During the inspection we observed people receiving the midday meal which looked appetising and ample in proportion, people said that they enjoyed the meals provided at the home. People spoken with confirmed there was no visitor restriction and that there was plenty of activities going on. One person said that Christmas was particularly happy there and everyone is given a present. We observed people receiving the midday meal which looked ample in proportion, people said that they enjoyed the meals provided at the home. The home produces its own newsletter The Boniface Bugle Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that any concerns or complaints they may have will be listened to and acted upon and that they are protected from abuse. Evidence: The complaints procedure was available within the front entrance of the home, and the procedure was available within the statement of purpose and service users guide. We people if they knew how to raise any complaints one person said that they would know the process, although they had not been given anything in writing to their knowledge. This person said that they did not have any complaints so far and confirmed that there was open access to visitors and they could come and go as they pleased. The home has a policy called How to be Heard and there is a whistle blowing policy in place. In discussion with the registered manager she confirmed that three complaints had been received since the last inspection, there was records of the investigation and the outcome available to view and the Commission for Social Care Inspection are satisfied that the complaints were dealt with according to the homes complaints procedure. Care Homes for Older People Page 16 of 26 Evidence: Records of staff training evidenced that safeguarding training is provide to all staff. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are provided with a clean, safe and attractive home. Evidence: We conducted a limited tour of the building to include sample checking bedrooms, communal areas bathrooms and lavatories and the kitchen and laundry facilities. The bedrooms viewed were clean, pleasantly decorated and individually personalised The communal areas were welcoming with sufficient seating and dining areas, each of the lounge diners had a small open plan style kitchen area, the cupboards and units in the kitchen areas looked well used and some consideration needs to be taken to the refurbishment of these areas to ensure that environment is well maintained. There was a smoking area available for people to use, there was an extractor fan fitted, we observed one person attempting to access this facility. The person required assistance from staff to smoke and an agreement was in place that the person use the call alarm within the smoking room to let staff know when they require their assistance. The person who used a walking frame had difficulty reaching the call bell as when the Care Homes for Older People Page 18 of 26 Evidence: door to the smoking room is opened it blocks access to the call bell. This was brought to the attention of the registered manager who said that she would look at other options available for the person to summon staff assistance. The kitchen and laundry facilities were clean and safe systems of work were in operation. The bathrooms and lavatories were clean and there was evidence that dross infection policies and procedures were being followed, hand sanitiser and personal protective equipment were seen to be in use, such as gloves and aprons. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected by having robust recruitment policies in place. Evidence: We looked the the recruitment files of two recently employed staff, there were records available to evidence that the home had obtained clearance through the Criminal Records Bureau (CRB) and pre employment histories had been explored through obtaining two written references from previous employers. There was records available within the staff files viewed of induction training having been provided upon taking up employment and further training had been provided. On the day of inspection there appeared to be sufficient staff on duty to meet the needs of the currents people using the service. Staff spoken with said they were treated well and that the other staff were always helpful. One member of staff spoken with said that they would feel comfortable whistle-blowing and confirmed that they had received training on the Protection of Vulnerable Adults (POVA) training and were very au fait with procedures. Other training included Food Hygiene, Fire Safety, First Aid, Moving and Handling, Hoist Care Homes for Older People Page 20 of 26 Evidence: Training and a three day course on Dementia. This member of staff said that they had yet to undertake training on Challenging Behaviour. They were proud of attaining a National Vocational Qualification (NVQ) level 2 in Care and that they had almost finished a level 3 NVQ. We asked if the staff support was adequate for their needs, they confirmed that it was and were aware of an outside support agency used by the company. This member of staff said that everybody was helpful and there was an atmosphere of free learning, saying they did know how to take appropriate action with regards to complaints regarding employment. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in best interests of people using the service Evidence: The registered manager had been at the home for a number of years, she holds the relevant management qualifications and has the necessary skills and competence to ensure that the home is well managed. There is an established senior team in post, staff supervision and staff training is given high priority. There is established quality assurance systems in place to ensure that the views of people using the service are listened to, regular meeting take place with people using the service and staff. The ethos of the home is that it is run in the best interests of the people using the Care Homes for Older People Page 22 of 26 Evidence: service, on the day of inspection people were seen to be treated with respect, the atmosphere was warm and welcoming and visitors were welcomed into the home by staff. We sample checked records of monies held on behalf of people using the service and transactions were well managed with records of withdrawals and receipts. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!