Care Home: Boscobel

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What the care home does well The people living at Boscobel told us that they like living there, one person told us, "It`s good living here, good food, you get out". The expert by experience commented, "Overall I thought the home was lovely and the staff and residents that lived there seemed very happy and safe the staff have a good rapport with the residents and know them well. I would feel happy to live at Boscobel". Before people decide whether to move into Boscobel or not they are provided with information about what the home is like and how it operates. Staff also meet with the person and they carry out an assessment of the person`s needs and choices. This exchange of information helps everyone to decide whether the home is a suitable place for the person to live and whether their needs can be met at the home. There is an established staff team working at Boscobel and the people living there told us that they like the staff who support them. Staff receive training in basic areas of care and have a good knowledge of the individual needs and choices of the people living there. There are sufficient staff working at Boscobel for them to spend time with the people living there, chatting and supporting them with their hobbies as well as with their personal care. This helps to make sure that people living in the home have their needs met in the way they prefer. The people living at Boscobel get to go out and about and are supported to attend church services if they wish to do so. Staff will support them with maintaining relationships they have and people can have visitors whenever they wish. This is to help make sure that people at Boscobel can live the lifestyle they prefer. The people living at Boscobel told us that they enjoy the meals provided and that they are always given a choice. This helps to make sure that they have a varied diet to keep healthy. People who live at Boscobel told us that they have regular meetings, which they can use to express their views and ask any questions they may have. This helps to make sure they have a say in how the home is being run. Support is provided to people to meet their health and personal care needs. Staff support people to make and attend health appointments and provide day to day support at home to people to maintain their personal care and appearance. The people living at Boscobel know how to raise any concerns they may have and are confident that staff will listen to them and provide support. What has improved since the last inspection? Since our last big inspection at Boscobel in January 2008, the way they manage money belonging to the people living there has improved. Money is now held for people in a bank account that is just for them. Before it was held in a company account, which meant it may not have been as safe as it could be.The way in which people`s medication is looked after has also improved. For example, clear records are now kept of medication peoples take only `when needed`. In addition everyone who needs a blood monitoring machine now has their own. These changes help to lessen the risk of mistakes occurring and to ensure that medication is managed safely. What the care home could do better: Some of the information provided for the people living at Boscobel is not as easy to understand as it could be. The use of larger print, plain English and pictures would help to ensure that people could understand as much as possible about how the home runs and about their rights. The people living at Boscobel are not as fully involved in drawing up and reviewing their care plans as they could be. The use of different styles of care planning and regular, formal discussions with people would help to make sure that any changes to their views or choices could be taken into account Parts of the house appear shabby and would benefit from a clear re-decoration plan. This would help to make all areas of Boscobel a comfortable, homely place to live. CARE HOME ADULTS 18-65 Boscobel 1 Preston Road Southport Merseyside PR9 9EG Lead Inspector Ms Lorraine Farrar Key Unannounced Inspection 16 & 20 September 2008 02:30p Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 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 Boscobel DS0000005357.V367484.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boscobel Address 1 Preston Road Southport Merseyside PR9 9EG 01704 537611 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) marjorieismay@btconnect.com Mr Derek Ellison Mrs M Ellison Mrs Marjorie Ismay Care Home 20 Category(ies) of Learning disability (20) registration, with number of places Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 20 Date of last inspection 18 January 2008 Brief Description of the Service: Boscobel is owned by Mr and Mrs Ellison and is managed by Mrs Marjorie Ismay. It provides accommodation, personal care and support for up to 20 adults who have a learning disability. Staff are available 24 hours a day to support the people living there. Located in Southport, Boscobel has easy access to public transport going to Southport & Liverpool, with Southport town centre approximately ten minutes bus journey away. There are local shops & facilities nearby, with a wider range available in the town centre. The property is a detached four-storey house in a wide, tree-lined street. There is plenty of parking available outside the home and some within its grounds. Accommodation is available on three floors. On the ground floor there are two shared lounges with the dining room in the basement. No passenger lift is available, however people can eat in the lounge if they choose and there are some bedrooms on the ground floor. There is a large, enclosed garden to the rear of the property. It costs £381.90 each week to live at Boscobel, though fees may vary depending on the level of support the person needs. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We gathered information for this inspection in a number of different ways. We carried out an unannounced visit to the home on the 16 September 2008 and an arranged visit on 20 September 2008. This took place over 5.35 hours and included reading records and looking at the building. We spent time looking at the support the people living at Boscobel receive. This included looking at the support they get with their daily lives, care plans, medication, money, activities and environment. We met several of the people who live at Boscobel and had discussions with three of them. We also talked with five members of staff including the manager. An expert by experience was present for part of the site visit on 16 September 2008. An expert by experience is someone who has had experience of using services for people with a learning disability. They also receive training in our inspection processes. The expert spoke with four of the people living there and with one member of staff. Following the site visit she wrote up her findings; we have taken these into account in writing this inspection report. Any information the Commission for Social Care Inspection (CSCI) has received since our last big inspection of Boscobel in January 2008 is also taken into account in writing this report. This includes information from a short focussed inspection we carried out there in March 2008. The manager completed a self assessment form we sent her before our visit. Information from this was again used by us to plan this inspection and in writing this report. An easy to understand summary of this report is available. If you would like to see a copy please ask staff working at Boscobel. What the service does well: The people living at Boscobel told us that they like living there, one person told us, “It’s good living here, good food, you get out”. The expert by experience commented, “Overall I thought the home was lovely and the staff and residents that lived there seemed very happy and safe the staff have a good rapport with the residents and know them well. I would feel happy to live at Boscobel”. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 6 Before people decide whether to move into Boscobel or not they are provided with information about what the home is like and how it operates. Staff also meet with the person and they carry out an assessment of the person’s needs and choices. This exchange of information helps everyone to decide whether the home is a suitable place for the person to live and whether their needs can be met at the home. There is an established staff team working at Boscobel and the people living there told us that they like the staff who support them. Staff receive training in basic areas of care and have a good knowledge of the individual needs and choices of the people living there. There are sufficient staff working at Boscobel for them to spend time with the people living there, chatting and supporting them with their hobbies as well as with their personal care. This helps to make sure that people living in the home have their needs met in the way they prefer. The people living at Boscobel get to go out and about and are supported to attend church services if they wish to do so. Staff will support them with maintaining relationships they have and people can have visitors whenever they wish. This is to help make sure that people at Boscobel can live the lifestyle they prefer. The people living at Boscobel told us that they enjoy the meals provided and that they are always given a choice. This helps to make sure that they have a varied diet to keep healthy. People who live at Boscobel told us that they have regular meetings, which they can use to express their views and ask any questions they may have. This helps to make sure they have a say in how the home is being run. Support is provided to people to meet their health and personal care needs. Staff support people to make and attend health appointments and provide day to day support at home to people to maintain their personal care and appearance. The people living at Boscobel know how to raise any concerns they may have and are confident that staff will listen to them and provide support. What has improved since the last inspection? Since our last big inspection at Boscobel in January 2008, the way they manage money belonging to the people living there has improved. Money is now held for people in a bank account that is just for them. Before it was held in a company account, which meant it may not have been as safe as it could be. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 7 The way in which people’s medication is looked after has also improved. For example, clear records are now kept of medication peoples take only ‘when needed’. In addition everyone who needs a blood monitoring machine now has their own. These changes help to lessen the risk of mistakes occurring and to ensure that medication is managed safely. 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. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Sufficient information is obtained about and given to people considering moving into Boscobel. This helps everyone to decide if it is the right place for the person to live. EVIDENCE: The people living at Boscobel told us that they like living there. One person described it as, “Good friends, nice place, good food. Good places to go with staff. I like it here”. Nobody new has moved into Boscobel since our last big inspection there. However the manager told us in the information she sent us before our visit that before anyone did move in they would be invited to visit the home and to stay overnight. A copy of a service user guide is given to people thinking of staying at Boscobel. This tells them about how the home runs and the things they can expect. The guide includes pictures of Boscobel, which can help people to understand the contents better. However it is not always written in plain English. For example, the writing is quite small which may make it difficult to read and it describes the regular house meetings as providing, “a recognised Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 10 forum…”. The way the guide is written may mean not everyone can understand the information easily. We looked at records of someone who had stayed at Boscobel for respite care. These showed that before the person moved in staff met with them to carry out an assessment of their needs and choices. These assessments and meetings help everyone to decide if the person’s needs and choices can be met at Boscobel and if it is the right place for them to stay. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use this service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Boscobel receive support to meet their individual needs and choices but providing systems to make sure they have more involvement in developing their own care plans would help to make sure that they have a say in how their support is to be provided. EVIDENCE: Each person who lives at Boscobel has their own care file. The ones we saw contained some clear guidance about supporting people with their personal care, relationships and daily routines. These care plans had been reviewed and were up to date. However some of the files we looked at contained an essential lifestyle plan that is designed to give full information about the person; these had not been reviewed since 2006. Although information about how to support people is available elsewhere in their file, the essential lifestyle plan (also known as a Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 12 person centred plan) gives people the opportunity to talk about the things they may like to do in the future and discuss how their choices may have changed. The expert by experience discussed person centred plans with some of the people living at Boscobel and with a member of staff. None felt that this type of planning was currently in use. The expert by experience commented that she felt this type of planning would benefit the people living there. Where information is held in a person’s care file it should all be reviewed regularly with the person to ensure it is accurate and up to date. Although care files have a section for formally discussing and obtaining the views of the person about their plan this had not been completed for some time. Setting time aside to formally discuss plans with people and to record their views provides a good way for people to have a meaningful contribution to the support that is provided for them. Individual risk assessments are in place within everyone’s care file. These help people to identify any areas of risk in their life and take steps to minimise it. Regular house meetings take place at Boscobel. In the past these have included discussions about a range of subjects such as current affairs, managing relationships and feeling blue. In addition they provide a way for the people living at Boscobel to express their opinions and influence what happens in the home. Although no formal minutes of these meetings had been taken for some time, the manager explained that meetings do still take place. For example, at one meeting the people living at the home discussed their forthcoming holiday plans. When the expert by experience asked people how they expressed their views, they told her that they attend regular meetings and that staff make sure they read the minutes back to them. The expert by experience commented that minutes are not provided in different formats, such as picture format or large print. This would help the people living there to understand as much as possible about the information provided for them. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Boscobel are supported so they can live a lifestyle of their choosing. EVIDENCE: During our visits to Boscobel, we saw the people living there were engaged in a number of different activities. Whilst at home people were spending time reading their magazines, chatting with staff, writing Christmas lists or drawing. Other people were out and about at work, their day service or socialising. One of the people living there told us, “I get to go out and about. I like the parties, music. We are having a party tonight with music” and another that, “it’s all right here” as he got to go out and about doing the things he enjoys. One person told us that he likes to go to church every week and that staff accompany him. Records confirmed that people are asked if they want support Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 14 to attend religious services of their choice and that this is provided if they wish. The manager told us that instead of holidays this year the people living at Boscobel had voted to go on day trips. They hired a mini bus for two weeks and went out and about to different places to suit different people’s choices. These included visiting a stately home, motor museum, local tourist attractions and walking in the Lake District. One of the people living there told us that he had particularly enjoyed a trip to the local waterfront. Records showed that the people living at Boscobel are able to invite their friends and family to visit whenever they want and also that staff support people to maintain or manage their relationships. In the past several of the people living at Boscobel have been supported to attend courses on dealing with relationships and sexuality. In addition past house meetings have included working through books with people on appropriate touching and relationships. This is good practice as it supports people to ask any questions or raise any concerns they may have, within a safe environment. Throughout our visits staff were seen to spend time socialising with the people living at Boscobel as well as providing support when needed. The people living there told us and the expert by experience that they like living at Boscobel and that they like the staff who work there. Some of the routines at Boscobel are flexible with people telling us they can choose when they want to get up and go to bed. However other routines such as mealtimes are not as flexible. The people living there told the expert by experience that meals such as suppertime are set. She commented, “I don’t think there should be a fixed supper time as it takes away independence, if the residents decide they want supper and a hot drink why can’t they ask the staff to support them to get one?” People told us they enjoy the meals at Boscobel. One person explained, we get good food” and another that “the food’s very nice. I enjoy it”. Everyone we spoke with said that they get a choice of meals and this was confirmed by looking at menu records, which showed a variety of meals are provided. Meals are served in the downstairs dining room. This is located in the basement and does not have a lift for access. However people with limited mobility are able to eat their meals with staff support in the lounge. There is limited opportunity for people to be involved in the shopping and preparation of meal times as the main kitchen is used by the cook and many of the supplies are delivered to the home. One of the people living there told us that staff do the cooking and shopping for food and that they don’t want to be Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 15 involved in this. However another person told the expert by experience that they would like more opportunities to be involved with meals and food preparation. In addition to the main kitchen there is a smaller kitchen in the basement that could be used for supporting people to learn lifestyle skills such as meal preparation. The expert by experience commented, “I think that the staff need to do the shopping with the residents and maybe they could be involved in making some of the food. If there is a problem with them being in the kitchen they could use the flat. I feel this will help the residents who want to become more independent”. Increasing opportunities for people to become more involved in making their meals would not only support people to become more involved in the day to day running of their lives it would also support them to learn new lifestyle skills. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Boscobel receive support from staff to identify their needs and to make sure these are met in the way they prefer. EVIDENCE: The people living at Boscobel told us that they get support when they need it with their personal care and with their health. One person explained, “They see to me, help me see the doctor. The optician comes here. I go to the dentist. The foot man comes here as well”. Records showed that staff support people to make and attend health appointments and staff we spoke with were knowledgeable about the different support needs and choices people have with their personal care. In meeting the people living at Boscobel it was evident that, where needed, staff provide them with support to look after their personal care and their appearance. One person explained, “I’ve got a keyworker” and that they and other staff supported him with his personal care. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 17 There are a variety of aids and adaptations at Boscobel to support people with their personal care. This includes an accessible shower room and shower chair and commodes for people who need them. Medication is stored in a locked cabinet and is given out by staff who have had training. At our last big inspection at the home, we identified some issues with the management of medication. These have now been resolved and there are clear records for medication that is given ‘as required’. People who need them have their own blood-monitoring machine, instead of sharing. This all helps to ensure medication is managed safely and well. We checked a sample of medication and records in the home and found that medication is managed safely and records are correctly completed. Again this helps to lessen the risk of any mistakes occurring. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Boscobel are confident that any concerns they have will be listened to and acted upon. This helps them to feel safe living there. EVIDENCE: Information about the home’s complaints procedure is made available to the people living there via the service users’ guide. The people living at Boscobel told us and the expert by experience that if they were unhappy about something they would speak to staff. One person explained that he would tell staff who would “sort it” for him. Thee are polices and procedures in place at Boscobel for dealing with any complaints or protection issues that arise. Staff we spoke with had had training in recognising and reporting protection issues and were clear about the action they would take. Since our last big inspection at Boscobel in January 2008, the way in which support is provided to people living at the home to manage their money has been improved. All money belonging to the people living there is now held in a bank account that is named as a residents’ account. This means that their money is now more easily accounted for than when it was held in a company account. We checked records and saw that accounts of people’s money were up to date and tallied with receipts held. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People who use this service experience adequate outcomes in this area. We have made this judgment using available evidence including a visit to this service. Boscobel is maintained so that it is safe but parts of the building need redecoration in order to make sure that people live in comfortable surroundings. EVIDENCE: Boscobel is a large detached house in a residential area of Southport. It fits in well with other, domestic houses in the area and does not stand out as a care home. To the front there is a garden with parking and a ramp and steps leading to the front door. There is additional parking available on the road outside. At the back of the house there is a large enclosed garden with seating available. Shared areas of the home include two lounges on the ground floor. In the basement there is a dining room and a ‘flat’, which provides a small kitchen and lounge. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 20 There are bedrooms on the ground and first floor, of which four are twin rooms, with the others providing single accommodation. Bedrooms are not ensuite but do have washbasins. Records showed and the people living there have previously told us that they only share a bedroom if they choose to do so. There are toilets and bathrooms throughout the house including two showers that are easy to use for people with mobility difficulties. In addition there are grab rails and painted steps to help people to get around more easily. Some rooms have been decorated recently; one of the people living at Boscobel told us that he thought his room was “very nice” and he had chosen the colour. However other rooms would benefit from redecoration as they are beginning to look shabby. For example, two men sharing a room have floral wallpaper. which may not be suited to their taste. The manager told us in the information she sent us before our visit that redecoration at Boscobel is ongoing. One of the people living at Boscobel told us they thought, “they could make it look nicer”. The expert by experience commented that she thought the home was lovely. However she also commented that the arrangement of chairs, set around the walls in the front lounge, felt like an elderly peoples home. Whilst the smaller back lounge is very homely in appearance, the larger front lounge does appear less homely. A separate laundry room is provided; this was well organised with systems in place to help prevent the spread of infection. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. The people living at Boscobel are supported by an experienced staff team who know them well and have received training to help make sure that they can meet people’s needs in the way they prefer. EVIDENCE: The people living at Boscobel told us that they like the staff who work there. One person explained, “It’s all right here. Got a good set of staff. I’ve got a very good keyworker, takes me everywhere I want to go. I love the staff”. During our visit staff showed a good knowledge of the individual needs and choices of the people living at Boscobel. They spent time socialising with the people living there, as well as providing support when needed. Over 50 of the staff team hold a care qualification (NVQ) and records showed that staff undertake training in various areas of care. This includes basic training such as moving and handling people, fire safety and protection of vulnerable adults. In addition some staff have undertaken training in more specialist areas such as the Mental Capacity Act. This training helps to ensure Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 22 staff are up to date with current good practices in supporting people safely and well. A training plan for ensuring all staff undertake basic training is in place. However this does not incorporate more specialist training that may be needed to meet the changing or existing needs of the people living there. A training programme around more specialist areas such as diabetes or age related illnesses would help to ensure staff are equipped with the knowledge to support people as their needs change. There is a very good induction programme in place for new staff. This consists of a series of booklets that staff follow and includes subjects such as health and safety, anti-discrimination and protection of vulnerable adults. This thorough induction for new staff helps to ensure that they are equipped with basic skills to support the people living there. Records we saw showed that before anyone starts work at Boscobel a series of checks are carried out. These include obtaining written references and checking with the Criminal Records Bureau (CRB) and register of people unsuited to work with vulnerable adults. These checks help to ensure staff are suitable to work with people who may be vulnerable. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People who use this service experience good outcomes in this area. We have made this judgment using available evidence including a visit to this service. Boscobel is well managed so it is run for the benefit of the people who live there. EVIDENCE: Mrs Marjorie Ismay is the registered manager of Boscobel. She is an experienced manager who holds qualifications in both care and management. Records showed that Mrs Ismay undertakes regular training to keep herself up to date with current good practices in the field of care. There are several systems in place at Boscobel for checking the quality of the service provided at the home. For example, staff files have recently been audited to ensure they contained all the required information. An external company is employed each year to carry out a quality audit of the service. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 24 This includes seeking the views of the people who live at Boscobel. Following the audit, Boscobel was awarded a five star rating for the service they provide. Mrs Ismay advised that each year they send out surveys to the people living at Boscobel and their relatives. These were last carried out in September 2007 and are due to be sent again. These provide a way for the people living at Boscobel to formally give their views on how it runs and make any suggestions for future changes. Records and certificates showed that regular checks are carried out on the building and equipment. This includes checking electrical appliances, the gas supply and regular fire checks. These checks help to ensure that the Boscobel is a safe place for people to live and work in. Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X 2 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 26 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 YA17 Good Practice Recommendations Consideration should be given to supporting people who live at the home to become more involved in planning and preparing meals. This will increase the input people have into the running of their day-to-day lives. An action plan for improving the décor and furnishings of the house should be drawn up and implemented. In addition, discussion should take place with the people living at Boscobel on ways to make the front lounge appear more homely and welcoming. This will help to ensure the house is comfortable and provides a nice environment for people to live in. A training plan should be compiled and implemented for staff around more specialist areas of support for the people living there. This would help ensure staff are as aware as possible of current good practice in supporting people as their needs change. DS0000005357.V367484.R01.S.doc Version 5.2 Page 27 2 YA24 3 YA35 Boscobel 4 YA1 Information for the people living at Boscobel should be provided in easy to understand formats, such as large print and picture formats. This includes the handbook they are given and records of meetings. This will support the people living there to understand as much as possible about the home and how it is run. The care plans of people who live at Boscobel should be regularly reviewed, including their essential lifestyle plans. This will help to ensure that accurate information is available and that as people’s needs and choices change, this is recorded. 5 YA6 Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North West Region Unit 1, Level 3 Tustin Court Port Way Preston PR2 2YQ 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 Boscobel DS0000005357.V367484.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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