Archived: Boden House

Updated 21 February 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: Two inspectors

Service and service type: People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. However, the current registered manager was on long term leave so another manager had been employed. This manager was commencing their registration with us. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: This inspection was unannounced.

What we did:

We reviewed information we had received about the service since the last inspection. This included details about incidents the provider must notify us about, such as potential safeguarding concerns; and we sought feedback from the local authority, clinical commissioning group (CCG) and other professionals who work with the service. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. However, the provider had completed this ten months ago and we therefore gave opportunities for them to update us throughout the inspection. We used all this information to plan our inspection.

During the inspection we spoke with six people who used the service. We spoke with two support workers, the activities coordinator, the nurse, the manager and regional manager.

We reviewed a range of records. This included four people's care records and medicine records. We also looked at two staff files around staff recruitment. Various records in relation to training and supervision of staff, records relating to the management of the home and a variety of policies and procedures developed and implemented by the provider.

After the inspection the manager sent us further information in relation to, the provider’s quality checks and audit process and training records. We have reviewed these as part of the inspection process.

Updated 21 February 2019

People’s experience of using this service:

The Provider had not ensured that information relating to infection control was available and there was no food hygiene rating completed for the home. Risk assessments had been completed, however they had not always been reviewed following incidents or when areas of concerns were raised.

Staff had not all received the training they required to support their role and this had not been followed up with structured support. People had not always been supported to access information or receive it in a different format to support their understanding.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not always support this practice.

Audits had been completed, however not for all areas of the home. These had not always been used to drive improvements or reflected the areas requiring improvement. Notifications had not always been completed to reflect events or incidents which had occurred.

People’s views were mixed about the approach to the meals at the home. Some people were supported and had their meals made. Other people were encouraged to make their own meals and were not in favour of a structured support approach. People were encouraged to attend a weekly meeting to discuss the events at the home.

People felt that they could receive support from staff when they required it and this was provided by kind and considerate staff. Peoples dignity was protected. When people required support from an advocate this was made available. Complaints had been addressed and people felt able to approach the management team.

There was enough staff to support people’s needs and the staffing had been increased to reflect the areas were additional staffing was required. Medicine was managed safety and people had received reviews for their medicine to continue to manage their mental health condition.

People felt safe and when incidents had occurred lessons had been learnt and shared with the staff. People’s health care had been considered and referrals had been made when required for all aspects of people’s health and wellbeing.

Care plans had been developed with people and they contained the detail about their history and needs. Some aspects needed to be improved and this had been recognised and there were planned improvements. People could access support with their cultural or religious needs.

Staff felt supported by the management and we saw that partnerships had been developed with a range of health and social care professionals.

Rating at last inspection: Good (report published September 2017)

About the service: Boden House is a care home that provides a recovery service and when required personal care for up to 27 people. The provider supported people with severe and enduring mental illness, learning disability and personality disorders. At the time of the inspection 16 people lived at the service. The home was established over four floors, each person had their own flat with the option of communal spaces on each floor. There was also an activities room and a garage area which was available for people to use for smoking or storage of outdoor items.

Why we inspected: This inspection was brought forward due to information of risk and concerns.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around governance and the environment. Details of action we have asked the provider to take can be found at the end of this report.