Boldshaves Oast

Updated 5 May 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 8 March 2018 and was unannounced. It was conducted by two inspectors.

Before the inspection the manager completed a Provider Information Return. This is 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. We used this information along with previous inspection reports and notifications received by the Care Quality Commission to inform the inspection. A notification is information about important events, which the provider is required to tell us about by law.

We spoke with the manager, deputy manager and four members of staff. We contacted two professionals who worked with the service before the inspection, and asked for their feedback.

We looked at four people's support plans and the associated risk assessments and guidance. We looked at a range of other records including two staff recruitment files, staff induction records, training and supervision schedules, staff rotas and quality assurance surveys and audits.

During our inspection we spent time with the people using the service. We observed how people were supported and the activities they were engaged in. We spoke with three people and one relative.

Updated 5 May 2018

This inspection was carried out on 8 March 2018 and was unannounced.

Boldshaves Oast is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Boldshaves Oast accommodates 14 people across four buildings.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The main building is a converted Oast where there are eight bedrooms set over three floors. There is a purpose built log cabin where two people's bedrooms are accommodated. In addition there is another self-contained log cabin and a cottage where two married couples live. There are a number of other buildings on site, including an art and craft room, woodwork room and horticultural area.

The service did not have a registered manager in post. The last registered manager left the service in March 2017, a new manager was appointed shortly after. The manager told us they had tried to submit an application to register to the CQC on more than one occasion but was unsure if it had been successfully received. After the inspection we checked this and a completed application had not been received. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We last inspected Boldshaves Oast in December 2016 when three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified. We issued requirement notices relating to safeguarding service users from abuse and improper treatment, good governance and fit and proper persons employed. At the last inspection, the service was rated 'Requires Improvement.' We asked the provider to take action and they sent us an action plan. The provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. Improvements had been made, and the previous breaches found at our last inspection had been met.

At our previous inspection we found that the provider had not always reported incidents under safeguarding procedures. Improvements had been made at this inspection and systems were more robust. We also found that people were not protected by robust recruitment procedures. During this inspection we found that all of the required checks had been completed.

Our last inspection found that systems were not consistently robust to monitor and improve the quality of services and mitigate risks relating to the health, safety and welfare of people. At this inspection we found that this had improved.

During this inspection we found that the manager had not notified the CQC of all events as they are required to do so, this is an area that requires improvement. We made recommendations around improving systems to review all feedback received and improving recording and monitoring systems.

Staff followed correct and appropriate procedures in the storage and dispensing of medicines. People were supported in a safe environment and risks identified for people were managed in a way that enabled people to live as independent a life as possible. People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

We found there were enough staff to keep people safe. Staffing levels varied according to planned activities or appointments. Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had attained the right skills and knowledge to be able to care for, support and meet people's needs. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people's care and lives. Staff worked well together and ensured that clear communication between themselves and external health professionals took place; for example with care managers, commissioner GP’s and district nurses.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns. Staff knew about the whistle blowing policy and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

The care and support needs of each person were different, and each person's care plan was personal to them. People had detailed care plans, risk assessments and guidance in place to help staff to support them in an individual way.

Staff encouraged people to be involved and feel included in their environment. People were offered varied activities and participated in social activities of their choice. Staff knew people and their support needs well.

Staff were caring, kind and respected people's privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff.

People were encouraged to eat and drink enough and were offered choices around their meals and hydration needs. People were supported to make their own drinks and cook when they were able and wanted to. Staff understood people's likes and dislikes and dietary requirements and promoted people to eat a healthy diet.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to implement improvements.

Staff told us that the service was well led and that they felt supported by the manager to make sure they could support and care for people safely and effectively. Staff said they could go to the manager at any time and they would be listened to.

The service was not currently supporting anyone at the end of their life.