Boulters Lock Residential Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment were effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People and relatives told us they were involved in initial and on-going assessments. Pre-admission assessments we viewed were comprehensive. They contained details of the person, their likes and dislikes, health conditions and all aspects of their lives. Based on this, a plan was devised on how to best support the person. Care plans were developed from the initial assessments and were regularly reviewed and updated as people’s needs changed.

Before living at the service, people were gently introduced and consulted about their preferences across all aspects of their lives to make them feel welcome and reduce the stress of moving.Once a person moved in, the provider put in place a 72-hour audit. This helped staff to identify any areas of the person’s care needs that needed to be changed or added to their existing care plan, to ensure they received care that was person-centred and meaningful. This approach had enabled staff to get to know people, create trust and build meaningful relationships from the start.

The provider planned and delivered people’s care and treatment with them, including what mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s care needs were monitored and reviewed to help ensure they received consistent care and support that met their needs. The local authority carried out reviews of people’s needs at the provider’s request. A healthcare professional told us, “The people tend to be happy and well cared for and have their individual needs met… I always find the relatives are happy with the care they receive when I talk to them, which is also a good reflection of the care that is given.”

People’s health and nutritional needs were assessed, recorded and met. Their comments included, “They do a good breakfast here. All of the food is good – probably a bit too good. I’ve put on some weight”, “The chef is great. [They are] a very good cook. I don’t eat fish and there is always an alternative on the days that we have fish.” Relatives agreed and said, “[Family member] likes curry but not with a very spicy sauce. [The chef] knows this so when [they] make a curry [they] make a separate sauce for [family member]. That is just so thoughtful.”

The chef told us they discussed people’s choices in relation to menus with them directly, and choices were offered at the point of serving, by showing plates or clear photographs of plated meals.

The staff kept the kitchen staff informed of people’s nutritional needs and any adaptations, choices or instructions they needed. For example, some people required their meals to be softly mashed, and this was provided. Some people had intolerance to certain foods, and this was recorded, and meals were adapted as needed.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People and relatives told us the staff worked well together and communicated with them well to meet their needs. Staff told us they enjoyed working at the home and that there was a strong culture of support and teamwork.

The registered manager told us they liaised with other professionals and agencies to share information and good practice, enabling continuous improvement to benefit people. They said, “The GP visits every week and has a good relationship with us. We have multi-disciplinary meetings, which the GP attends. The district nurses are also very supportive. We also meet quarterly with the local authority and have a catchup. We have a good relationship with the safeguarding and quality assurance team.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to access a range of health care professionals. Care records contained detailed information about people’s health conditions and how these might affect them. There were regular visits from health care professionals involved in people’s care, and communication between them and the staff and management was effective. A healthcare professional told us, “I feel that the service provided is consistently of a high standard… on each visit I am well briefed beforehand on any new people, their relevant medical conditions and on any specific needs or concerns the person or the staff have with their health.”

Relatives felt their family members’ health needs were met. Their comments included, “[Family member’s] health has improved phenomenally since moving here. It’s remarkable… Living here [they have] gone from strength to strength” and “My family member has seen a doctor – if they think she needs to they will organise it.”

The management team worked together to find ways to improve people’s health and wellbeing. After a number of falls resulting in injuries, the team reviewed them, looking for trends and identifying lessons learned. They worked with professionals such as the GP, occupational therapists, the falls clinic, hospitals and district nurses to ensure any future risk was removed or minimised.

For example, they looked at busy times of the day and reviewed their dependency tool. As a result, they increased staffing, such as the kitchen assistant, starting at 8am instead of 10am to support breakfast. The team also carried out some research around activities such as balanced based exercises as they learned this could help to build muscle strength and prevent falls. As a result of these changes, there had been a significant reduction in falls and serious injuries and people’s dining experience over breakfast had also improved.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There was evidence of regular reviews and immediate action following any changes to people’s health needs. The service worked closely with healthcare professionals who knew people well and followed their advice to help meet people’s changing needs. A healthcare professional told us, “I always find that [Registered manager] has thought about each person we are discussing and contributes to that discussion in a timely manner to improve the care of the people.”

The provider supported people to understand their rights around consent and respected these when delivering person‑centred care. Staff explained decisions in ways people could understand and encouraged people to make choices wherever possible.

Some people were living with conditions that could affect their ability to make specific decisions, which meant there was a risk that consent might not always be understood. The provider mitigated this risk by carrying out decision‑specific capacity assessments and recording the least restrictive options when people were unable to make certain decisions. Care records included information about people’s communication preferences and any support they needed to make choices.

People told us their choices were respected and relatives confirmed this. Staff told us they always sought consent before providing care, and we saw this reflected in practice during our observations.

Staff had completed training in the Mental Capacity Act 2005 (MCA) and demonstrated a good understanding of its principles, including acting in people’s best interests when required. The provider ensured any Deprivation of Liberty Safeguards (DoLS) applications were submitted where necessary to ensure restrictions were lawful.