26 February 2015
During an inspection looking at part of the service
We observed how people spent their time and their interactions with staff. We also spoke with the Chief Executive Officer, the registered manager, three staff and one person during our inspection. We reviewed care plans and other records relating to the management of the service.
Below is a summary of what we found. The summary describes what people using the service and others told us, what we observed and the records we looked at.
Is the service safe?
People felt they were safe living at Boldshaves Oast. Staff had received training and understood how to recognise abuse. Staff were aware of how to report abuse if they suspected it had taken place. There was evidence that staff had been given detailed information about external agencies, such as the local authority, which could provide further guidance and information.
We reviewed five care plans and found that they all contained risk assessments, which provided detailed information on how to minimise risks and hazards to the person. For example, how to safely care for a person who was epileptic, if the person had a seizure whilst in a car.
There was an effective system to manage accident and incidents and learn from them, so they were less likely to happen again. This reduced the risks to people and helped the service to continually improve.
We found a policy covering the arrangements for the management of people's medicines, although there were some areas which needed more clarification for staff.
Is the service effective?
We observed care being given to people, and found that interactions between staff and people at the home were positive. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well.
People's needs were assessed by the service. Care plans were in place for each person, which detailed people's wishes and preferences. We noted that care plans included information on the person's cognition and ability to make decisions. We found that each person had an annual review, and this included information on the person's ability to make decisions independently.
People had access to a variety of health care professionals to help make sure their health care needs were met.
There were no Deprivation of Liberty Safeguards authorisations in place, and no applications had been made. Staff understood the importance of supporting people to make their own decisions, and also demonstrated an awareness of when a formal assessment of a person's mental capacity might be required.
Is the service caring?
We saw that staff were kind and patient with people at the service. For example, we observed one staff member supporting a person at lunchtime, and noted that the staff member waited until the person was ready before offering the next mouthful, and explained what the food was. We saw that staff knocked on people's doors and waited for a response before entering.
We saw good interactions between staff and people who lived at Boldshaves Oast. People were treated with dignity and had their privacy respected. Staff demonstrated a caring approach when discussing people that used the service during the inspection.
Is the service responsive?
Staff were responsive to people's needs. We saw and heard during the inspection that some people were able to make their views known about what they wanted in relation to their day to day care and support. We saw that staff respected these wishes. People had annual review meetings with staff, their relatives and their care manager to discuss their future. The complaints procedure was written in easy read format, and clearly displayed.
Is the service well-led?
There was a clear management structure in place, although this had gone through several changes over the last few months, which had been unsettling for people that used the service.
Staff knew their roles and responsibilities. Staff had an understanding of the ethos of the service and quality assurance processes were in place. The registered manager was approachable and was present in the service during the inspection. Staff told us that the registered manager was easy to talk to.
Where investigations had been required, for example, in response to accidents and incidents, the service had completed an investigation. This included what actions needed to be taken so that risks to people of future occurrences were minimised.