Boulevard House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service now had effective systems to protect people from abuse. Risks were now assessed and mitigated more effectively. Medicines management systems now guided safe practice. People told us they felt safe living at Boulevard House and relatives agreed with them. There were enough suitably trained and experienced staff to make sure people’s needs and wishes were met.

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.

People were unable to explain how the learning culture affected their experience in the care home. However, due to effective processes and good staff knowledge, we assessed that people had a positive experience.

Staff we spoke with told us there was a proactive approach to the learning culture within the home. One staff member said, “Incidents are not treated as an opportunity to blame someone for a mistake, this means people are not afraid to speak up.” Staff confirmed they had regular team meetings in which lessons learned were shared from events or incidents. This meant people’s support continually developed and improved.

We saw evidence of the registered manager raising lessons learned and best practice guidance in team meetings and via internal communication with staff. Competency checks were completed which supported the embedding of good practices and upskilling of staff.

People did not raise any concerns with us about being able to access health and social care services. Relatives told us appropriate referrals were made so people had access to services such as podiatry, GP’s and dieticians whenever needed.

Staff knew which external professionals supported which people and how to refer for specialist support services when needed. The registered manager told us they were confident that people had access to the health and social care services they required to lead healthy and fulfilling lives.

Partners had no specific feedback on this area.

There were processes in place to ensure people could transition safely to and from different services. For example, person centred hospital passports had been developed with people.

People told us they felt safe living at Boulevard House. One person said, “They [staff] help me to stay safe, we talk about it a lot.” Another person showed us a display board which contained information about keeping safe. The person demonstrated their understanding of how and who to report things to if they felt unsafe at any time and pointed out relevant information that helped them to do this. Relatives echoed what people told us. One relative said, “I think [loved one] is very safe, [loved one] is well taken care of.”

Staff spoke knowledgeably about how to keep people safe and understood the different types of abuse people may face. They understood how to report any safeguarding concerns to the provider and external agencies such as the local authority and police. They also told us they received regular training about how to keep people safe.

People were comfortable and relaxed in the company of staff. Staff showed they were actively listening to people which gave them reassurance that any issues or concerns they raised would be taken seriously.

Systems were in place to protect people from the risk of abuse. Processes clearly set out the actions that managers and staff should take if abuse had occurred or was suspected. Records showed staff had completed regular training courses about how to keep people safe.

People had a positive experience when managing risk and were encouraged to take risks safely. For example, people were supported to undertake work placements and participate in activities within the local community. One person was supported by 2 staff members when they started their work placement and through encouragement and confidence building, they were now attending that placement alone safely.

The registered manager included people in their care planning and risk assessments and ensured people’s goals and aim were supported by managing and reducing risks. Staff were supportive of this practice and were knowledgeable about people goals and aims. One staff member said, “Nothing is off limits, people have personal aims so risk assessment are personal too.”

We observed people being supported to plan and manage risk. For example, we saw staff supporting a person to organise and plan their birthday party, which included a venue in the community and guest list.

People had comprehensive care plans and risk assessments in place. Care plans detailed how people communicated and expressed themselves and gave staff clear guidance on how to support people. One person had a risk assessment in place for planned restraint. The risk assessment stated it was a ‘last resort’ support system to keep the person safe and ensured any restraint was lawful, for a legitimate purpose, safe and necessary, and staff always follow best practice. Where relevant, equality and human rights legislation was considered.

Everyone we spoke with told us they felt safe living at Boulevard House, people told us they were proud of their home and included about decisions made. One person said, “I like living here, I have my own space and I can decorate it as I want. I am safe and have all I need here.”

Staff we spoke with told us the home and environment felt safe. One staff member said, “They [provider] are very responsive if we need anything repaired or replacing.” Another staff member said, “We take pride in the home and so do the people living here, we all have responsibility to keep the home clean and tidy.”

Overall, the home was clean and hygienic and maintained to a good standard. There were areas and items within the home that required upgrading however these did not pose an immediate risk to people living at the home.

The environment was kept safe, by regular checks and maintenance. We saw there had been regular checks to ensure the home was safe in the event of a fire (for example, by checking the alarm systems.) Systems were in place to ensure the water quality was maintained to reduce the risk of water-borne bacteria (like legionella.) The gas heating system was regularly serviced to prevent harm to people.

People told us there were enough staff to support them to live their lives the way they want to. They spoke about being supported with holidays, day trips and going shopping. Some people told us how staff supported them to cook, make drinks and do their laundry. When asked what was good about the staff team, one person sought out and pointed at the registered manager and hugged her.

Staff told us there were enough staff to support people with whatever they needed and wanted. Staff spoke about covering shifts when there was any sickness in the team so that people had consistent support. The registered manager was complimentary about how staff supported each other in this way. Staff said they had received training which supported them to do their jobs well and were able to demonstrate how they applied the learning when supporting people.

Throughout the visit we saw people had their needs and wishes met. Staff made sure people were supported with things like shopping trips, planning a celebration, baking and individual supportive chats.

Records showed staff had completed training which was relevant to their role. Systems and processes were in place to ensure staff were safely recruited. This included Disclosure and Barring Service (DBS) checks. These checks provide information about previous convictions and cautions held on the Police National Computer.

People and their relatives told us the home was kept clean. One person told us how they liked to help polish and hoover around the home, especially in their own room. Another person told us about their recent experience of illness and how staff had worn gloves and an apron when supporting them.

Staff knew about infection prevention and control (IPC) principles including the use of personal protective equipment (PPE). They were able to describe how laundry was processed in line with good IPC practices.

We saw the service was clean, hygienic and odour free.

Processes were in place to monitor IPC practices. The registered manager carried out monthly audits and daily walk arounds. Records showed staff had received training about IPC practice.

People we spoke with told us they were assisted safely with their medicines. We observed people being supported to make informed decisions regarding ‘as needed’ (known as PRN) medicines. For example, one person requested pain relief for a headache; they were supported to go somewhere private to discuss their pain level and assisted to make an informed choice about dosage of pain relief medicines in line with guidance specific to the person’s safe administration PRN protocol.

Staff we spoke with were knowledgeable about medicines and what current medicines people were receiving. Staff confirmed they received regular competency checks and support from management when dealing with medicines and reviews. Staff could explain how they would escalate concerns to the registered manager or involve other medical professionals if needed.

The home used medicine administration record (MAR) charts effectively to safely monitor and administer people’s medicines. These were regularly reviewed and audited to ensure if any medicine error occurred, they were identified quickly. The registered manager was working with senior staff to train and upskill them where appropriate, to ensure a consistent and knowledgeable approach was taken to auditing to ensure this practice was upheld in the registered managers absence.