Boldshaves Oast

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

Staff knew people well and helped keep them safe as they were able to identify any changes in their behaviour and presentation that could indicate they were upset or anxious about something. We saw that staff followed guidance about how to keep people safe and minimise any potential risks. Staff were recruited safely and enough staff were available so people could lead active lives. Staff received training specific to people’s needs and felt well supported in their roles. There were some inconsistencies around records with regards to assessing and managing risks, and staff recruitment.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People felt safe living at Boldshaves Oast. People told us sometimes they worried about things. They said that if this happened they spoke to a member of staff who listened and talked with them and this made them feel safe. Relatives said people were kept safe from avoidable harm because staff knew their family member well. One relative told us, “I think it's the whole package that gives me that assurance. There is a real culture of care and safety.” Another relative said, “Staff make me feel my family member is safe. Staff know them extremely well.”

Staff had received training on how to recognise and report abuse and understood their responsibilities to report any safeguarding concerns. For example, staff knew the importance of recording any bruising on a person’s body so it could be investigated how they had occurred. Staff felt confident if they raised concerns they would be acted on and gave examples of when this had occurred.

We observed people were familiar with staff which helped them to relax and feel safe. Staff supported people with safe practice whilst allowing them to maintain their routines and freely move around their home. Staff also supported people with their emotional well-being by reassuring people when they became anxious. People sought the company of staff and the registered manager throughout our visit for reassurance. Staff and the registered manager showed patience and understanding in listening and responding to people appropriately which lessened their anxieties and helped them to feel safe and reassured.

There were processes to monitor, report and escalate concerns about people’s safety. Information about how to safeguard people and whistle blow was accessible to staff. Safeguarding was regularly discussed at team and management meetings. The registered manager had appropriately reported safeguarding concerns to the local authority. A record was kept of all safeguarding raised and these were tracked together with all relevant actions taken as a result.

People were encouraged to pursue their interests, maintain relationships and be a part of their community through positive risk taking. People told us they took part in lots of activities at their home and also outside of their home. Some people told us they enjoyed being able to walk around their home and its extensive grounds by themselves. People were informed about any potential risks in their daily lives and how to keep themselves safe. The overwhelming majority of relatives told us potential risks to people were managed well. One relative commented on the safety of the environment and said, “I think they've done everything that they can to make the environment safe. There is a field with a pond and all sorts of potential problems, but it is all fenced in and taken care of and a hundred percent safe.” Another relative told us how effectively potential risks were managed when their family member became anxious. “There is a very lovely behavioural lady who has done a lot to work with my relative and it’s all very positive. It all seems very calm and well run when I visit.”

Staff knew people well and gave examples of how they had identified changes in people’s presentation that had caused them to concern. Staff helped to keep people safe through sharing information about potential risks. Staff could recognise signs when people experienced emotional distress and knew how to support them to minimise the need to restrict their freedom to keep them safe. People had positive behavioural support plans. These plans set out preventative and reactive strategies for staff to follow to help people receive a good quality of life and minimised the need to restrict their freedom.

We observed staff supporting people to manage and mitigate risks for them and so help keep them safe. Some people required staff support or equipment to move around their home. We saw these people being appropriately supported by staff according to their needs. Other people had specific guidelines from health care professionals about how they should be seated when eating and the consistency of their food and drink. We saw staff support people with their meals according to the professional guidance set out in their plan of care.

Although the majority of risk assessments contained information to guide staff about how to minimise identified risks to people, there was some inconsistency in this practice. One person required equipment to move them but the type of hoist and size of the sling which was suitable for them was not recorded. This person’s risk assessment directed staff to reposition the person regularly from their left to right hand side to maintain their skin integrity. However, this information was often missing from their care record. Another person required regular physiotherapy exercises to maintain their mobility. However, there were a number of gaps in their daily records so it could not be assured if this had taken place or if staff had omitted to complete the record.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were complimentary about staff. They told us about specific staff they enjoyed spending time with and about their shared experiences with staff which were positive and memorable. One person described certain staff as, “Very special.” However, there were mixed views from relatives. Most relatives were positive about staffing describing staff as ‘friendly’ ‘helpful’, ‘patient’ ‘caring’ and ‘well trained’. However, a minority of relatives felt some staff did not have the right skills to care for their family member. Also, that due to the absence of a deputy manager or administrator that skilled senior care staff were being taken away from their support role to complete these tasks.

Staff benefitted from being well supported which enabled them to care for people in the right way. Staff told us they received a comprehensive induction, including shadowing experienced staff and undertaking essential training before working on their own. One staff member told us, “You are not thrown in at the deep end but supported. You can always ask a question if you are not sure, and it is no problem”. All staff were complimentary about the registered manager. They said she was available, listened and took action when it was needed. Staff told us there had previously been a number of management changes and it was reassuring to have a manager who had consistently managed the service for a number of years.

We saw there were enough staff, including one-to-one support, for people to take part in activities at their home, to go out and to complete daily living tasks. During our visit staff we observed one to one support provided by staff to enable people to walk around their home and to eat their meals. We saw care staff taking people out on planned activities and also specific activities staff providing horticulture and cooking. Staff were responsive to people, did not rush them and took time to sit and have a chat.

The provider could not be assured that all necessary checks had been undertaken for new staff to ensure safe recruitment decisions. The provider had identified that one member of staff had no application form or work references. For another staff member we found there were no explanations given when there were gaps in their employment history. During our visit the registered manager was able to locate these records. They also spoke with the specified staff member to confirm the reasons for the gaps in their employment. Staff training was monitored using performance reports and discussed during team meetings to maintain training compliance. Staff had undertaken training in the wide range of strengths and impairments people with a learning disability and or autistic people may have. Staff were regularly checked to ensure they were competent in applying in practice the skills and knowledge they had gained from completing training. The support hours required by each person were assessed jointly with the service and people’s funding authority. The provider kept staffing levels under review.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.