7 May 2021
During a routine inspection
The Boltons is a residential care home providing personal care to 20 people aged 65 and over at the time of the inspection. The service can support up to 27 people. Some people supported by the service are living with dementia or a mental health condition.
The premises are two interconnected houses and people live across three separate floors. There are single bedrooms, most of which have their own ensuite toilet and bathroom. There are some communal bathrooms, two communal dining rooms and a communal lounge. There is a large garden to the rear of the building.
People’s experience of using this service and what we found
Improvements were made to medicines management since the last inspection. People were protected from abuse, neglect and discrimination. There were satisfactory risk assessments for people’s care. Premises risks were assessed and managed. There were enough staff deployed to meet people’s needs. Infection prevention and control was satisfactory.
People's likes, preferences and dislikes were considered. Staff had the necessary knowledge, skills and experience to support people. Staff had a good knowledge of people's needs. People received enough food and fluids to prevent malnutrition and dehydration. People's care was provided in conjunction with local and community-based health and social care professionals. The service was compliant with the provisions set out in the Mental Capacity Act 2005. The service was appropriately decorated and refurbished.
The staff were kind and caring. People and relatives were complimentary about support provided by the staff at The Boltons. People's rights were respected, and their dignity and privacy maintained. People's independence was promoted. People were involved, as far as possible, in their care planning and reviews.
Care plans were individualised. The daily notes were satisfactory. Some improvement in documenting people’s emotional and psychological health was required. The service worked to prevent social isolation during the pandemic and lockdowns. There was a satisfactory complaints mechanism in place. There was good planning for people's end of life care.
The management team had correctly notified us of incidents required by the regulations. Improvements were made to the governance of the service. Audits and other quality assurance processes were better used to gauge, monitor and report on the quality and safety of care. Appropriate actions were taken when issues were identified. There was a positive workplace environment. The management team were knowledgeable, skilled and experienced and were able to lead the service well. The service showed transparency and accountability in reporting matters when things went wrong. We made a recommendation about reviewing the duty of candour process.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported did not support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 31 January 2020). There were three breaches of the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.