Boston West Care

Changes to the management team had affected the service. A new manager had been appointed who had developed an action plan to support and drive the required improvements, and these actions had commenced. New and improved systems and processes required further time to become fully embedded and sustained.

Guidance to support staff on how to meet people’s individual care and treatment needs, and how to manage and mitigate risks, was not consistently detailed and or up to date. Whilst we found examples of guidance that reflected important information to support staff in providing personalised care, this area also required further review and improvement, actions were well underway to make these required improvements.

Currently, clinical support, oversight and leadership were provided by the clinical lead from the provider’s other registered nursing home. The internal clinical lead position was being recruited to.

Staff had received safeguarding training and were aware of their responsibilities to protect people from abuse and avoidable harm. Whilst safeguarding incidents had been reported to the local authority, and action taken to mitigate further risks, the provider had not always notified us, the Care Quality Commission (CQC) as required.

There were enough staff available to meet people’s care and treatment needs, and safe staff recruitment checks were completed before staff commenced. Actions were being taken to assess staff and nursing competencies, and the manager informed us of their plan to further upskill staff training. Staff told us they felt supported.

Health and safety checks were completed on the environment, premises and equipment. The service was clean and hygienic.

People received their prescribed medicines when needed and were supported with their health conditions, including access to health services. People received sufficient food and drink, and plans were in place to review the menu options with them, offering an increase in variety and choice.

People were supported to participate in activities provided internally and by visiting entertainers.

Observations of staff engagement with people found staff to be kind, caring, and respectful.

Recent improvements had been implemented in internal communication systems and processes. This included a daily head of department meeting and a review of the ‘resident of the day’. People, staff, and relatives received opportunities to share their experiences of the service.

External partnership working was an area of continued development and improvement. The provider’s governance systems and processes, used to assess, review, and monitor quality, safety, and mitigate risks, were being reviewed to strengthen and improve their effectiveness.