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Inspection on 10/09/09 for Burlam Road Nursing Home

Also see our care home review for Burlam Road Nursing Home for more information

This is the latest available inspection report for this service, carried out on 10th September 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home continues to provide a good standard of care to the people living there. Comments about the staff were positive and people living at the home said that they were well cared for. People living at the home, were generally happy with the environment, the activities and the choice of food provided. There are clear policies and procedures in place for managing complaints and adult protection issues. Good staff recruitment systems are in place and staff receive regular training and support to enable them them carry out their roles effectively.

What has improved since the last inspection?

The home now carries out a full assessment of need prior to any person being admitted to the home. Each person also has a care plan, which is a written document which details how the individual`s care needs should be met. Additional locked storage has been provided for the storage of medication. Since the last inspection, staffing numbers have been increased. Work continues to take place to improve the environment.

What the care home could do better:

The date of any eye drops being opened must be recorded and any prescribed disposal time must be adhered to. Bottles of medication must always have sufficient labeling in place to ensure that it can be appropriately identified and administered to the correct person. The storage arrangements should be further reviewed so that equipment and other large items are stored safely. The home should provide additional support for staff to gain a national vocational qualification (NVQ) so that they meet the target of having at least 50% of their work force trained. The home must ensure at all times that hot and cold running water is available in bedrooms and that identified maintenance issues are being addressed in a timely manner.

Key inspection report Care homes for older people Name: Address: Burlam Road Nursing Home 113 Burlam Road Middlesbrough TS5 5AR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Tanya Newton     Date: 1 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 22 Information about the care home Name of care home: Address: Burlam Road Nursing Home 113 Burlam Road Middlesbrough TS5 5AR 01642824947 01642850632 burlam.road@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd care home 44 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accomodated is 44 The registered person may provide the following category of service only: Care Home with Nursing - Code (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following catagories: Old Age not falling into any other catagory - Code OP, maximum number of places: 44 Physical disability - Code PD - maximum number of places: 12 Date of last inspection Brief description of the care home Burlam Road is a care home providing both nursing and personal care for older people. It is a two-storey purpose built home, with an extension, providing single and double accommodation for 50 Residents; the 38 single bedrooms are a minimum of 10 sq.m. and the 6 double bedrooms are a minimum of 16 sq.m. There is a passenger lift giving access to all floors. There are three lounges, one on each floor and the third in the extension and a large communal dining room on the ground floor and a smaller dining room in the extension. Care Homes for Older People Page 4 of 22 Over 65 44 0 0 12 Brief description of the care home The home is close to local shops and amenities with a car park at the front of the home. The current fees structure is £418.00 to £449.00 a week depending on the level of care the Resident requires. Care Homes for Older People Page 5 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was carried out between the hours of 9.30am and 4:30pm and was unannounced. The inspection report includes information obtained from an Annual Quality Assurance Assessment (AQAA) which is a self assessment document, completed by the manager of the home. The inspector also spoke to people living and working at the home, took a tour of the environment and looked at documents, which included peoples individual case files, policies and procedures, records of complaints, staff files and health and safety records. Fourteen surveys were also received, this included 4 from Care managers or other health professionals, 4 from staff and 6 from people living at the home. Comments from surveys and feedback have been included within the body of the report. Care Homes for Older People Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 22 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to admission to ensure that the home is able to meet their needs. They are given information about the home to ensure it is suitable. Evidence: Three assessments were viewed. People who had been funded by the local authority had assessments in place which had been carried out by a care manager. These were then shared with the home. The home also carries out an assessment to determine whether or not the home is able to meet the persons individual needs. Comments from people include, I was admitted from hospital, my relatives looked around for me and I was able to visit the home, before deciding to move in. All six comment cards from people living at the home confirmed that they had been given sufficient information about the home prior to moving in. The home does not admit people for intermediate care. Care Homes for Older People Page 9 of 22 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs are generally being well met by the home. There were some issues with medication which aquire address. Evidence: Three care plans were looked at. Care plans set out the way in which peoples individual health and personal care needs will be met by staff working at the home. Care plans were reviewed regularly to reflect any changes in need. Care plans included risk assessments to minimize risks to people living in the home. There was clear evidence within care plans that peoples health needs were being closely monitored with input being sought from other professionals where this was required. Comments from health professionals include, the nursing and care staff in the home provide excellent care to all its service users. They provide a relaxed, friendly atmosphere, for people to feel at home in and the people living at Burlam Road are very well cared for. Comments from people living at the home include, I am happy that I am being cared for, I receive very good care and would thoroughly recommend the home to friends and relatives, I am well looked after here and the Care Homes for Older People Page 10 of 22 Evidence: staff answer my buzzer quickly if i need help and nothing seems to be a trouble for them. Medication systems were viewed. Two of the bottles of eye drops with a twenty eight day shelf life were found to be out of date, others had no labels on the bottle to identify who they were prescribed for. The home said that they were experiencing problems from their pharmacy with delivery of certain stock items and that they were still waiting for a disposal bin for medication which needed to be destroyed. Staff were observed throughout the inspection to be respectful to people, they always knock on bedroom doors before entering the room and people are spoken to politely. The relationship between staff and people living at the home was very relaxed. Comments from people include, the staff are lovely, they always knock on my door and they speak nicely to you and in the main the staff are very good, always polite. Care Homes for Older People Page 11 of 22 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are able to make choices about their lifestyle, and are supported with social, and recreational activities that meet their individual expectations. Evidence: People were asked about the activities provided by the home. There are a range of activities offered and the home employs an activities co-ordinator. Activities include church services, bingo, lunch out, exercises, skittles, sing a longs. The home is starting life story work to try and gather information about peoples previous likes and dislikes socially. Lots of people were seen to be enjoying a quiz in the dining room. On the day of the site visit the menu was a choice of either steak pie and vegetables or spaghetti bolognaise. Comments from people include, I had the steak pie for lunch, it was lovely. I like a sandwich at tea time and you always get a sweet. The food is good, I had the bolognaise today, the food is reasonable, cant grumble,you get nice meals here, I like them, I would like to see more variety in menus and we receive lovely varied food. Care Homes for Older People Page 12 of 22 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The home has a satisfactory complaints procedure. People spoken to during the inspection said that they had no concerns or complaints but felt confident in raising any issues if they arose. There were clear records in place of any complaints made and the action taken by the home in response. Comments from people include, I could tell the staff if I had any problems or concerns and I would raise concerns if I needed to, yes. The home has procedures in place to help protect people from abuse. Staff had received training in safeguarding vulnerable adults. Staff spoken too during the inspection said that they knew what procedure needed to be followed if an allegation was made. They also confirmed that they would not hesitate to whistle blow (tell someone) if they saw or heard anything inappropriate. Care Homes for Older People Page 13 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, generally well maintained and comfortable environment. Evidence: Some refurbishment has taken place within the home since the last inspection, new patio doors have been fitted to 2 downstairs bedrooms and a smoking area has now been provided for people living at the home. The area outside the lift is being used to store hoovers etc and they had been left plugged in which was a trip hazard. Hoists and wash bins were still being left in corridors due to lack of storage facilities in the home. Fridges were still being stored in the dining room due to lack of space in the kitchen. Communal areas were pleasantly furnished and people were encouraged to bring their own items to make their bedrooms more homely. The home has started a gardening club and is involved in the company gardening competition. The home was clean and odour free. Care Homes for Older People Page 14 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were recruited, inducted and trained so that they were able to meet the needs of people living at the home. Evidence: Staff recruitment files were looked at. All contained an application form, two references, a CRB (police check) and an induction. This information helps to protect people living and working at the home. Training files were looked at. Mandatory training includes induction, fire, first aid, infection control, manual handling, food hygiene and health and safety. Training is also provided in the protection of vulnerable adults (POVA). Some staff had been on crime prevention training earlier in the year. The home have recently completed a tackling health care associated infections outside of hospital development programme. Only 9 of the 33 care staff employed have gained an NVQ qualification in care. At least 50 of all care staff should obtain this award. Comments regarding staff include, the home would benefit from additional staffing, as they are still very short at times, staff are very welcoming and friendly, excellent staff team and I get on well with staff, they give me support but we could do with more of them. Comments from care staff include,I have had previous jobs and this is the best place Care Homes for Older People Page 15 of 22 Evidence: of employment so far. There are plenty of training sessions, staff get on well. Overall I would say that Burlam Road is a happy home, Burlam Road is excellent for training, it has a fantastic reputation and is an excellent place to work, I like working at Burlam Road because the staff are good, co-operative, committed, hardworking and have the interests of residents at heart Care Homes for Older People Page 16 of 22 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, and has effective quality assurance systems. Evidence: The manager of the home is a registered nurse who has many years of management experience. Comments about the manager were positive and include, the senior staff and our manager are there to support us, listen to us and deal with any issues at all times. Quality assurance systems were viewed. Surveys are sent out to people to gain their views of the service being provided at the home. The provider visits the home and a report of their visit is made available, May, June and Augusts visit reports were seen. Regular meetings are also held for people living at the home, their relatives and staff. The manager carries out regular in house audits and these reflect any action to be taken as a result. Surveys are sent out by the home to seek the views of people living at the home, their relatives, other professionals and staff. The results of these surveys Care Homes for Older People Page 17 of 22 Evidence: are collated and displayed in a graph and an action plan is developed from this. Health and safety systems were viewed. Although safety checks do identify any action which needs to be taken, maintenance issues are not being addressed in a timely manner. The home had identified that three of the bedrooms had either no hot or no cold water since June 2009 and this was still the case when the inspection was carried out. The manager was told that immediate action must be taken to rectify this so that people had access to hot and cold running water in their rooms. Following the inspection, the manager confirmed that this action had been taken. Care Homes for Older People Page 18 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 19 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The home must make sure 31/10/2009 that bottles of eye drops are dated on opening and discarded within the prescribed timescale. All bottles of medicines must have appropriate labels to identify who they are for. To ensure that medication is administered safely. 2 38 23 Bedrooms must be supplied with hot and cold running water at all times. To ensure that people at the home have access to hot and cold water facilities. 31/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 The storage arrangements need to be looked at so that equipment and other items can be stored safely. Care Homes for Older People Page 20 of 22 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 2 30 50 of the care staff should have an NVQ in care at level 2 or above. Care Homes for Older People Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 22 of 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!