Inspection on 21/08/07 for Burger Court

This inspection was carried out on 21st August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Burger Court 05/09/06

Burger Court 08/12/05

Burger Court 13/04/05

Burger Court 11/11/04

Burger Court 14/09/04

Burger Court 17/06/04

Similar services:

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Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Burger Court 131 Barkerend Road Bradford BD3 9AU Lead Inspector Mary Bentley Unannounced Inspection 21st August 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burger Court Address 131 Barkerend Road Bradford BD3 9AU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01274 726826 01274 726292 burgercourt@eldercare.org.uk Mr B W Vincent Mrs H M Vincent Mrs Ann Van Lelyveld Care Home 24 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (24), of places Physical disability (4), Physical disability over 65 years of age (4), Terminally ill (4) Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of four places in total to be occupied by PD and PD (E) service users 5th September 2006 Date of last inspection Brief Description of the Service: Burger Court is registered to provide personal and nursing care for up to 24 people. It is a converted property close to Bradford city centre and is easily accessible by public transport. The home has 18 single and 3 double rooms, privacy screening is provided in the shared rooms. One of the bedrooms has en-suite facilities. There are bedrooms on three floors; a passenger lift and stair lift provide access to all floors. The home has three communal bathrooms, one on each floor. There are two lounges, one on the ground floor and one on the first floor; there is also a dining room, which is on the ground floor. There is a small garden at the front of the home but is not suitable for everyone because it is not secure and the home is on a busy road. The home is within easy reach of a number of local amenities including shops and a public house. A small number of car parking places are available at the front of the building. The weekly fees in August 2007 ranged from £374.71 to £548.38. Hairdressing and private chiropody are provided at an additional charge. People are also asked to contribute to the cost of some organised outings for example visits to the theatre. Information about the home (The Statement of Purpose) is available in the entrance area. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We did this unannounced inspection in one day between the hours of 9.30am and 6.00pm. The purpose of this visit was to assess how the home is meeting the needs of the people who live there and to check if the requirements from the last inspection had been dealt with. During the visit we spoke to people living in the home, staff and management. We observed staff caring for people in the communal rooms, looked at various records relating to care, staff, and maintenance, and looked at some parts of the building. We sent a total of 17 comment cards to people involved with the home, including people living there, their relatives and health care professionals. Comment cards give people the opportunity to share their views of the service with us. The information we get is shared with the home without identifying who has provided it. A number of people living in the home have dementia and would not necessarily be able to complete these cards. The three cards that were returned were from relatives. Before the visit the home provided us with a completed quality assurance selfassessment form. In preparation for the visit we also looked at any information we have received about the home since the last visit. We have taken account of all this information when preparing this report. What the service does well: These are some of the comments made by relatives of people living in the home: • “They are very caring people” • “We are very satisfied with the staff and home” • “Found staff helpful and friendly” Burger Court is homely and comfortable and several people described it as “friendly” and “welcoming”. People said they enjoy the food and they are offered a choice. There is now more home baking and people enjoy this. The home has been given a four star rating (the best is five) by Environmental Health for its standards of food safety. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 6 People are encouraged to visit the home before making a decision about moving in and are given enough information to help them make an informed decision. The home works with other health care professionals to make sure that people’s health care needs are met and that people have access to the full range of NHS services. The home makes sure that all new staff are fully checked before they start work and this helps to make sure that people are protected. The home encourages people to tell them what they think about the service. There are regular meetings for people living in the home, and questionnaires are sent out approximately once a year. What has improved since the last inspection? What they could do better: We asked people what the home could do better. One person they would like to the staff to take more time with the people who are upstairs. Another said, “Examine the feasibility of providing a secure outdoor area at the rear of the property to enable residents to spend time outside” The home needs to continue to improve the care plans to make sure that there are clear instructions for staff on how to meet all the needs identified by assessment. This is so that people’s care needs are not overlooked. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 7 To make sure that the needs of people with dementia are properly addressed the home needs to continue to develop a person centred approach to care. They need to be able to show that they are helping people to make the most of their abilities. More needs to be done to make sure that people living in the home, or people close to them, are involved in the care planning process. This is to make sure that people’s preferences about how their care needs are met are taken into account. The home has already identified a need to improve the way in which people are helped/supported to follow personal interests and activities. The home is working on ways of making sure that people have easy access to information about how to make a complaint and this needs to continue. More work needs to be done to make sure that people can live in pleasant home that is suitably equipped to meet their needs. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, & 5. Standard 6 does not apply to this service. People who use the 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 can be confident that the home will be able to meet their needs. This is because they, or people close to them, are involved in an assessment of their needs before they are offered a place. EVIDENCE: One person said “We were given a fully comprehensive welcome pack on our first visit to Burger Court and the staff have responded well to any questions we have raised”. The records showed that the home carries out detailed pre admission assessments. They visit people and get information from relatives and other professionals to help them decide if they will be able to meet people’s needs before a place is offered. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 10 The terms and conditions (contracts) have been changed and now give people clear information about how much they will pay and what is included in the fees. The home does not provide intermediate care. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. For the most part people’s personal and health care needs are met in a way that respects their privacy and dignity. However, this is not always fully evidenced in the care records. Medicines are managed safely. More needs to be done to make sure that people living in the home, or people close to them, are involved in the drawing up and reviewing the care plans. EVIDENCE: One person said, “The staff at Burger Court are so good to him, now he is feeding himself, walking and is clean and happy”. Everyone living in the home has a care plan. We looked at the care plans of three people in detail. The plans are based on detailed assessments of needs. The care plans set out how personal and health care needs will be met. One care plan about personal hygiene made it clear that the person could not do Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 12 anything for himself or herself because they could not follow instructions. Two other care plans about personal hygiene did not give enough detail, for example it wasn’t clear whether people preferred baths or showers or how often the liked to bath/shower. The care plans did not always address all the areas of need identified in the assessment. For example one person needed help with finding the toilet but the care plan did not reflect the actions that staff were taking to deal with this. The same person was having disturbed nights and wandering around the home but there was no care plan to say what actions staff should take to deal with this. The nursing staff review the care plans monthly. There was little or no evidence that people living in the home, or their representatives, are involved in the planning and reviewing of care. The daily notes contain a lot of information about how people’s physical care needs are met but very little about how people actually spend their time or how they are feeling. Risk assessments are done in relation to falls, pressure sores, nutrition, moving and handling and the use of bed rails. Where necessary plans are in place to show how these risks will be managed. A wound care plan looked at showed that the home had consulted the tissue viability nurse specialist for advice. People’s weights are recorded every month. One person had been identified as being at risk nutritionally when they came to the home. This is being dealt with, the care plan is detailed, and the person is steadily gaining weight. One person had a care plan about social care, which included information on cultural and religious needs. The home told us they are planning staff training to create a greater awareness of people’s diverse needs in relation to culture, religion, age, disability, gender and sexual orientation. The records showed that people have access to a range of NHS services. There are systems in place to make sure that medicines are managed safely. The area manager checks that these systems are being followed when she does her monthly visits and if necessary takes action to deal with any shortfalls. No one in the home is able to manage his or her own medicines. Generally people looked well cared for. The home manager said there has been a problem with the hairdressing service and this is being dealt with. Staff were seen to be kind and respectful in the way they spoke to people and helped them with their care needs. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 13 Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s individuality is recognised and respected. The home is aware that more needs to be done to support people to follow personal interests and activities and is working to improve this. EVIDENCE: The friends of someone who recenlty moved into the home said, “Our friend is more animated which suggests that staff are taking time to to communicate with him.” Another visitor to the home said, “Meals look wholesome and on the occasions I’ve been they have been prepared for each residents’ individual likes and needs (at tea time).” Daily routines are reasonalby flexible. Some people in the home are clearly able to express their preferences about their daily routines, others are not but there was evidence that the home had tried to get this information from Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 15 other sources. For example the care plan for one person with dementia showed their preferred times for going to bed and getting up. Increased staffing levels on the evening shift mean that the evening meal is more relaxed and there is more flexibility about the times people go to bed. The home has an activities organiser who works approximately 18 hours a week. She organises games, videos, quizzes, sing-a-longs, entertainers, and outings. People’s birthdays are celebrated. She also spends time with people on an individual basis, for example reading to someone who prefers to stay in their room. People enjoy these activities and look forward to them. However, it was evident that, while staff talk to people while they are working, there are long periods of time when some people have nothing to do other than watch television. The home told us (in their self assessment form) that they have identified the way social care needs are met as an area that they want to improve. The amount of information recorded about people’s lives and interests varied. One person has a care plan explaining what they are interested and how they like to spend their time. The care records of two other people had some basic information about their past lives and interests but there were no care plans to show how their social care needs would be dealt with. This means that people’s social and cultural needs may be overlooked. The home has visitors from the local Anglican and Roman Catholic churches. One person had specifically requested to have contact with a local church and this had been arranged. The home encourages people’s families and friends to be as involved as they want to be. One person went out with their family during this visit, this is a regualr weekly outing. Relatives and friends described the home as “friendly”. The home had a four weekly menu. The meal served on the day of the visit was the one on the menu. The lunchtime meal looked appetising and people enjoyed it. People were helped discreetly where necessary. Aids such as plate guards were provided to make it possible for people to eat without needing help from staff. The home has a new cook and there is a lot more home baking. People enjoyed the home made scones at teatime. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the 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 home has procedures in place to deal with any concerns that people may have and is taking action to make people more aware of how to make a complaint. EVIDENCE: The home has not had any complaints since we last visited and none have been referred to us. The home has a complaints procedure. Information about how to make a complaint is displayed in the entrance area. The complaint’s procedure is not available in alternative formats; this means that some people may have difficulty understanding it. The most recent survey done by the home showed that a lot of people were not aware of the complaints procedure. The home is taking action to address this, for example by discussing it at meetings. The majority of staff have attended training on the protection of vulnerable adults. The manager has recently attended a training course that will enable Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 17 her to provide training for staff on adult protection and the prevention of abuse. The recently introduced Mental Capacity Act has implications for how people’s rights are safeguarded, particularly in the areas of capacity and consent. Training for the home manager has been arranged. The manager is aware of the local Adult Protection procedures and has used them appropriately when necessary. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, & 26. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and safe. It is usually clean however at times there are unpleasant odours in some areas. Improvements are being made and this needs to continue to make sure that the environment is suitably equipped to meet people’s needs. EVIDENCE: One person said, “It’s not posh but it’s right homely”. One the day we visited there was an unpleasant odour in some parts of the home. The manager said she was aware of this and trying to deal with it. The home is comfortably furnished and there is an ongoing programme of redecoration to make sure that the home provides a pleasant place for people to live. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 19 In many of the bedrooms we saw evidence that people are able to bring some of their personal belongings, such as photographs and ornaments, with them when they move in. Some people’s clothing was in the wrong rooms and some items of personal clothing were not named. This means that people could be wearing clothes that do not belong to them. The path leading to the back door, which is the door that provides wheelchair access, is very uneven, this makes it difficult to manoeuvre wheelchairs and creates a potential hazard. This was discussed at the last inspection and has not been dealt with. The top floor bathroom has been converted to a shower (wet room) and can now be used by people living in the home. The ground floor bathroom, which has the assisted bath, has not yet been upgraded. The bath is located against the wall meaning that it can be difficult for staff to help people and the general appearance of the room does not make it a comfortable and relaxing place for people to enjoy a bath. The manager said quotes for the work had been obtained and it would be starting soon. There are two communal toilets on the ground floor but only one is suitable for use by people who need assistance. There is a small garden at the front of the home. The home is on a busy road and there is nowhere secure for people to sit outside. The home told us (in the self assessment form they completed before the inspection) that they are planning to make improvements to the outside of the building. The home has suitable systems in place for preventing the spread of infection and four staff have attended infection control training. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are usually enough staff available to make sure people’s needs are met. People are protected because all the required checks are completed before new staff start work. Staff are supported in developing the skills and knowledge they need to care for people properly. EVIDENCE: These are some of the comments people made about staff in the home: • “They are very good staff” • “The overall impression is that the staff have good and caring relationships with residents” At previous inspections we have discussed concerns about daily routines being focused on tasks rather than on the needs and expectations of people living in the home. Since the last visit staffing levels on the evening shift have been increased. There are now 3 care staff and a nurse on duty from 6.00pm until 8.30pm. Staff said it is much better, the late shift is less rushed, and people have more choice about when they go to bed although some people still choose to go early. Other changes have also been made to working practices Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 21 such as the staggering of staff breaks. The area manager said they are continuing to work on promoting a more person centred approach to the dayto-day running of the home. No one raised any concerns about the availability of staff. From our observations it was evident that staff know people well and are able to talk to them about their lives, families and interests. There is good interaction between staff and people living in the home and lots of friendly banter. Information provided by the home showed that 58 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. There is an ongoing programme of NVQ training. We looked at the files of two newly appointed staff and they showed that all the required checks are completed before new staff start work in the home. The records showed that new staff are given training when they start work to make sure they have the right skills and knowledge to care for people properly. Training is provided on safe working practices such as moving & handling and fire safety as well as on more specialist subjects such as dementia care and palliative care. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37 & 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements in place to make sure that the home is managed properly. The home provides a safe place for people to live and work. EVIDENCE: The home manager is a nurse with several years experience in the care of older people and she has successfully completed management training. The organisation has recently appointed a new area manager with specific Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 23 responsibility for the nursing homes within the group. She is an experienced nurse manager. She visits the home regularly to provide support to the home manager and staff. During these visits she audits various aspects of the service and agrees with the home manager any actions that are needed to deal with any shortfalls. We receive regular reports form these visits and this helps us to monitor the service. The organisation sends questionnaires to people using the service, their representatives, and staff. The most recent surveys were sent in April and May this year. The results are analysed at the company’s head office and the home manager is given feedback on any issues that need to be addressed. The home has also received feedback from a survey done by Bradford Social Services, most of the comments were positive; one person said they “found staff helpful and friendly”. The home has residents’ meetings about every 2 months; relatives are also invited to attend. Staff meetings are held every month. The home collects pensions on behalf of two people, this is a long standing arrangement, and the home manager is continuing her efforts to find independent advocates to take over this responsibility. People’s personal money is dealt with at the company head office and kept in a separate bank account. Records are kept of all transactions and invoices are issued for sundry services provided to people such as chiropody. There are systems in place to make sure that people can have access to their money when they want it. The self-assessment form completed by the home indicated that all the required maintenance and servicing of equipment is up to date, the records we looked at confirmed this. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X X 3 X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001, and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement The care plans must set out in detail how all people’s assessed needs in relation to personal, health and social care will be addressed and must show that people, or their representatives, are involved in the care planning process. This is to make sure that care is delivered in way that takes account of people’s preferences and abilities. Previous timescale of 15/12/06 not met. 2 OP20 23 The path that provides access for 14/12/07 disabled people must be repaired and maintained in a safe condition to reduce the risk of people being injured. Previous timescale of 24/11/06 not met. 3. OP26 16 The home must be kept clean and free of offensive odours at all times so that people can live in a pleasant environment. DS0000029144.V350515.R01.S.doc Timescale for action 14/12/07 14/12/07 Burger Court Version 5.2 Page 26 Previous timescale of 24/11/06 not met. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP16 OP26 Good Practice Recommendations The complaint’s procedure should be made available in alternative formats suited to the needs of people using the service. More care should be taken to make sure that people’s clothing is named and returned to the right place so that people can wear their own clothes. Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Burger Court DS0000029144.V350515.R01.S.doc Version 5.2 Page 28 - 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. 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