Inspection on 05/09/06 for Burger Court

This inspection was carried out on 5th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 21/08/07

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:

Snydale Care Home

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 Key Unannounced Inspection 09:30 5 & 6th September 2006 th 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.V302001.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.V302001.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.V302001.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 8th December 2005 Date of last inspection Brief Description of the Service: Burger Court is registered to provide personal and nursing care for up to 24 older 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. Bedrooms are located on three floors and access is provided by means of a passenger lift and a stair lift. The home has three communal bathrooms, one on each floor. The ground floor bathroom has a bath hoist, the first floor has a disabled access shower, and the bathroom on the top floor is being converted to a shower room. There are two lounges, one on the ground floor and one on the first floor; there is also a dining room, which is located on the ground floor. 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 provided at the front of the building. The weekly fees range from £360.00 to £480.00. Hairdressing, chiropody, newspapers, toiletries, and clothing are not including in the fees. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate”, and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk The last inspection was done in December 2005 and there have not been any additional visits to the home since then. The purpose of this inspection was to inspect all the key standards, (the key standards are identified in the main body of the report), to assess how the needs of people living in the home are being met. The methods used in this inspection included looking at care records and other paperwork such as staff and maintenance records, talking to residents, staff and management, observing care practices in the home and looking at some parts of the home. The home completed a pre-inspection questionnaire and the information provided was used as part of the inspection. The inspection was unannounced; it was carried out on 5th and 6th September 2006. On 5th September the inspector was in the home between the hours of 9.30 am and 5.30 pm and on 6th September between the hours of 10.00 am and 3.00pm. Feedback was given to the manager at the end of the visit. Comment cards were sent to a number of residents and relatives before the inspection. These provide people with an opportunity to share their views of the service with the CSCI. Information obtained in this way is discussed with the home without identifying who has provided it. Residents and relatives returned fourteen comment cards; their feedback has been included in the relevant sections of this report. Comment cards were also sent to a number of GP practices, two were returned and overall they were satisfied with the service provided by the home. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Despite the fact that the home is registered to provide care for up to 12 people with dementia there is no evidence that the home offers any specialist care to people with dementia. Working practices continue to be mainly task orientated and focused on meeting physical care needs. Despite changes to staffing levels on the afternoon shift and training there is no evidence that the home is working towards providing a more person centred approach to care. The home must address how it is going to support residents with limited capacity to exercise their rights. More attention must be given to meeting the needs of people who are nutritionally at risk, particularly with regard to making sure that people get snacks and drinks between meals. The home must also look at how mealtimes are organised to make sure that there is enough time for people to enjoy their meals in a relaxed atmosphere. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 7 The home must make sure that the systems for administering medicines do not put residents at risk. Fifteen requirements have been made about these and other issues identified in the main body of the report. 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. Burger Court DS0000029144.V302001.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.V302001.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 3. Standard 6 does not apply to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. In most cases the needs of prospective residents are assessed before they are admitted to the home. Most people said they had been given enough information about the home before they moved in. EVIDENCE: A resident was recently admitted from outside the area and a pre-admission assessment was not done. The home had obtained information from other professionals involved in this persons care and from the family who chose the home on the resident’s behalf. Pre admission assessments had been done for other new residents. Most residents said their families had chosen the home for them, they were not sure if they had received contracts but thought their families probably had. Two residents said they had chosen the home because of a personal recommendation. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Overall the health and personal care needs of residents are met however more attention must be given to developing a person centred approach to the delivery of care. Some of the practices in relation to the administration of medicines place residents at risk. EVIDENCE: Three care plans were looked at in the course of the inspection. The home continues to use a pre printed format, which is personalised to reflect individual needs and preferences. The degree to which care plans were personalised varied but overall the plans set out how health and personal care needs would be addressed. Social care plans are kept separately and are compiled by the activities organiser, she also keeps a separate record of residents’ participation in social events. The care plans are reviewed monthly and there was some evidence that residents and/or their representatives are Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 11 consulted about how care needs will be met. Most relatives said they were kept informed by the home and just over half of them said they were consulted if their relatives could not make their own decisions. Risk assessments were in place relating to pressure sores, falls and nutrition and where necessary care plans had been put in place saying how the risk would be dealt with. One resident had a pressure sore and the Tissue Viability nurse had been consulted about treatment, this is good practice. There were care plans in place saying how the home would manage the care of people identified as being nutritionally at risk. However some concerns were identified about this aspect of care, particularly in relation to the provision of additional drinks and snacks outside of meal times. More details are provided in the Daily Life and Social Activities section of this report. One relative said she was concerned that staff did not always have the time to make sure that people actually got their drinks. One relative said that they would like residents to be able to have baths more often; the records showed that most residents have a bath once a week. Since the last inspection the home has provided a large medicines fridge so that medicines can be stored safely. Secondary dispensing of medicines was observed during the inspection, this is not safe practice and increases the risk of residents being given the wrong medicine. This has been raised at previous inspections. While it was evident that staff are kind and well intentioned the dignity of residents is potentially compromised by some working practices, for example rushed mealtimes and staff not being available to take residents to their rooms so that they can see their visitors in private. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. There are some opportunities for residents to take part in social and leisure activities, which they clearly enjoy and benefit from. However outside of these organised activities there is very little opportunity for residents to take part in any form of social interaction. Generally residents were satisfied with the food but the whole approach to mealtimes needs to be reviewed to make them a more pleasant and sociable occasion for residents. EVIDENCE: There is some flexibility in daily routines and generally those residents who can make their wishes known can exercise some choice and control over their lives. However approximately half of the residents in the home have some degree of dementia and/or some difficulties with communication and for these people the opportunities to exercise choice are fairly limited. There was no evidence of a person centred approach to care and daily routines continue to be focus on the completion of a series of tasks. This has been raised at previous inspections and despite the fact that some training has been provided on dementia care Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 13 there was no evidence that this had led to any changes in working practices. More information on this is provided in the staffing section of the report. The home has an activities organiser who works on average between 16 and 20 hours a week and she organises games, videos, quizzes, sing-a-longs and entertainers. Some residents have been out to the pub and a shopping trip was organised for two female residents. Two residents pay to have companions from Crossroads, one has visits at the home, and the other has regular trips out to the pub or the cinema. It was clear that residents enjoy the activities and have a high regard for the activities organiser. When residents are not involved in organised activities they spend long periods of time either sitting in one of the lounges or in their bedrooms with little or no stimulation and as one relative observed “too much time is spent sitting in the lounge with the TV on”. The home does not have any restrictions on visiting and relatives said they are always made welcome. One person said they could not always have visits in private because there were not always enough staff to take the resident to their room. The home has established links with local Christian churches and services are held in the home for those residents who wish to attend. Generally residents were satisfied with the food and one person said “sometimes there is something I don’t like but they will try to find something else instead”. The home has one resident of Caribbean origin and it was evident that the cook makes an effort to provide some of his favourite meals such as rice and peas. During the inspection the lunchtime meal in the first floor lounge and the teatime meal in the ground floor dining room were observed. On both occasions the meal service was rushed and did not seem to be a particularly pleasant experience for residents. There are 10 people in the home that depend on staff to help them eat their meals. At lunchtime there were 2 staff on the first floor, there were three residents in bedrooms that needed help to eat, this left one inexperienced member of staff in the lounge to look after four residents. The food was not in a hot trolley so it is likely that it would be cool, if not cold, by the time some residents got their meal. At the start of the meal there was not enough cutlery so one of the care assistants had to go downstairs to get some. Later the carer in the lounge had to break off twice from helping a resident to eat, once to go and get napkins and the second time to cut up food for another resident because it had not been cut small enough the first time. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 14 One resident was helped to the table; the remaining three stayed in their armchairs with small tables put in front of them. One resident said she did not like sausages, she was not offered an alternative and agreed to have them because she did not want to cause a fuss. Although there was salt on the table it was not left within her reach. She did not want the drink that was offered with the meal but said she would like a cup of tea at the end of her meal; she did not get it. Another resident said he did not want sausages, he was not asked what he would like but was told he could have mince meat instead. Two residents in the lounge needed staff to help them eat; both had their meals served at the same time. While the care assistant was helping one person the other was repeatedly calling to her to come and help her. When the first resident had finished her meal the carer went to help the second resident who them refused to eat either her lunch or the pudding. During feedback the manager said that this resident would not eat if she saw someone else being helped to eat before her, clearly the care assistant had not been made aware of this. At teatime in the dining there were four residents at one table that needed help with eating, the cook helped one person to eat her main course. There was one care assistant to help the other three residents with their soup and yoghurt and to give the 4th resident her yoghurt. In between she was serving residents at another table and answering the phone and the door. One resident had to wait for the nurse to give him his insulin but his soup was served at the same time as everyone else’s therefore it was cold before he could eat it. The notes from staff meetings showed that earlier in the year the home had been serving meals in two sittings and that this had worked well. It was not clear why this had been changed. None of the three meals served during the inspection were the meals that were shown on the menus displayed in the home. Information on the next meal is put on a board in the dining room but this is of little value to residents, as they do not use the dining room outside of meal times. Information provided by the home showed that supper is served between 7.00pm and 8.00pm however it was not clear how many people actually get supper. The food/fluid charts of three residents, identified as being nutritionally at risk, showed that they were not having anything to eat between teatime (4.30pm approx.) and breakfast. The charts also showed that snacks were not routinely served between meals and in at least one case a resident was regularly only getting 775mls of fluid, despite the fact that the care plan said the daily fluid intake should be 2 litres. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home has the required policies and procedures in place to make sure that complaints’ are dealt with appropriately and that residents are protected from abuse. However more needs to be done to actively promote the rights of residents particularly those with impaired capacity. EVIDENCE: The manager said there had not been any complaints since the last inspection and no complaints were recorded. Three relatives who completed comment cards said they had made complaints but it was not possible to get any further information. Residents said they would talk to the manager or the activities organiser if they were unhappy and most people said that staff listened to them and acted on what they said. Some residents said they never had any reason to complain. Five of the seven relatives who completed comment cards said they were aware of the complaints’ procedure. The majority of staff have attended training on abuse and Adult Protection and are aware that there are different forms of abuse. However working practices in the home do not always support residents in exercising their rights and making choices and decisions. More information on this is provided in the Daily Life and Staffing sections of this report. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Burger Court provides a homely and comfortable environment and generally the home is clean. Improvements are being made and these must continue to make sure that the environment is suitably equipped to meet residents’ needs. EVIDENCE: There is an ongoing programme of refurbishment. Two bedrooms have been completed since the last inspection; one of them has been equipped with an en-suite toilet. The new rooms have been decorated and furnished to a high standard. A new cooker and a carpet shampooer have been provided. Work was in progress on the top floor bathroom at the time of the visit; this is being converted to a shower room, this will be an improvement because the existing bathroom was of limited use. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 17 The manager said the ground floor bathroom will be refurbished next and a central bath will be fitted, this will make it easier and safer for residents and staff. There are two communal toilets on the ground floor but only one is suitable for use by residents who need assistance. The home was generally clean. Residents said the home is usually fresh and clean except on Sunday evenings when they are waiting for the cleaners. The home does not have any housekeeping staff at the weekend. 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. In most of the rooms residents had some of their personal belongings, including photographs, ornaments and personal memorabilia. The majority of bedrooms have door locks fitted, one bedroom provides access to the fire escape, and a door lock that is automatically released when the fire alarm is activated must be fitted to this door. None of the residents in the home at the time of the visit had keys to their bedrooms doors. Valves fitted centrally rather than at individual hot water outlets control hot water temperatures. The home checks the hot water temperatures and the records showed that they are maintained close to 43 degrees C. The temperatures of the hot water in the ground floor bathroom was checked, it was 42 degrees C. An Environmental Health Officer recently inspected the kitchen, the outcome was satisfactory, and some recommendations for good practice were made and are being dealt with. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. There are not always enough staff to make sure that residents needs are met in a timely and consistent way. Despite the fact that the workforce is generally well trained and staff are kind the delivery of care continues to be predominantly task orientated rather than person centred. The recruitment procedures are robust and offer protection to residents. EVIDENCE: In response to concerns raised at the last inspection staffing levels were increased on the afternoon shift between the hours of 2.00pm and 5.00pm. This meant that there was an additional care assistant on duty between 2.00pm and 5.00 pm with responsibility for kitchen duties, giving a total of one nurse and four care assistants until 5.00pm. From 5.00pm to 6.00pm there are 3 care assistants and a nurse and the staffing levels for the evening remain unchanged with one nurse and 2 care assistants on duty between 6.00pm and 8.30pm. This had been changed for the week commencing 4 September 2006 and when the inspection was done the cook who worked until 5.00pm had replaced the fourth care assistant. Despite the fact that the actual number of people on duty was the same the general consensus was that staff would prefer to have Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 19 an extra care assistant until 5.00pm as this person could help with care and the laundry which the cook could not. Because the cook finishes work at 5.00pm care staff still have to clean the kitchen. This and the fact that another member of staff goes off duty at 6.00pm is no doubt a contributory factor to the evening meal being rushed as described in the Daily Life section of this report. Observing staff throughout the day it was evident that they feel under some pressure to complete tasks as quickly as possible, and in order to address this there are a number of issues that the management team need to explore. These include staffing levels and the fact that care staff are responsible for additional duties such as the laundry, some cleaning and some cooking, the dependency of the residents in the home, the physical layout of the building and the fact that it has become custom and practice for all staff to take their breaks at the same time. Despite assurances from the home that there are enough staff from 6.00pm to 8.30pm, (3 in total), to meet residents needs concerns were identified during this inspection that some of the more dependant residents are not getting a supper. Details are provided in the Daily Life section of the report. A number of relatives said they did not think the home had enough staff and one person was concerned that care staff are regularly taken away from care to do other things such as cooking. Residents’ said staff were usually available when they are needed and one person said they always seem to be busy and short staffed. As stated in the Environment section there are no housekeeping staff at the weekend and residents said the home is not always clean on Sunday evenings. Despite concerns about shortages of staff residents and relatives clearly have a high regard for the staff and two people described them as “excellent”. The files of two new staff were looked at and showed that the required checks are completed before new staff start work in the home. Information provided by the home showed that 51 of care staff are qualified to NVQ (National Vocational Qualification) level 2 or above. This National Minimum Standards recommend that 50 of care staff be trained to this level. The home has its own induction checklist and the manager said new staff go straight on to NVQ training following induction. Since the last inspection training has been provided on adult protection, palliative care and dementia care. The manager is responsible for dementia care training and although the home has purchased a video on the subject this is not her area of expertise, this is a concern because as stated previously there is no evidence that the training is changing working practices. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Generally the home is well managed and residents are safe. In order to achieve a good quality outcome the management team will have to demonstrate that the home is working to continuously improve services and to provide an increased quality of life for residents. EVIDENCE: The manager is a nurse with several years experience in the care of older people. She has completed the work for the registered managers award and has submitted her portfolio for assessment. She is supervised and supported in her role by the group area manager. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 21 Residents’ meetings and staff meetings are held approximately every three months. The majority of relatives said were consulted about care needs and kept informed by the home. The home sends questionnaires to relatives throughout the year, 3 were returned in April 2006 and generally showed that people were satisfied with the service. The area manager visits the home at least once a month and audits different aspects of the service, the CSCI is provided with a report following these visits. The home collects pensions on behalf of four residents, these are long standing arrangements, and the manager is continuing her efforts to find independent advocates to take over this responsibility. The home does not get involved in dealing with the financial affairs of new residents. Residents’ monies are dealt with at the company head office; money collected on behalf of residents is paid into a separate bank account. No personal allowance money is held in the home, when residents want money it is given from petty cash and reclaimed from head office. Records are kept of all transactions and invoices are issued for sundry services provided to residents such as chiropody. The administrator said residents could have their money whenever they want it; if she is not there she can be contacted and will come in with the keys. There is a system for staff supervision and the records showed that supervision is more or less up to date. Information provided by the home showed that most of the equipment and installations are checked and serviced at the required intervals. The testing of portable electrical appliances was overdue and some new small electrical items had not been tested before being put into use. The fire safety systems are checked weekly and fire training was up to date. Moving and Handling training for staff was overdue; the manager said a manager from another home within the group provides this. The maintenance man is responsible for checking bed rails and the manager said he is kept up to date with information related to the safe use of bed rails. There were a large number of bed rails in use and the home should review this to make sure that they are only being used where necessary. Staff were observed moving residents in wheelchairs without making sure the footplates were in place. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 22 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 2 2 X X 2 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 23 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 OP2 Regulation 5A Requirement For residents in receipt of a “nursing contribution” as defined in the Care Homes Regulations the Terms and Conditions must include specific information about this, including the amount to be paid, the date of payment and how it is to be taken into account in calculating the fees. The registered persons must continue to develop the care planning systems to make sure that; a) The care plans set out in detail how all the needs identified during assessment will be met and b) The delivery of care is in accordance with the instructions set out in the care plans. The registered persons must make proper arrangements for the safekeeping, administration, and recording of all medicines. Previous timescale of 31/03/06 not met. Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 24 Timescale for action 15/12/06 2 OP7 15 15/12/06 3 OP9 13(2) 15/12/06 4 OP10 & OP18 12 5 OP12 12 & 16 The registered persons must make sure the home is conducted in a way that respects the privacy and dignity of residents and promotes the rights of residents to exercise choice and control over their lives. The registered persons must ensure that daily routines are varied and flexible and take account of the needs, preferences and capabilities of service users. Previous timescale of 15/07/05 and 31/03/06 not met. 15/12/06 15/12/06 6 OP14 12 7 OP15 16 8 OP20 23 9 OP24 12 The registered persons must make sure that the home is conducted in a way that supports all residents to exercise choice and control over their lives. The registered persons must make sure that residents have a varied and nutritious diet that meets their assessed needs and takes account of their dietary preferences. The interval between meals, including snack meals, must not be longer than 12 hours. The registered persons must make sure that the path that provides disabled access is repaired and maintained in a safe condition. Door locks must be provided on all bedroom doors and residents must be provided with a key to their room unless there is a documented risk assessment indicating the reasons why this would not be appropriate. Bedrooms that are fire exists must have door locks that are automatically released when the fire alarm is activated. DS0000029144.V302001.R01.S.doc 15/12/06 24/11/06 24/11/06 15/12/06 Burger Court Version 5.2 Page 25 10 11 OP26 OP27 16 18 The home must be kept clean 24/11/06 and free of offensive odours at all times. The registered persons must 24/11/06 ensure that there are at all times suitably qualified, competent and experienced staff in sufficient numbers to meet the needs of service users. Previous timescale of 15/07/05 & 31/01/06 not met. Staff must receive training that 15/12/06 is appropriate to the work they perform from a suitably qualified person. 22/12/06 The registered persons must establish and maintain a system for evaluating the quality of the services provided at the home. They must provide the CSCI with a report which describes the extent to which, in their reasonable opinion, the home a) Provides good quality services and b) Takes account of the views of service users and their representatives on what services are to offered and the manner in which they are to be provided. The report must include details of any measures the registered persons are going to take to improve the quality and delivery of services. Tests on portable electrical appliances must be done at least once a year. New electrical appliances must be tested before they are put into use. The registered persons must make sure that all staff have moving and handling training at least once a year. DS0000029144.V302001.R01.S.doc 12 OP30 18 13 OP33 24 14 OP38 13(4) 24/11/06 15 OP38 13(5) 24/11/06 Burger Court Version 5.2 Page 26 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. Refer to Standard OP7 Good Practice Recommendations Care staff should be encouraged and supported in recording details of personal and social care in the service users plans. Carried forward from the last inspection. Consideration should be given to improving the availability of disabled access toilets on the ground floor. Carried forward from the last inspection. The manager should inform the CSCI when obtains confirmation that she has successfully completed the Registered Managers Award. The home should review the use of bed rails to make sure that they are only being used in response to an identified risk. 2. OP21 3 4 OP31 OP38 Burger Court DS0000029144.V302001.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 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.V302001.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. 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