Inspection on 15/06/05 for Burgess House

This inspection was carried out on 15th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Burgess House 02/03/07

Burgess House 21/11/05

Burgess House 22/10/04

Burgess House 30/07/04

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Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Burgess House 236 Felixstowe Road Ipswich Suffolk IP3 9AD Lead Inspector John Goodship Announced 15 June 2005 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Burgess House Address 236 Felixstowe Road Ipswich Suffolk IP3 9AD 01473 588500 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Suffolk County Council Ms Mandy Cattermole Care Home 10 Category(ies) of LD Learning Disability (10) registration, with number of places Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22/10/04 Brief Description of the Service: Burgess House is a local authority resource providing respite care and short breaks for younger adults (namely those under 65 years old) with learning disabilities. The house and grounds are owned by Mencap, but managed and supported financially by Suffolk County Council’s Social Care Services. Staff are County Council employees. The people who use the service are known as ‘guests’. They go to their normal day care service, returning to Burgess House in late afternoon. People come to live at the home mostly for short periods of time, from a day or two to a weekend, seven days to a couple of weeks. Occasionally it is used for what are termed ‘emergency placements’ because no other accommodation can be found and guests then may stay for a number of weeks or months.Referrals are made for the service through the Community Care Team. A new day resource building has been built at the rear. There is a separate entrance for day attenders. A new office for the Home manager is also included. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and was the first in the current inspection year. The manager was on sick leave, but the senior care support worker and the residential resource manager from another respite service were present. Although the day service provided in the new extension is not required to be registered with the Commission, the facilities were inspected, as short stay guests used the shower and WC rooms, as well as the main room as a lounge during the evenings and at weekends. The home is registered for up to 10 users at any one time, but in fact is currently providing a service to 77 families. The home continues to meet all the standards inspected. What the service does well: What has improved since the last inspection? The extension, although providing a day resource to outside people, has also given guests more facilities, such as another sitting room with access to the garden, and an assisted shower room and WC. There were no requirements or recommendations from the previous inspection. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 6 What they could do better: 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. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Guests are fully informed about the respite stays, and given every opportunity to decide if Burgess House is right for them. EVIDENCE: The Home had a complete Statement of Purpose, and a Service Users Guide. Strenuous efforts were made by staff to assess whether the home could meet the individual needs of the people referred to the service and to ensure the compatibility of the people concerned. The process often started while the person was still in school. Carers assessments were also made by the social worker. Copies of these were held in the guests’ files. Family visits, day visits by the prospective user, and overnight stays were offered until the person was sure that they wished to come to Burgess House for their respite stays. In all cases a review meeting was held within 3 months to confirm that the home was providing the required support. Each service user had a contract. There were 2 long staying ex-emergency guests. One was due to move to other accommodation shortly, although further risk assessments would be done before a date was set for the move. The second long staying guest would be assessed for a move when the family’s ability to support the person was clearer. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 9 Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9. Guests look forward to staying at Burgess House because it provides a friendly and supportive environment, according to their individual needs. EVIDENCE: Each guest had a Care Plan, which contained their profiles and information on preferences. The needs of people using the service were identified, with action plans to meet them. Specific risk assessments were carried out, including the opportunity to allow independence within limits. As guests only stayed for short periods at a time, the home had to ensure its plans were linked to what the guest did when not at Burgess House. One relative explained how helpful the staff had been at a difficult time for the family due to bereavement and illness. Staff had been most patient with the guest and an improvement was evident in the way the guest interacted with other residents. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,14,15,17. Guests continue their normal routines of daily living and activities while staying in the House. They are supported to develop social relationships and activities. EVIDENCE: Guests attended their usual day resource centres during the week. For some this meant attending the new 40 Plus centre attached to Burgess House. This contained a large activity area which reverted to a sitting room configuration in the evenings, an assisted shower room, and the main office for the House. Weekend activities were arranged by the home. Family contact was a key part of the assessment and on-going reviews. There was a 5-week menu, which provides for full meals at breakfast and evening. Packed lunches were provided for those going off-site for day care. Staff knew the likes and dislikes of the people using Burgess House. Special diets were catered for. From discussion, it was clear that staff knew the guests well, and care plans showed that, in some people, their behaviour and interaction had improved. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 12 Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20. Residents’ health needs are identified, monitored and action taken with professional advice. EVIDENCE: Examples in care plans showed that guests’ health was closely monitored and professional advice sought as needed. Pre-admission assessments identified health care issues to ensure the staff were aware of the action to be taken, and if necessary, had been trained appropriately. The guests brought in their medication for each short stay. This was recorded as was the medication remaining when they went home. Simplified MAR charts were used, and a controlled drugs book. The latter was only being used to record the administration of Temazepam, often with the service user’s signature. A new fridge had been installed in the old office for drugs required to be kept below room temperature. The fridge was not lockable but the room itself was controlled by keypad entry. Training in administration was done by the supplier, and certificates recording training were in staff files. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Guests and relatives are in close touch with the home and can raise issues before they become complaints. Staff are well trained to protect guests from abuse. EVIDENCE: The home had a Complaints Procedure, which had been produced in a user friendly format for guests and relatives. The manager and some staff had completed POVA training. Staff did not act as appointees in respect of benefit payments. The home had received one complaint in the previous 12 months. This followed a change in the arrangements for booking respite stays. The staff had instigated a POVA referral after witnessing abusive behaviour. No member of staff was involved in this incident. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30. Communal and bathing facilities have been improved with the extension, giving guests more choices. EVIDENCE: There had been no change in the guest rooms. They continued to meet the National Minimum Standards. One room was used by a guest with continence problems. Although there was a slight smell of urine in the room, the home had taken all reasonable measures to change the behaviour of this guest and to clean the room thoroughly after each stay. The flooring had been changed to improve cleaning and hygiene measures. The new day centre extension had given guests access to some new facilities, a shower room and a WC, for use separately from the day activities. They could also use the main room as an additional lounge area in the evenings and at weekends. The dining room had been re-decorated and re-carpeted. Although the people using the short break service cannot be guaranteed that they would always be allocated the same bedroom, every effort was made to accommodate individual wishes. Where a guest had special physical needs his Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 16 or her stay could well be arranged so that the same bedroom was provided because of the specialist equipment in situ. Some laundry was done for guests, but mostly their laundry was bagged and went home with them at the end of their stay. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36. Guests benefit from well-trained staff, who know them well in spite of the short stays. EVIDENCE: Staff records showed that a comprehensive training programme was available to meet staff needs, and to meet needs presented by guests, particularly communication and behavioural needs. Recruitment practice followed national standards and the required documentation was stored in staff files. Staff received regular supervision. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42,43. Guests live in a cheerful, well-staffed and safe home with good relations and interactions with the staff. EVIDENCE: The provider had proposed some changes in the management arrangements of this and another short stay home. These proposals were being processed by the Commission. Guests and their relatives were regularly consulted about aspects of the home. There were 77 families receiving the support of the respite service and discussions had been held with them about the newly introduced booking arrangements. The home did not believe that any family would be disadvantaged by the changes. Health and safety procedures and records were complete and up-to-date. Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Burgess House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 20 NO Are there any outstanding requirements from the last inspection? 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 Regulation NONE Requirement Timescale for action 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 NONE Good Practice Recommendations Burgess House I54 - I04 S37332 Burgess House V228905 050711 Stage4.doc Version 1.30 Page 21 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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. 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