Inspection on 02/03/07 for Burgess House

This inspection was carried out on 2nd March 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 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 21/11/05

Burgess House 15/06/05

Burgess House 22/10/04

Burgess House 30/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

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 Burgess House 236 Felixstowe Road Ipswich Suffolk IP3 9AD Lead Inspector John Goodship Key Unannounced Inspection 2nd March 2007 13:10p DS0000037332.V331054.R01.S.doc Version 5.2 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 DS0000037332.V331054.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 Adults 18-65. 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. DS0000037332.V331054.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burgess House Address Burgess House 236 Felixstowe Road Ipswich Suffolk IP3 9AD 01473 588500 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) Suffolk County Council Ms Mandy Lena Cattermole Mr Robert Illingworth Care Home 10 Category(ies) of Learning disability (10) registration, with number of places DS0000037332.V331054.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2005 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 Councils 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. DS0000037332.V331054.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and covered the key standards which are listed under each Outcome group overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. The inspection took place on a weekday afternoon. Both managers were present, together with staff on the late shift. The inspector toured the home, and spoke to some of the staff. The day of the visit was the change-over day, and some guests started to arrive from mid-afternoon onwards. The inspector also examined care plans, staff records, maintenance records and training records. A questionnaire survey was sent out by the Commission to guests and to relatives. Ten relatives responded and nine guests. All the latter had been completed by the relative. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. The home was originally registered for ten places. However, as all bedrooms had now been furnished as single rooms, the home only accepted eight guests at a time. The service is currently providing respite breaks for 95 families. Although the day service provided in the 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. What the service does well: The staff have to be capable of getting to know their guests for the brief time they are in the home on each visit. They not only do that successfully, but can support guests to manage any challenging behaviour, particularly towards others, while they are in the home. This was confirmed by comments from relatives. The staff cope well with the ever-changing population, and with the occasional emergency admissions. The home has ways of getting regular feedback from guests and families, which is essential with so many families involved. Guests are given every opportunity to ensure that Burgess House will be the most appropriate place for their respite care, through information, assessments and visits. Burgess House provides a supportive environment, according to their individual needs. Their specialist needs are met to encourage maximum independence. DS0000037332.V331054.R01.S.doc Version 5.2 Page 6 In the short periods of time which each person stays at the home, staff ensure that they are able to continue their normal activities. The home has good links with families for whom the respite care is a much-appreciated resource. Guests are protected by proper medication procedures and staff training, and are able to follow whatever administration practice is usual for them when at home. Staff respond to complaints, and are alert to any evidence of abuse. Guests are protected with appropriate safety and security devices. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. DS0000037332.V331054.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection DS0000037332.V331054.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Quality in this outcome area is good. Guests and their families are given every opportunity to ensure that Burgess House will be the most appropriate place for their respite care, with prior information, assessments and visits. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and the Service Users’ Guide contained all the items of information required by regulation. They both contained a simple signing sheet for those without verbal communications. This was part of the “Having your say” policy of the provider which encouraged comments, compliments and complaints about Social Care Services. Both documents also contained information about how to complain about the home initially through the manager, or alternatively the Director of Social Care Services or the Commission for Social Care Inspection. The Service Users’ Guide also included three examples of completed end-of-stay questionnaires. The Service Users’ Guide was to be updated to include the manager’s recent NVQ Level 4 success. His name and qualifications were to be added to the Statement of Purpose, although they were already included in the Service Users’ Guide. DS0000037332.V331054.R01.S.doc Version 5.2 Page 9 There was a copy of the Guest Contract in the Service Users’ Guide, which included clear information on the level of fees, stated on a per night basis, as well as how these fees would be charged, what they did not cover, and what spending money guests should bring with them. The manager discussed two guests whose birthdays were imminent, when they would reach 65 years of age. Advice was given after the inspection on seeking a variation to cover ageing guests. Pre-admission assessments were seen in the care plans, together with records of visits to Burgess House by new guests. Residents commented that they were initially shown round by the staff before they started, who put them at their ease. Some relatives pointed out that this was the only resource for respite care in Ipswich, so choice was limited. The service was currently providing support to about 95 families. Respite breaks are usually either 5 days Monday to Friday, or a weekend stay, or a two week holiday break. The home was originally registered for ten places. However, as all bedrooms had now been furnished as single rooms, the home only accepted eight guests at a time. A variation to the home’s registration was to be made to the Commission. DS0000037332.V331054.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10. Quality in this outcome area is good. Care plans show that guests are supported to maintain independence, and to continue their activities so that there is no interruption because of the stay in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were examined. They were both of similar layout, with sections on risk assessments, medication, finance records, pre-admission assessments. They also had a useful profile which summarised the care needs, and likes and dislikes of each guests. As guests only stayed for short periods at a time, it was important for the home to find out what the normal daily routines and activities were for each guest when not at Burgess House to ensure continuity where possible. This information was logged in the care plan. DS0000037332.V331054.R01.S.doc Version 5.2 Page 11 The guest contract set out the number of nights allocated to that user for respite for the year, together with the cost. Frequency of stays were assessed by the community team and agreed with the families. Risk assessments included, amongst others, moving and handling, epileptic episodes, poor circulation in the feet, and the need for staff to control the level of mobility after surgery. The finance records detailed the amount of cash which the guest brought into the home on each stay, and the amount they took home. A previous matter, which the Commission had been notified about, had shown that the home handled personal information in a confidential and secure way. DS0000037332.V331054.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. In the short periods of time which each person stays at the home, they are able to continue the activities and interests they enjoy while at home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Guests were expected to continue to attend their usual day resource centres during the week. For some this meant attending the 40 Plus centre attached to Burgess House. This extension at the rear of the property 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. Family contact was a key part of the assessment and on-going reviews as evidenced in the care plans. It is unusual for families to visit the home during the respite break. DS0000037332.V331054.R01.S.doc Version 5.2 Page 13 Guests staying for a weekend could, according to the Service Users’ Guide, go out to the nearby shops, or the cinema, the local pub, or the park. None of the guests replying to an end-of-stay questionnaire had in fact been out during their weekend stay. The guest contract made clear that staffing resources usually meant that it was not possible to accompany guests to regular clubs or meetings. Parents/carers were asked to make arrangements for this. The kitchen was following the “Safer food, Better business” approach to quality assurance in catering. The chef reported that the kitchen had been deepcleaned a fortnight prior to the inspection. The dry goods store was well stocked. It was locked as it contained the kitchen knives, and the drug fridge. There was a 5-week menu, which provided 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 the behaviour and interaction of some guests did improve during their stays. DS0000037332.V331054.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Quality in this outcome area is good. Guests can be assured that their health needs will be identified and monitored, and appropriate action taken. They are protected by proper medication procedures and staff training, and are able to follow whatever administration practice is usual for them when at home This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examples in care plans showed that guests’ health was closely monitored and professional advice sought as needed. The care plans held records of any contacts or visits by health professionals. 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. Medication was brought in by guests to cover the duration of their stay. A letter of authorisation signed by the GP had to accompany all medication and be in the original containers clearly marked with the person’s name, the date DS0000037332.V331054.R01.S.doc Version 5.2 Page 15 dispensed and the correct dosage. Details of these were recorded at the beginning and the balance at the end of each stay. Simplified MAR charts were used, and there was a controlled drugs book. The latter was only being used to record the administration of Temazepam. Training in administration was done by the pharmacy supplier, and certificates recording training were in staff files. A new drug cupboard had been installed since the last inspection together with a drug fridge. The fridge was now kept in the dry goods store which was lockable, as the former office had become a fire route and was therefore no longer secure. . DS0000037332.V331054.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. Guests are enabled to express any concerns and staff are alert to any evidence of abuse in order to protect guests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no complaints since the last inspection. The home’s complaints policy incorporated the County Council policy called “Having your say”. It was available in a pictographic format in the home. All of the ten relatives who replied to the pre-inspection survey said they had never had to make a complaint. Staff training in the protection of vulnerable adults was recorded, and staff were able to describe the action they would take if any abuse was alleged. This had been tested at the time of the previous inspection when appropriate action had been taken by staff on a matter of concern. DS0000037332.V331054.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,30. Quality in this outcome area is good. Guests stay in a comfortable and safe environment with appropriate facilities and aids. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were eight single bedrooms. None were en-suite but all had a wash hand basin. Although the people using the short break service could not 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 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 DS0000037332.V331054.R01.S.doc Version 5.2 Page 18 such as soiled underwear, but mostly their laundry was bagged and went home with them at the end of their stay. There was a bathroom on each floor, and two shower rooms downstairs, one with a ceiling hoist. The downstairs bathroom had a Malibu bath with a hoisting chair. The room was spacious enough for wheelchair access. There was some paint peeling off behind the WC. One bedroom was fitted for guests who needed to be hoisted. Slings with guests’ names on them were kept in the wardrobe. The hot water was tested in this room and measured 40°C. All guest rooms had been fitted with automatic electronic door closers linked to the fire alarm. DS0000037332.V331054.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. Quality in this outcome area is good. Guests are protected by the home’s recruitment procedures, and through its training commitment guests benefit from being cared for by competent staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been no new staff appointments since the previous inspection. On previous inspections, recruitment files contained the required identification and verification checks, with induction and training programmes in place. Supervision schedules were available and records were kept in staff files. Four staff were trained as moving and handling risk assessors. One of the managers was to be trained as the workplace handling co-ordinator. Training for staff is organised for the year. The majority of the training is done on site. The home is closed on training days. It had been closed for three days in October 2006. These dates were notified in advance as unavailable. The Commission was also informed. The training on those days covered Food DS0000037332.V331054.R01.S.doc Version 5.2 Page 20 Hygiene, COSSH, Sensory Awareness, Unisafe, and the Protection of Vulnerable Adults. There were two staff with NVQ Level 4, eight with Level 3 and three with Level 2. Relatives commented that staff were very understanding and would always listen and try to make any adjustments. One said that their relative liked the staff. DS0000037332.V331054.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. Guests benefit from staying in a well-run home with their health and safety protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were two people registered as joint managers. One worked full-time, the other part-time. Management tasks were divided between them although good communications meant that each was aware of the whole picture of activity in the home. Staff confirmed that the split role caused them no problems, as they knew who to go to on various issues. DS0000037332.V331054.R01.S.doc Version 5.2 Page 22 The home conducted a survey of relatives annually about how the allocations system works for them. The last survey showed a 93 satisfaction rate. Guests also complete an end-of stay questionnaire, examples of which were included in the Service Users’ Guide. Relatives normally acted as advocates for guests, according to staff, although staff felt able to take on that role in certain circumstances. The Commission was aware of an instance where this had been done following concern about a guest’s relations with their family. Health and safety records were examined. The home did an analysis of incidents and accidents which would be helpful in highlighting any trends. There were records of weekly checks on hot water temperatures of baths and showers, and monthly checks of hand wash basins. Fire alarms were tested weekly by staff and quarterly by an outside contractor. There had been a visit from the Fire Officer in July 2006 which recommended attention to a number of matters. Evidence was seen of action taken, including the testing of emergency lighting, and the training of staff. DS0000037332.V331054.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000037332.V331054.R01.S.doc Version 5.2 Page 24 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. Standard Regulation 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. Refer to Standard Good Practice Recommendations DS0000037332.V331054.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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. 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