CARE HOMES FOR OLDER PEOPLE
Burlam Road Nursing Home 113 Burlam Road Middlesbrough TS5 5AR Lead Inspector
Julia Connor Unannounced 15 July 2005 09:50 am 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 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. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Burlam Road Nursing Home Address 113 Burlam Road Middlesbrough TS5 5AR 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) 01642 824947 Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Heath Care) Ms Karen Miller Care Home 50 Category(ies) of OP Old age (50) registration, with number of places Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th November 2004 Brief Description of the Service: Burlam Road is a care home providing both nursing and personal care for older people. It is a two storey purpose built home, with an extention, providing single and double accommodation for 50 Residents; the 38 single bedrooms are a minimum of 10 sq.m. and the 6 double bedrooms are a minimum of 16 sq.m. There is a passenger lift giving access to all floors. There are three lounges, one on each floor and the third in the extention and a large communal dining room on the ground floor and a smaller dining room in the extention. The home is close to local shops and amenities with a car park at the front of the home. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out over two days; the reason for this was the Inspector was unable to access some information due to the Manager being at a meeting. The first visit on the 15th July 2005 commenced at 9.35 a.m. and concluded at 12.05 p.m. The second visit on the 18th July 2005 commenced at 9.50 a.m. and concluded at 12.50 p.m. Six Residents and two members of staff were spoken to during the inspection. What the service does well:
Many of the staff have worked at the home for many years and have a good knowledge of the Residents they care for. One Resident who spoke to the Inspector spoke highly of the staff calling them wonderful and that she could not ask for better care. She stated that as soon as she entered the home she got a good feeling about it. She stated that she gets treated as an individual and with respect and dignity by the staff, who told her that Burlam Road was her home. This Resident stated that she likes her bedroom and has recently had a fridge installed for her water and her family and friends often bring her in juice and cream cakes. She stated that she had chosen to eat in her bedroom and the staff have respected her decision and bring her meals to her. She stated that the food served to her was good and an alternative was always available and was pleased to tell the Inspector that she had gained weight since her admission to the home. She stated that she like to read, complete cross words and watch TV. Another Resident who spoke to the Inspector stated that the home was very good, much better than the previous home he had been in. He stated that the girls who looked after him were great and that he could do what he wanted when he wanted. He stated that the food was nice and he could have what he wanted. He stated that the Manager was very good and if he had any concerns he would speak to her. He stated that his wife was always made welcome and his Grandson took him to watch the cricket and football on a weekend. He stated that he goes home every Saturday and has made friends in the home. Another Resident who spoke to the Inspector stated that it was not as good as being at home but the staff was helpful when they had the time, but she felt that there was insufficient staff on duty. She stated that the staff did not rush her but they were always so busy. She stated that she was always treated with respect and dignity and if she were unhappy about anything she would speak to the Manager.
Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 6 She stated that there were plenty of activities, something every afternoon. She stated that she enjoyed the library, which visited the home every three weeks and sitting on the patio in the sun. Another Resident that spoke to the Inspector stated that he choose Burlam Road himself and had to wait for a bed to become available. He stated that he was very happy and had no complaints. He enjoyed sitting with other male Residents for his meals and he felt the home was like one big happy family, and he enjoyed the company. He stated that the girls were lovely and that he was always treated with respect and dignity. He stated that he enjoyed staying in his bedroom as he liked his TV but he and his niece always went downstairs for the race night. He went onto say that he receives Holy Communion every week and that was very important to him. If he had any concerns he would speak to the Manager and she would look into it for him as she was very good and always had a joke with him. He stated that the food was good and that he enjoyed his meals. The last Resident who spoke to the Inspector stated that the staff was good but she was concerned over how busy they were and that the shifts were long and the staff often appeared tired. She stated that if she had a complaint she would speak to the Manger about it. 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. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 8 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 standard(s) 3. Residents are assessed prior to being admitted to the home. EVIDENCE: There was evidence in the care files that the home received information from the Social Worker or discharging ward regarding the Resident prior to them being admitted to the home. A member of the home staff also visits the Resident prior to admission to ensure that the home can meet the prospective Residents needs. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8 and 10 The Residents health, personal and social needs are recorded in an individual plan of care. The Residents health care needs are met and Residents are treated with respect and dignity. EVIDENCE: Four sets of Residents care files were audited and all contained an adequate amount of information. There was evidence that Residents or their representative had had access to their files and agreed the plans of care. The Residents have access to out side health professionals e.g. Doctor, District Nurse, Dentist and Optician. The Residents who spoke to the Inspector stated that the staff always treats them with respect and dignity. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12, 13, 14 and 15 Residents are satisfied that the home meets their social, religious and recreational needs. Residents maintain contact with family and friends and are encouraged to take control over their lives. Residents are served a wholesome and balanced diet. EVIDENCE: The home employs an activity organiser. The Residents who spoke to the Inspector stated that there were regular activities such as Bingo, Play Your Cards Right and Darts; and that the visiting library ensured they always had something to read. The Residents also stated that they liked to sit on the patio and attend the race nights that were held at the home. One Resident stated that she preferred to stay in her bedroom and read, watch TV or do her cross words. One Resident was very pleased that he still received Holy Communion on a regular basis. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 11 The Residents who spoke to the Inspector stated that they maintained contact with their family and friends. One Resident stated that he goes home every Saturday and that his grandson takes him to watch the cricket and football. Another Resident was waiting for her daughter to visit her with her new grandchild. Residents stated that they are encouraged to be as independent as possible but knew that the staff were there for help and assistance. The Residents stated that they felt their choices were respected. The Residents stated that the food was good, however two Residents stated that there were occasions when the beef was not up to standard. All of the Residents stated that there was an alternative offered if they did not like what was on the menu. One Resident stated he liked it when the cook made her own cakes. On the day of the inspection the kitchen was clean and there was a good stock of dried food. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 Residents are confident that their complaints will be listened to seriously and action taken. EVIDENCE: There is a complaints policy and procedure in place, which outlines the stages the complainant should take to make a formal or informal complaint. The Residents who spoke to the Inspector stated that they would speak to the Manager if they had any complaints or concerns and were confident that she would take the appropriate action. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19, 20, 23, 24 and 26 The Residents live in a clean, hygienic and well-maintained environment and have access to comfortable indoor and outdoor communal facilities. Resident’s bedrooms meet their needs and are personalised to their wishes. EVIDENCE: On the day of inspection the home was clean, pleasant and odour free. The Residents who spoke to the Inspector were satisfied with décor of the home. The Residents use the patio area at the front of the home during the fine weather. One Resident informed the Inspector that there was going to be an awning for the patio area, as it could get very hot with no shade. Resident’s bedrooms met their needs. All of the double bedrooms are currently being used as single bedrooms, and are predominantly used by the younger Residents being cared for in the home, e.g. in one bedroom there is an overhead hoist to promote the Residents mobility and independence.
Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 14 The bedrooms had been personalised by the Resident or their family members. One Resident had just had a fridge bought for her by her family so that she could keep her drinks cold; she informed the Inspector that her family and friends also brought her cream cakes, which she now kept in her fridge. One Resident told the Inspector that she liked her bedroom as it was at the front of the home and she could see what was going on outside. Another Resident had a computer in his bedroom, which he used for the homes newsletter. The carpet in bedroom 9 needs to be replaced due to general wear and tear. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 and 30 Staff are being trained to NVQ level 2 which should ensure that they can meet the Residents needs. The Residents are protected by the home’s recruitment practices and the staff receives training to do their jobs. EVIDENCE: The home now has 55 of the staff trained to NVQ Level 2 or 3. Six personnel files were audited; all contained the required information as stipulated in Schedule 2 of the Care Homes Regulations 2001. The following is an example of the training that has taken place: Manual Handling. Fire Awareness. Challenging Behaviour. Dementia. Diabetes Infection Control. First Aid. Wound Care. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 35 and 36 A person who is fit to be in charge manages the home. The home is financially viable. The Residents personal finances are safeguarded. Staff receive formal supervision. EVIDENCE: The Manager has the nursing qualification to ensure that the needs of the Residents are met. The Residents and staff spoke well of the Manager. The Commission for Social Care Inspection has received evidence that the home is financially viable. The Residents combined monies are kept in an interest bearing account; at the end of each year the interest accumulated goes into the Residents Activity Account.
Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 17 The Inspector was told that there was no evidence to show that the Residents were satisfied with this arrangement but a letter was due to go out to Residents asking for their agreement to this arrangement. Six personnel files were audited and all contained supervision documentation. The staff that spoke to the Inspector confirmed that they received regular supervision. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x 3 3 x x 3 STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x 3 3 3 x x Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 19 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 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. 2. 3. Refer to Standard OP19 OP31 Good Practice Recommendations The carpet in bedroom 9 should be replaced due to general wear and tear. The Registered Manager should have a qualification at NVQ Level 4 in Management or equivalent by 2005. Burlam Road Nursing Home B51-B01 S154 Burlam Road V235572 150705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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