Inspection on 07/01/09 for Burleigh House

This inspection was carried out on 7th January 2009.

CSCI found this care home to be providing an Good service.

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

Burleigh House 09/01/08

Burleigh House 11/05/07

Burleigh House 08/12/06

Burleigh House 14/06/06

Burleigh House 19/01/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burleigh House 41 Letchworth Road Baldock Hertfordshire SG7 6AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Greaves     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Burleigh House 41 Letchworth Road Baldock Hertfordshire SG7 6AA 01462893216 01462894799 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Manage Care Homes Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 19 Number of places (if applicable): Under 65 Over 65 19 19 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 Burleigh is a detached Edwardian House situated in a residential area of Baldock. It is close to the A1 and within easy walking distance of local amenities and shops. The home has nineteen single rooms; ten with en-suite shower facilities and all are on the ground floor. In all there are fourteen toilets, one assisted bathroom, one assisted shower room, a conservatory which is used as the communal lounge, a dining room and small lounge area in the dining room. There is ample parking to the front of the home and a small patio next to the conservatory and a small paved area with seating in the garden to the rear of the building. Accessed via steps in the rear garden is a large wooden building, which provides open plan office accommodation for the manager and the proprietors and is also used for meetings. Information regarding the service is available in the Statement of Purpose and the Service User Guide. These and Care Homes for Older People Page 4 of 27 Brief description of the care home a copy of the most recent inspection report are freely available on request from the manager or proprietor of the home. A copy of the report is also available from the Commission for Social Care Inspection, whos contact details are on the back page of this report. Fees at the time that this inspection took place, range from £450 to £650 per week. Charges for additional services such as hairdressing and chiropody are explained in the individual service contracts. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key site visit that took place over 6 hours. The previous key inspection of this service took place on 9th January 2008 At this visit we considered how well the home meets the needs of the people living there and how staff and management support people. A tour of the premises was undertaken, care records, staff records, medication records and other documents were assessed. Time was spent talking to, observing and interacting with people living at the home, visitors and staff. Care Homes for Older People Page 6 of 27 Prior to the site visit the manager had completed and sent into the Commission for Social Care Inspection the homes Annual Quality Assurance Assessment (AQAA). This is a self assessment document required by law and tells us how the service feels they are meeting the needs of the people living at the home and how they can evidence this. Before the site visit a selection of surveys with addressed return labels had been sent to the home for distribution to residents, relatives and staff. Views expressed by visitors to the home during the site visit and in surveys responses have been incorporated into this report. Feedback on findings was provided to the manager throughout the inspection and the opportunity for discussion and clarification was given. We would like to thank the residents, the manager, the staff team and visitors for the help and co-operation throughout this inspection process. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People making Burleigh House their home can be confident that a robust assessment process ensures their needs can be met. Evidence: The manager, residents and staff had worked together to develop a DVD all about daily life at Burleigh House. The DVD, together with a detailed and clear Statement of Purpose and Service User Guide provided good information about the home to help prospective residents decide whether it was the right home for them. The Statement of Purpose and Service User Guide were also available in large print. Residents contributed to the Service User Guide by writing articles on their experiences of living at the home. We looked at the pre admission assessments for 3 people recently admitted to Burleigh House. These showed us that the manager carried out in depth assessments Care Homes for Older People Page 10 of 27 Evidence: of peoples needs to ensure that the home could safely meet all their care and support needs such as mobility or dietary needs and preferences before they entered the home permanently. Each person was offered a taster day to sample life at the home and meet other residents. A one month trial period of occupancy was built into the contract. The Statement of Purpose stated that a review involving the resident, their family or representative, staff and management takes place at the end of the trial period to ensure all parties are confident that the home could meet all the individuals needs according to their wishes and preferences. A family member we spoke with confirmed this review meeting was very comforting as it provided them confirmation that both their relative and the home were happy to continue with arrangements as they were. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Burleigh House receive good quality care Evidence: We looked at the care plans for 3 people living at the home to confirm there was appropriate information for care staff to follow to meet peoples assessed personal and support needs. The plans sampled included good information about the person, their social/cultural background, early life, employment, relationships, major life events and medical history. The files sampled contained pre admission assessments from the Local Authority Adults Care services and Burleigh House. These assessments formed the basis of the care plans addressing such areas as nutritional assessment and monitoring, risks of falls, pressure area care and mobility. The care plans provided clear detail for care staff to follow to ensure peoples needs were met. For instance, how one person needed clear, gentle verbal instruction from staff when mobilising so as not to make them anxious and how another person preferred to be helped to bed and what their exact bedtime routine entailed so they could settle for a good nights rest. All care plans we looked at confirmed that residents and/or their representatives Care Homes for Older People Page 12 of 27 Evidence: were consulted about their care plans and involved in regular reviews to ensure the home continued to meet peoples individual needs. Daily recording varied in the care plans sampled. We saw instances where the term all care given had been recorded. This did not provide clear information about what personal care and support had been provided for people. We looked at the storage and administration of medication within the home. Medication was stored in a lockable trolley that was secured to a wall when not in use. We observed care staff giving people their lunchtime medication. This was done with patience and without rushing anyone. Medication Administration Records were completed without any gaps in recording, this meant it was possible to identify which residents had taken their medication. There was a secure facility for the storage of controlled medication. The registered manager was able to demonstrate that all staff responsible for administering medications had attended appropriate training, delivered by an external pharmacy. Staff told us that the training had involved a pharmacist spending a whole day at the home, observing staff administering medication and undertaking an audit of the medication held. People we spoke with during the course of this visit told us they felt the staff respected their dignity and privacy at all times. The managers AQAA told us that do not disturb signs had been introduced for people to use for added privacy. On the day of this visit we saw various documents and books containing personal information relating to individual residents on the desk in the dining area of the home. This practice did not protect or respect peoples dignity or privacy. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Burleigh House enjoy a varied and nutritious diet and have the opportunity to participate in interesting and varied activities to kep them entertained and stimulated. Evidence: Since the previous inspection visit the manager had introduced cognitive and dexterity based therapies into the schedule of activities that took place at Burleigh House. The therapies strengthened hand eye co-ordination, dexterity and thought processes and were implemented through the use of everyday household kitchen items and other household goods. We saw that each person had an activities file entitled This is my life. The manager described to us how she felt it was important to try to not only gain information on peoples likes and dislikes but to fully understand people as individuals and personalities. We saw a life story booklet developed by the manager incorporating questions such as If you were Prime Minister what would you do for the country? and what advice would you give to a younger person about life in general? The managers AQAA stated the results of these questions were thought provoking and gave myself and the staff clear indications of what was important to them and it taught us about the way they shaped their lives. Care Homes for Older People Page 14 of 27 Evidence: There were activities scheduled for each day of the week, in the morning these took place in the dining room and in the afternoon they took place in the conservatory. Examples of these activities included: arts and crafts. needlework, pottery, 10 pin bowling championship, Manicure sessions, Quiz, Sing-a-long, playing percussion instruments, bean bag exercises, reminiscence and the Montessori therapies. Framed artwork created by residents adorned the walls of the communal areas of the home. A nativity scene crafted from clay and hand painted by the residents was on display in the dining area. There were photo collages on the dining room walls depicting the residents enjoying events such as bonfire night and Halloween. On the day of this visit 2 carers were in the conservatory in the afternoon doing a range of activities with a group of 13 residents. People told us that this was a common occurrence to help to keep us occupied. One person said Sometimes we do quizzes, we do arts and crafts 2 mornings a week, a teacher comes to help us, we enjoy that. Relatives told us The service supports people beyond expectations with encouragement to participate in diverse activities accommodating individual needs. Visit books had been created for residents to provide them with a way of remembering the visits they had from families and friends. We saw that people wrote brief messages and reminders of their visits in these books, including a date and time when they intended to visit again. The staff reported that this form of communication was priceless if a resident became anxious or emotional about family events, it provided staff with the necessary knowledge to help them to reassure the person. Relatives told us they were always made welcome at Burleigh House and that the staff were polite and courteous to them at all times. People told us I have always been welcomed into the home no matter what time I have had to visit my relative, if any member of the family phones the home my relative is given the phone to talk to them and The staff go beyond the call of duty to facilitate phone calls and to be welcoming during visits. The managers AQAA told us We have widened our relationship with the community. Activity records contained information about a fun day in August 2008 where people living at the home were involved in running their own stalls. The manager reported that many members of the local community attended the event. Coffee mornings had been held at the home where local clubs had been invited. Records showed us that opportunities for religious observance were provided in accordance with individuals wishes. We took lunch with the residents in the light and airy dining room on this day, it was a chatty, cheerful and relaxed affair. People told us they enjoyed the food provided at Burleigh House. The menus available on the dining tables showed us there were Care Homes for Older People Page 15 of 27 Evidence: choices offered daily for breakfast, lunch and supper and that snacks were offered mid morning, mid afternoon and late evening. Residents told us Food is very nice, you get a choice here and The food is really really good, there is no other word for it. One relative told us My relative certainly seems to enjoy the food and happily eats the meals. The managers AQAA stated that the homes menu had changed 3 times in 9 months to reflect residents requests and to accommodate seasonal changes. The menu has been created to incorporate residents wishes and improve the dietary value in meals with a focus on protein to assist with tissue viability. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Burleigh House or their representatives may be confident that any concerns would be listened to and taken seriously. Evidence: There was a copy of the homes complaints policy and procedure available in the entrance hall for residents and visitors to use. The home had received 4 complaints since the previous inspection visit, all had been documented appropriately and dealt with in line with the homes policies and procedures. People responding via our questionnaires told us they had not had any cause to complain but would be confident to do so should the need arise. Records showed us at the time of this visit there were 16 staff employed to work with residents at Burleigh House, one member of staff had not attended training in Safeguarding Vulnerable Adults since the previous inspection site visit. The home had policies and procedures in place in relation to Safeguarding Vulnerable Adults and Whistle Blowing in the event that anyone had any cause to suspect that abuse may be taking place. A copy of the Local Authority guidance was available for care staff to access. Staff we spoke with were clear about what constituted abuse but were not all clear about the first steps they should take. All staff undertook an enhanced Criminal Records Bureau Disclosure before they Care Homes for Older People Page 17 of 27 Evidence: started to work at the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Burleigh House provides people with a warm, comfortable homely environment. Evidence: Burleigh House is an established building in a residential area. The grounds to the front and rear of the building were kept neat and tidy, there was a patio area to the rear of the house with ramped access. We saw photographs of residents enjoying this outside space during the summer months. There was a staff notice board in the dining room that held many notices and signs. This detracted from the homeliness of the unit. In the communal hallway near the kitchen there were a number of staff training certificates displayed on the wall. Some people felt this was not homely however one family member told us that she found it reassuring to see the training certificates. The home has the services of a handyman contracted to work at Burleigh House for 65 hours per month. The handyman was responsible for carrying out routine checks on the fire system, call bells, emergency lighting and water temperatures. Evidence was available to show that these checks had been made and where an issue had been identified there was evidence that appropriate actions had been taken. Care Homes for Older People Page 19 of 27 Evidence: We took a physical tour of the home, generally the home was clean and tidy with no offensive odours and just routine refurbishment necessary. One shower room seen was tired with stained flooring and tiles. The manager was able to report that the service had been recently awarded a grant of 5000 pounds which was going to be used to purchase an assisted bath and refurbish the bathroom facilities within the next 12 months. The manager reported that as bedrooms become vacant they were redecorated before being reallocated. Each persons bedroom seen was personalised with items of their own furniture and ornaments and pictures. One relative told us, On the whole my relatives room is kept clean and tidy. There was a book for staff to enter any maintenance issues such as dripping taps or missing light bulbs. This record showed us that issues such as these were dealt with in a timely manner. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Burleigh House are cared for by a competent and well recruited staff team. Evidence: Staff rotas showed us that 3 staff were on duty for each of the day shifts and 2 staff on waking night duty. People we spoke with were satisfied with the numbers of staff on duty and the calibre of staff. Residents told us: The staff basically do everything with ease and a smile, I couldnt manage without their help Relatives told us: The senior carers are very experienced and seem able to manage and help the people living at the home, and The staff are caring and considerate and The staff are very perceptive to the needs and interests of individuals, keen to converse and encourage my relative. Observation showed us that staff interacted positively with individual residents and there was a general sound of laughter throughout the home. All permanent staff working at the home had either achieved or were working towards their NVQ level 2 in care. Of the three senior care staff, two had achieved their NVQ 3 and the third had been trained as a nurse overseas and was working towards her NVQ level 3. We looked at recruitment documentation for 3 staff members to confirm that all the Care Homes for Older People Page 21 of 27 Evidence: necessary checks had been made to ensure the right people were employed to work with the vulnerable people living at Burleigh House. All files contained evidence of enhanced Criminal record Bureau Checks, references from previous employers, proof of identification and terms and conditions of employment. The staff training records showed us that there was a programme in place to refresh staffs knowledge in the basic core training such as moving and handling, protection of vulnerable adults, medication, fire safety, food hygiene, first aid and infection control. Staff also attend training to improve their skills in delivering person centred care and other service specific training such as Mental Capacity Act. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home that is run in their best interests. Evidence: The manager had been in post at Burleigh House for one year at the time of this visit. Her application to register with the commission had been submitted. The manager has over nine years experience in care home management and considerable experience of working with people living with Dementia. She has achieved the NVQ level 4 in care and holds the Registered Managers Award. Relatives spoken to as part of this inspection were full of praise for the manager, comments received included: everything is so much better under the new manager, New manager is very good, The manager is very understanding and The care home manager is in touch with the needs of the people living at the home and her staff. She seems to have lots of good ideas. One member of staff told us they rated the manager as 10 1/2 out of 10 saying how supportive and inclusive she was. One Care Homes for Older People Page 23 of 27 Evidence: person told us the manager deserved recognition for the massive changes that have been made to the lives of the people living at the home. Another said, fair management makes happy home for all. The managers AQAA informed us that the home operates a robust system of quality assurance having completed 3 surveys in a nine months period. These are subject to analysis and action taken depending on the results. Residents meeting minutes showed us that where people asked for activities to be changed to include more art and craft sessions this had been acted upon. This showed us that residents were empowered by the management regime. The managers AQAA stated that neither the management nor the providers acted on behalf of any of the people living at Burleigh House in respect of finances. Monthly bills were sent to the resident or representatives for sundry items such as hairdressing, chiropody, toiletries etc. We saw evidence to confirm that all staff had received training in relation to the safety and welfare of the people living at the home and that all routine checks were carried out in relation to the health and safety of the premises. The manager was able to provide us with evidence to show that Portable Appliance Testing, central heating, boilers, gas, electrical system, Legionella, disposal of hazardous waste and moving and handling equipment had been checked and certificated. Policies were in place for maintaining safe working practices, these had been reviewed. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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