Inspection on 01/03/07 for Burlington House

This inspection was carried out on 1st 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

Burlington House 24/02/09

Burlington House 22/03/06

Burlington House 20/09/05

Burlington House 11/02/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOMES FOR OLDER PEOPLE Burlington House Burlington House 51 & 53 Warren Road Torquay Devon TQ2 5TQ Lead Inspector Susan Samways Unannounced Inspection 11:15 1st March 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burlington House Address Burlington House 51 & 53 Warren Road Torquay Devon TQ2 5TQ 01803 298810 01803 553580 burlingtonhouse@fsmail.net 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) Amanda Jane Sutherland Amanda Jane Sutherland Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13) of places Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22/03/06 Brief Description of the Service: Burlington House provides accommodation and personal care for up to 13 adults who have a learning disability The home is sited in a residential area close to local facilities. Residents are encouraged to integrate with the local community as much as possible. The home’s facilities are domestic in nature and Residents are supported in maintaining their individuality and independence as much as possible. Current fees are £350 - £580 based on the social services assessment of the needs of each resident. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection which lasted for 6.75 hours. The care manager was on duty at the start of the inspection and the registered provider, who is also the registered manager, was available for the second half. During the inspection a variety of records, including Service Users’ files and staff files were examined and discussions were held with both the registered manager and the care manager. Four of the Service Users were spoken to and others were seen in passing. Prior to the inspection a pre-inspection questionnaire had been completed by the registered manager and survey forms were received from six service users, four staff, a relative and a visiting health care professional. What the service does well: Residents were very positive about living at Burlington House. They said that they receive the care they need, that the staff listen to and act on what they say and that they know how to make a complaint if necessary. They also said that they like the activities they are involved in, that they enjoy the meals and that the home is clean. The home has a good procedure for admitting a new resident which actively involves the existing residents. The detailed assessments and care plans, agreed with the residents, ensure that the residents’ needs are clearly identified and met including accessing specialist services when required. The home operates a keyworker system which ensures individual attention for each resident. Monthly residents’ meetings provide the residents with information about the home and any future plans and gives them the opportunity to express their views and to be involved in decision making. Although many of the residents are now over the age of 65 all are encouraged to be as active as possible and a wide range of activities is available in the home and in the local community. All who wish to also have an annual holiday which could be in this country or abroad. The home has an excellent training programme for staff which safeguards residents and promotes their well-being. The staff recruitment procedure and Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 6 system of supervision also protects residents and provides good support for staff. The open management style encourages the active participation in the home of staff and residents. 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. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 7 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. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment is made of prospective residents, which provides sufficient information to enable all those concerned to make the decision as to whether Burlington House is an appropriate home for them. EVIDENCE: The home has a Statement of Purpose and a Service Users’ Guide which are available to residents and visitors. The Service Users’ Guide is in both text and symbols. Since the last inspection a new resident has been admitted, transferred from their previous care home which was closing. The care manager and the Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 10 registered manager independently described the admission process, the plan for which was very detailed. Prior to the prospective new resident’s visit the residents were told the reason for the visit and that if they were to move in the office would become their bedroom as they required ground floor accommodation and the office would move upstairs. The registered manager and the care manager liaised closely with the other care home to obtain as much information as possible and to arrange the visit. The prospective resident was accompanied on the visit by an advocate as well as a member of staff they knew well. The visit included meeting some of the staff, being introduced to the residents and ensuring that all essential areas of the home could be accessed. A longer visit, including staying for a meal, was offered but the other home did not take it up. Despite communication difficulties, the advocate and the registered manager ensured that the views of the prospective resident were ascertained prior to the decision to move in was obtained. A longer visit, including staying for a meal, was offered but the other home did not take it up. The home has a detailed assessment process which for new residents takes place over several months to allow them to settle in to their new home. The assessment is used for all residents as their needs change and forms the basis for the care plans. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their care plans clearly identify their needs and how they will be met. Residents’ health and social care needs are well met and regularly reviewed. EVIDENCE: The care plans for four residents were examined. These were found to be of the same high standard usually seen at Burlington House, they were comprehensive, each was signed by the resident and had a review date. Care plans include a photograph of the resident, their preferred name, support required with daily activities, a skills profile, likes and dislikes, body maps, medication and visits to professionals. Residents with conditions such as epilepsy and diabetes have detailed profiles regarding that condition. Attention is also paid to those residents still under the age of 65 ensuring that their Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 12 social and educational needs are met. Detailed risk assessments were also seen to be in place. The file for a resident who had been very ill clearly demonstrated the involvement of specialist health care professionals and the support they had provided to the resident and the staff. A monitored dosage system for medication is used and records were seen to be correct. The majority of staff have been trained in the administration of medication. Two staff are involved whenever medication is being given. One gives out the medication and signs the MAR sheet, the other checks the blister packs and signatures. Creams and eye drops, prescribed for specific residents, had been dated when opened and also had the date when they should be discarded. One resident takes some responsibility for their medication both in the home and when visiting relatives. The resident has their own record sheet which they use at all times. The resident removes the medication from the blister pack while being observed by staff who then complete the MAR sheet. Staff were observed to treat residents with respect and those who completed surveys said that the staff listen to them and act on what they say. Residents’ privacy was seen to be respected. Staff were observed to knock on residents’ doors and wait to be invited in. The home has a procedure for staff to follow if there is no response to their knock. The procedure has been shared with residents, discussed at house meetings and agreed. Residents’ preferred term of address was seen to be recorded in the care plans. Residents are able to use a telephone in private should they wish to do so. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a varied social life both in the home and in the local community. The dietary needs and preferences of the residents are met with the provision of nutritious and varied meals. EVIDENCE: The home operates a key worker scheme which means that each resident has a member of staff who works with them on an individual basis. The system has recently changed to a rolling programme where the key worker changes every three months. This enables the residents to benefit from the different skills and abilities of each member of staff in turn. This change was discussed and agreed at the monthly residents’ meeting and has been positively received by both the staff and residents. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 14 Each resident has an individually agreed programme of activities based on their assessed needs, preferences and risk assessments. These include college courses such as art, pottery and use of computers, visits to the cinema and theatre, swimming, going to restaurants and pubs and attendance at day centres as well as a variety of leisure activities within the home. Five residents are also enjoying cookery sessions with the cook and their key workers which include baking on a Sunday. All residents have the opportunity for an annual holiday and the minutes of a residents’ meeting recorded the discussion which took place and the choices made by each resident. The home’s policy states that visitors are welcome at any reasonable time and residents know that they can invite friends to their home if they wish. Residents who have relatives are encouraged to maintain contact with them. Relatives do occasionally visit but most live some distance away. The registered person acts as appointee for nine of the residents. Four residents manage their own bank accounts, the others have joint bank accounts with the registered person. Residents’ financial records were seen to be detailed, but it is recommended that each entry be signed by the resident or two members of staff. These records have been audited. An up to date record of residents’ personal possessions was seen in their care plans. Residents are actively involved in menu planning with each one taking turns to choose the main course and then, if possible, help the cook prepare and cook the meal. The menu for the week is displayed in the dining room with the name of the resident who has chosen the each meal. The staff are encouraging residents to broaden the scope of the menus and to consider seasonal variations. Special diets are catered for and alternatives offered for those who do not like what is on the menu. These changes are recorded on the menus for the week. All staff have done food hygiene training so can take on the cook’s role when required. Residents were observed helping with the day-to-day running of the home by laying and clearing the tables, helping with the washing up and sweeping and mopping the floors. A housekeeper is employed whose duties include helping the residents to keep their rooms clean and tidy. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ rights are protected and they are safeguarded from abuse by staff training in adult protection procedures. Residents can be confident that their views will be listened to and that any complaints they may have will be dealt with promptly. EVIDENCE: The home has a clear complaints procedure, which is available in symbols as well as text, a copy of which is displayed on the notice board. Residents’ views and concerns are listened to on an individual basis and at house meetings, notes of which were seen to include a record of issues discussed and action taken. The residents who completed surveys stated that the staff listen to them and act on what they say, that they know who to speak to if they are unhappy and how, if necessary, to make a complaint. No complaints have been received by the Commission for Social Care Inspection about this service. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 16 Issues regarding the protection of vulnerable adults are included in the induction programme for new staff in order to raise their awareness of what constitutes abuse. The home also has two copies of the ‘No Secrets’ video which staff are encouraged to watch and discuss. One unit of the L.D.A.F. foundation course undertaken by all staff focuses on adult protection and ten staff have also completed a further course of study regarding this. The registered person is due to do the trainers course run by Devon social services in April. Induction training includes dealing with aggression by residents and detailed advice regarding each resident’s behaviour is provided for staff. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Burlington House provides residents with a homely, comfortable and safe environment in which to live. EVIDENCE: The home is suitable for its stated purpose. The premises are safe, comfortable, bright and clean. Communal areas are of a good size, comfortably furnished and can be used for a variety of activities. Outdoor space is small but the home is close to all local amenities and there is good access to local transport. A programme of planned maintenance and renewal of the fabric and decoration of the premises is in place. A carpet identified at the last Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 18 inspection as being a potential trip hazard has been re-fitted and has been included in the maintenance programme for future replacement. The home employs a housekeeper part of whose responsibility is to do the laundry and ironing. The housekeeper was involved in planning the laundry room which has specialist flooring and commercial standard appliances. The home has an infection control policy in place and training records show that all staff have undertaken infection control training using a distance learning pack through Exeter College. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded by the staff recruitment procedure and the excellent staff training programme. EVIDENCE: Staff rotas seen showed sufficient staff to be on duty during the day and at night when two staff sleep-in. Residents, with support from the housekeeper, are encouraged to keep their own rooms clean and tidy. A cleaner is employed on a part-time basis for the rest of the home. The cook is responsible for the kitchen including ordering provisions. The files for three members of staff were examined. These clearly demonstrated that the recruitment procedure had been followed. Each had a completed application form, two references, police checks, proof of identity and interview notes. The registered person described the staff as loyal and reliable and that it had never been necessary to use agency staff. The registered person is committed to staff training and takes responsibility for the training programme which is provided in a variety of ways. These include in-house sessions, study days organised by the local social services and health Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 20 services and distance learning courses. Staff are encouraged to access the training opportunities available and are given support by the registered person. Records showed that virtually all staff have had training in administration of medication, food hygiene, manual handling health and safety, infection control, epilepsy, protection of vulnerable adults and total communication. In addition staff are required to complete NVQ 2 in Care and this is written into the employment contract. There are also opportunities for staff to undertake LDAF training at induction and foundation levels and NVQ 3 in Care. At the time of the inspection nine staff had completed NVQ 2 and another five staff were doing it and one member of staff had NVQ 3 and another one was undertaking it. The care manager has completed her training to be an NVQ assessor. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management style is open and receptive to the views of the residents and others involved with the home. Safe working practices provide protection for both residents and staff. EVIDENCE: The registered person is also the registered manager and has considerable management experience. However, she has appointed a care manager who has taken on some management responsibilities. Both have NVQ level 4 in Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 22 care, the registered person has the Registered Managers Award and the care manager would like to do it. The registered person and the care manager were present at different times during the inspection. Both were observed to be approached with confidence by the residents and the staff. Most staff said that they felt well supported and one member of staff described the registered person and the care manager as being very fair. The care manager has taken on the responsibility for staff supervision and the records show, and staff confirmed, that this is taking place on a regular basis. Staff meetings are held monthly, chaired by the care manager, with minutes kept. As already stated the registered person acts as appointee for nine of the residents. Residents are encouraged, with the degree of support from staff they are assessed as needing, to make their own decisions regarding how they spend their money. Detailed records of all transactions are kept which are audited, but it is recommended that each entry be signed by the resident or two members of staff. The views of residents are regularly sought through their monthly meetings and by the use of questionnaires. The questionnaires are written in text and symbols and an advocacy service is used to enable residents to complete them. Minutes of the meetings are kept with issues raised and the action taken recorded. Both the registered person and the care manager said that residents make their views known at any time and residents said that they are listened to. The home has policies in place covering all aspects of Health and Safety. All staff have had training in manual handling, First Aid, food hygiene and fire safety. All staff undertake distance learning in infection control. Records of fire safety checks were seen to have been completed. Fire drills are also carried out, the last one having been held in May. Environmental risk assessments were seen to be in place. Access to the laundry is kept locked. Safety notices are in symbols as well as text. Burlington House DS0000061310.V320320.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 3 Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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. 1 Refer to Standard OP14 OP35 Good Practice Recommendations The registered provider should consider obtaining the resident’s signature or two staff signatures to verify each day-to-day financial transaction. Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. Extracts may not be used or reproduced without the express permission of CSCI Burlington House DS0000061310.V320320.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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