Inspection on 20/09/05 for Burlington House

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Burlington House 24/02/09

Burlington House 01/03/07

Burlington House 22/03/06

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 Announced Inspection 20th September 2005 10:00 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.V253053.R01.S.doc Version 5.0 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.V253053.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Burlington House Address Burlington House 51 & 53 Warren Road Torquay Devon TQ2 5TQ 01803 298810 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 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.V253053.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th February 2005 Brief Description of the Service: Burlington House provides accommodation for up to 13 adults who have a learning disability The home is sited in a residential area close to local facilities and Service Users are encouraged to integrate with the local community as much as possible. The home’s facilities are domestic in nature and Service Users are supported in maintaining their individuality and independence as much as possible. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and lasted for 7.5 hours. The registered provider/manager was present throughout the inspection. Most of the service users were spoken to and two new members of staff were interviewed. Areas of the home where alterations had taken place or were proposed were visited. A comment card was received from a visiting professional. What the service does well: Although most of the Service Users 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 detailed assessments and care plans, agreed with the Service User, ensure that the Service User’s needs are clearly identified and met including accessing specialist services when required. The home has an excellent training programme for staff which safeguards Service Users and promotes their well-being. The staff recruitment procedure and system of supervision also protects Service Users and provides good support for staff. The management approach is open and inclusive and Service Users are encouraged to express their views about the home through surveys and especially the monthly house meetings. Service Users are involved in the running of the home. Their rooms are personalised, they are encouraged to keep them clean and they are all involved in menu planning and, where possible, meal preparation. Their privacy is respected and the home has a very good policy regarding the action to be taken if a Service User does not respond to a knock at their door. Good support is provided to Service Users if a relative or friend of theirs dies which includes being accompanied to the funeral if they wish to attend. Service Users spoken to said that they liked living at Burlington House, they clearly took pride in their rooms and they were observed to interact well with the registered person and the staff. The staff spoken to said that they felt well supported by the registered person, were pleased with the level of training provided and that any ideas they had were taken seriously. The home is clean, well decorated and comfortably furnished. It provides a safe environment for Service Users and staff. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 6 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. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 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 the following standard(s): 3,5 A comprehensive assessment is made of prospective Service Users, 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: Since the last inspection a new Service User has been admitted, the first new admission for several years. The records showed that the registered person visited the Service User in their home to discuss a possible move to Burlington House. They discussed her likes and dislikes and what she was looking for in a home. She was then invited to visit Burlington House for lunch. An overnight stay was offered but declined. Information was also obtained from other professionals including assessments by the care manager and reports from the hospital. From this the home’s detailed assessment was completed identifying the Service User’s needs. The registered person was very clear about Service Users’ needs and how these could be met. The staff are well trained and use sign language and symbols to aid communication. Records show that specialist services are Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 9 accessed as required e.g. diabetic services, Specialist Learning Disability Support team. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 7,8,9,10,11 Service Users can be confident that their care plans clearly identify their needs and how they will be met. Service Users’ health and social care needs are well met and regularly reviewed. EVIDENCE: Comprehensive care plans, signed by the Service User, are in place, each with a review date. Care plans include a photograph of the Service User, their preferred name, support required with daily activities, a skills profile, likes and dislikes, body maps, medication and visits to professionals. Service Users with conditions such as epilepsy and diabetes have detailed profiles regarding that condition. Attention is also paid to the four Service Users still under the age of 65 ensuring that their social and educational needs are met. Detailed risk assessments were also seen to be in place. Records show that, when it is necessary, Service Users access local health services wherever possible rather than having professionals visit the home. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 11 Service Users with conditions such as diabetes and epilepsy were seen to be well supported by Primary Care Teams and Specialist Services. 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. Creams and eye drops, prescribed for specific Service Users, had been dated when opened and also had the date when they should be discarded. One Service User is self-administering medication. Assistance with medication had been offered but refused. A risk assessment has been completed. Service Users’ privacy was seen to be respected. Staff were observed to knock on Service Users’ 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 Service Users and discussed at house meetings. Service Users’ preferred term of address was seen to be recorded in the care plans. Service Users are able to use a telephone in private should they wish to do so. Since the last inspection one of the Service Users who had lived at the home for many years has died. As there were no known relatives the registered person dealt with all the funeral arrangements. This has prompted her to ascertain wherever possible from the Service Users how they wish to be cared for when coming to the end of their lives, what funeral arrangements they wish to have in place and whether they would like to make a will. Five of the Service Users have also lost friends and relatives in recent months. All chose to attend the funerals, accompanied by staff, and were given the support they needed afterwards. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 12,13,14,15 Service Users enjoy a varied social life both in the home and in the local community. The dietary needs and preferences of the Service Users are met with the provision of nutritious and varied meals. EVIDENCE: Service Users are encouraged to access a wide range of activities both in the home and in the community. These include college courses such as art, 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. All the Service Users have recently been reviewed by social services and the responsible person was successful in obtaining funding for two of the oldest Service Users to enable one to return to the CRC once a week and the other to have additional staff support to enable him to continue to go out on a regular basis. The registered person stated that this has made a significant difference to their well-being. All Service Users are able to take an annual holiday if they wish. Two Service Users chose not to this year but others went in small groups to places such as Bournemouth, Isle of Wight, Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 13 Ireland and Euro-Disney. Holiday photographs were displayed around the home. The home’s policy states that visitors are welcome at any reasonable time and Service Users know that they can invite friends to their home if they wish. Relatives do occasionally visit but most live some distance away. The registered person acts as appointee for nine of the Service Users. One Service User manages their own financial affairs. Four Service Users manage their own bank accounts, the others have joint bank accounts with the registered person. Service Users’ financial records were seen to be detailed, with each entry signed by the Service User or their key worker. These records have been audited. An up to date record of Service Users’ personal possessions was seen in their care plans. Service Users are actively involved in menu planning with each one taking turns to choose the main course and then, if possible, help in the preparation and cooking of the meal. The menu for the week is displayed in the dining room with the name of the Service User who has chosen the each meal. The staff are working with Service Users to encourage them 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. One Service User particularly enjoys baking cakes and is supported by staff to do this. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16,17,18 Service Users’ rights are protected and they are safeguarded from abuse by staff training in adult protection procedures. 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. Service Users’ 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. No complaints have been received by the Commission for Social Care Inspection about this service. All Service Users are registered to vote and everyone that wished to vote at the last election did so, one by postal vote, the rest were assisted by the staff to go to the polling station. 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 staff focuses on adult protection. The registered person is waiting to do the trainers course run by Devon social services and some of the staff are booked to do the one day course run by them. Induction training includes dealing with aggression by Service Users Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 15 and detailed advice regarding each Service User’s behaviour is provided for staff. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 19,20,22,24,25,26 Burlington House provides Service Users 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. It was seen that where equipment or adaptations are required to aid independence, these had had been provided following a specialist assessment. One Service User has a call system in their room. Temporary call systems are available for Service Users if they are unwell. An assessment of the premises and facilities by an occupational therapist has been made but the home has not yet received the report. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 17 Service Users’ rooms seen had been personalised and Service Users spoken to said that they had chosen the décor and furnishings. All bedrooms now have wash hand basins. Risk assessments have been carried out regarding the installation of water temperature regulators to wash hand basins. None were identified as urgent so a plan has been produced to gradually fit them over the next twelve months. The home now employs a housekeeper part of whose responsibility is to do the laundry and ironing. The registered person has had plans drawn up for the refurbishment of the laundry room to include specialist flooring and commercial standard appliances. The housekeeper was involved in the planning process. The home has an infection control policy in place and all staff undertake infection control training using a distance learning pack through Exeter College. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staff have the skills, training and understanding to meet the needs of Service Users. EVIDENCE: Staff rotas seen showed sufficient staff to be on duty during the day and at night when two staff sleep-in. Service Users, with support from the care staff, 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. A housekeeper is also employed who is responsible for the laundry, food shopping/ordering and stock control for all other products used within the home. The home has a good recruitment process. The files for two newly appointed staff were examined. Both had completed application forms, CRB and POVA checks. One file had the required two references the other had an additional reference covering a period spent working in care as the last employment was in an unrelated field. Interview records were also seen. 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 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 recent training sessions have included administration of Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 19 medication, food hygiene, understanding challenging behaviour 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 four staff had completed NVQ 2 and another two staff were doing it and one member of staff had NVQ 3 and another one was undertaking it. The deputy manager has been training to be an NVQ assessor and has nearly completed the course. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 The management style is open and receptive to the views of the Service Users and others involved with the home. Safe working practices provide protection for both Service Users and staff. EVIDENCE: The registered person, who also fulfils the role of manager, has significant management experience and has the Registered Managers Award. The management approach was observed to be open, positive and inclusive with both staff and Service Users. Staff spoken to said that the registered person makes time for the staff and any difficulties are addressed directly and quickly. They also said that she is open to ideas and suggestions as to how the service can be improved. Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 21 House meetings are held monthly, with minutes taken, at which any issues of interest or concern to Service Users can be raised, discussed and decisions made. Service Users are encouraged to express their views and to ask questions. The meetings are also used by the registered person to inform Service Users of any proposed changes within the home and to seek their opinions. Staff meetings are held weekly chaired by the deputy manager except for every fourth week when they are taken by the registered person. Progress has been made in the system of quality monitoring. The views of Service Users are sought through the use of surveys, which are in text and symbols, and the monthly house meetings. Surveys are also available for relatives and other visitors to complete. The results of surveys have all been very positive. The majority of policies and procedures have been reviewed in the last three months. A plan for the maintenance and refurbishment of the home is in place covering the period up to June 2006. Staff meetings are now held weekly. The system of staff supervision is well established with frequency ranging from weekly to every two months depending on experience. This was confirmed by staff spoken to who said that the sessions were very positive. They also said that they felt well supported and looked forward to coming to work. Records were seen to be kept of each session. The deputy manager has completed a supervision skills course and is now taking some of the supervision sessions. There is a rolling programme of annual appraisals which clearly identifies the time scale for each part of the process for each member of staff. The registered person has devised a questionnaire regarding the staffs’ knowledge of the job in order to identify gaps in their knowledge and devise individual training plans. Copies of these and how they linked in to the individual training plans were seen. 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 June. 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.V253053.R01.S.doc Version 5.0 Page 22 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 4 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 3 18 3 3 3 x 3 x 3 3 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 4 x 3 Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 23 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. Refer to Standard Good Practice Recommendations Burlington House DS0000061310.V253053.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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