Inspection on 24/02/09 for Burlington House

This inspection was carried out on 24th February 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

Burlington House 01/03/07

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burlington House Burlington House 51 & 53 Warren Road Torquay Devon TQ2 5TQ     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: Michelle Finniear     Date: 2 4 0 2 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 25 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Burlington House Burlington House 51 & 53 Warren Road Torquay Devon TQ2 5TQ 01803298810 01803553580 burlingtonhouse@fsmail.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Amanda Jane Sutherland care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 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 homes facilities are domestic in nature and people living there are supported in maintaining their individuality and independence as much as possible. Current fees are 350 - 628.25 pounds per week based on the social services assessment of the needs of each resident. 13 Over 65 13 Care Homes for Older People Page 4 of 25 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: To complete this inspection we received information about the home in an AQAA document. This was sent to the home for completion and it tells us about how the home is being run; We sent questionnaires to the people who live and work at the home to gain their experiences about the home; We made a site visit without telling the home the date we were coming; we looked round the home and spoke to the people there; we looked at the policies and procedures the home keeps along with records of day to day activity. We also looked at information we have received about the home since the last inspection, and the last inspection report. Care Homes for Older People Page 5 of 25 What the care home does well: What has improved since the last inspection? What they could do better: Some carpets on the stairs in hallways need to be replaced or repaired to ensure they Care Homes for Older People Page 6 of 25 do not present a trip hazard. The low bannisters need to be risk assessed and action indicated taken as a result to make sure that people cannot accidentally fall from them. Information gathered about the quality of the service provided needs to be incorporated into an annual development plan for the home. This should include the views of people living at the home about the service. Where staff are giving out medication with a variable prescription ie one or two tablets to be taken, staff should record the number taken. This helps to ensure too much medication is not being given to each person. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 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 8 of 25 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. Information is available to help people judge if the home is the right place for them. Evidence: Burlington House has a statement of purpose and a service user guide available to people thinking about moving to the home. The guide is currently being made accessible in a symbol format which people at the home will find easier to understand. People considering moving to the home would usually have an assessment undertaken which would help the home manager and owner decide if they could meet the persons needs. Time and opportunity would be given to the person and their supporter or advocate to visit the home and make a decision about whether they thought the place was the right one for them. People at the home are also consulted about whether they felt the new person would fit in with them. In the case of two recent referrals the home had accepted them for emergency respite. However after a short period the people had decided they wished to stay longer term. In this instance the manager Care Homes for Older People Page 9 of 25 Evidence: used the period of respite as an assessment period. People accommodated at the home at the current time are funded by the Care Trust. As a result the contracts the home has are with the Care Trust and not the individuals concerned. The Care Trust contract is a lengthy document and is not in an accessible format for people to understand. The home has not issued people with a statement of the terms and conditions for living at Burlington House.. The home does not provide intermediate care. This means that they do not provide intensive programmes of rehabilitation with a view to returning people to their previous home. Care Homes for Older People Page 10 of 25 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. Care plans identify the support people need and how it is to be given. Medication recording needs minor amendments otherwise medication arrangements were safe. Evidence: Each person living at Burlington House has a care plan which includes information about peoples needs and how they are to be met. The plans seen focussed on peoples strengths as well as areas where they needed support, which was positive. The plans seen may benefit from additional information being made available on peoples past histories and social supports. This information helps put peoples life experiences in context and helps people understand the lives they have led. For each area where a person has been identified as needing support a separate plan is produced outlining the support needed and how this is to be given. A plan was seen and discussed in detail with a member of staff, who outlined the care actually given to that person each day. This helped to identify that the plan was an accurate reflection of the persons needs and lifestyle choices. Care Homes for Older People Page 11 of 25 Evidence: Plans contain information on communication needs and body maps showing any specific identifying featueres or areas of concern. Information is available in files on specific conditions people may be diagnosed with along with information on their management, for example Epilepsy or Diabetes. Evidence could be seen in files of consultation and links with supporting medical and community services. These included dietetic services and palliative care teams from the local hospice. These staff also provide support to staff if they have any concerns. Equipment for pressure relief was being provided by the district nursing teams and advice has been given to staff about the care of frail people and their skin. This is important in helping to prevent skin breakdown in people who may be bed bound or very frail. Medication management systems seen were appropriate with secure storage and records of administration completed by staff whenever medication is given out. Records were satisfactory, however where there is a variable prescription ie one or two tablets prescribed in a dose the person giving the tablet should record the number given on the administration sheet as well as in a separate book. A senior was observed giving out medication and this was being done discreetely with respect for peoples privacy. Care Homes for Older People Page 12 of 25 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 have opportunities to be as active as they choose and are able. Meals offer choice and flexibility. Evidence: People at Burlington House all have a learning disability, but now most are over the age of 60. The home has on this occasion been inspected under the Older persons standards. However the home must also bear in mind the National Minimum standards for younger adults when devising policy. People at the home remain reasonably active and the home have told us that they encourage people to remain so. For many of the people at the home this requires staff support to assist them out of the home and in some cases additional funding has been obtained for this. As an example one person has funding to enable a member of staff to go with them to a day centre three days a week. This helps people maintain valued and positive interests. Other people spoken to regularly were involved in activities in the local community. On the day of the visit one person was taken out for a walk and another person went shopping with a staff member. Other people played cards, watched television, did craft Care Homes for Older People Page 13 of 25 Evidence: work or spent time in their rooms. The home has access to transport facilities. A senior staff member has been given specific responsibility for social activities, in house activities, holidays and entertainment and the home plan to offer more at peoples request. For example people are now going out on a weekly pub evening trip. People are encouraged to maintain contact with families and friends who are welcome to visit. Keyworkers support this through telephone calls and letters. People are encouraged to remain independant and be involved in the running of the home wherever possible. People can be supported by keyworkers to keep their own rooms clean and do their own laundry. The home has a chef who prepares the meals. The main meal of the day is eaten at lunchtime. On the day of the visit this was Pasta Bolognese with garlic bread and pancakes for dessert as it was Shrove Tuesday. People living at the home have a say in the meals provided and take turns to choose the menu. The home can provide for some special diets. Care Homes for Older People Page 14 of 25 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. The homes policies on safeguarding and complaint management help to protect people from abuse and ensure their rights are observed. Evidence: In the last year there have been no complaints made to or about Burlington House. There is a complaints procedure and policy available in the home and people who completed questionnaires said that they knew what to do if they were unhappy about something. This was confirmed in conversations with people spoken to on the visit. One person said I havent got any complaints I am very happy here. and another said I would talk to the staff and they would sort it out. One person said they had recently had a problem with a person who was living at the home and it was sorted out for them. Senior staff have received training on the Mental Capacity Act and on safeguarding, which should help to ensure people are protected from abuse. Some staff are still waiting for this training but are booked to do it in the near future. The owner/manager has attended a course so that she can train others in safeguarding issues. The home has also obtained copies of guidance for people working in social care settings about the Mental capacity Act so that they are clear about their reponsibilities and duties under the new legislation. Care Homes for Older People Page 15 of 25 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. The home offers homely accommodation for people to live and work in. Evidence: During the site visit a tour was made of all area of the home, looking at the accommodation for people who live there as well as service areas. We also looked at records of maintenance and servicing of electrical items, boilers and at when the home was last seen by the Environmental Health officer. Burlington House comprises two period terraced houses joined at first and ground floor levels. There is also a newer built property to the rear which accommodates two people and an office. The properties are situated in a residential area of Torquay above the main town and harbour, and accessed from them via a steep hill, although the property itself is fairly level. There is limited parking at the home and on nearby streets. Accommodation is in single rooms and there is a choice of three lounges available. Service areas are on the ground floor in the main building with some separate facilities in the adjoining house. This included an unused kitchen area which could offer potential to develop the intensive support services. The home owner also owns supported living accommodation next door to the home. The people in the coach house do their own laundry, but receive meals from the main kitchens. The area Care Homes for Older People Page 16 of 25 Evidence: between the two properties is partly being closed over to protect staff and make access easier. There is limited outdoor space at the home, with only a small courtyard with seating area available. The properties, including some peoples bedrooms front directly onto the street, but the owner stated that this has not caused any problems with privacy or noise disturbance. All areas of the home seen were clean, warm and homely. The main lounge/diner is due for refurbishment and redecoration in the near future and people living at the home will be consulted on choices of colour schemes, as they are when their rooms are redecorated. One person said that next time their room is redecorated they wanted it to be yellow. The kitchen has been seen by the Environmental health officer in the last 9 months and minor works required have been attended to. Infection control is being assessed and the home has safe systems for the transportation of potentially infected lnens to the laundry were there is a machine capable of a sluicing cycle. This means that linen and clothing can be appropriately disinfected. One bathroom seen has no heating, but the owner said the room also contained the imersion heater and the room was always warm. Water tested at random was regulated to a temperature that ensured people could not be scalded by coming into prolonged contact with it. The bannisters in one area were low, and the owner agreed to risk assess this and take any action indicated to ensure people could not accidentally fall over them. Window openings are restricted to make sure people cannot accidentally fall from a window. Some stair carpets needed attention as they were becoming worn. There is a choice of bathing facilities including a near level access shower room in the coach house and shower and bath facilities in the main house. People spoken to liked their rooms. One person was keen to show photographs and items from their family in their room. Another person spoke about how much they enjoyed their room and the facilities including their own television and DVD player. Several rooms have been refurbished since the last inspection and nearly all the external doors and windows have been replaced with double glazing. New electrical systems have been fitted and a bathrioom was completely refurbished. Some people purchased their own furniture for their rooms. Furniture in the louge has been raised Care Homes for Older People Page 17 of 25 Evidence: to help people get up from them more easily. The home plan to continue wuith the refurbishement of the property, and increase the amount of equipment available to meet the needs of the people at the home who are getting older and less agile. Care Homes for Older People Page 18 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements meet the needs of people living at the home. Evidence: On the site visit we looked at a selection of staff files to see how the home recruited people to work there; we looked at training records and development plans; and we spoke to people who were living and working at the home to see how the staffing structures worked. The home has now implemented a system where there are four team leaders who work at the home, each of whom has a special area of responsibility. This means there is nearly always a senior person on duty at all times. Management and staff meetings are held regularly which helps to ensure people communicate effectively, work as a team and in a consistent fashion to support people. Most staff at the home have achieved an NVQ level 2 and six have achieved their NVQ level 3. NVQs aere a national award reflecting the competency of a person in their work role. There is a learning and development programme in place which ensures that people receive training they need, including core training updates in areas such as first aid and food hygiene. The home is also planning to introduce the new specialised training and Induction programme for people working with Adults with a learning disability. Care Homes for Older People Page 19 of 25 Evidence: The team leaders are also responsible for a number of care staff who they will be involved in mentoring and carrying out supervision alternately with the owner. Supervision helps staff feel supported in their role and helps to ensure they are working to their full potential. Staff recruitment systems were also seen on the visit. The home follows a full recruitment procedure which involves the taking up of references and criminal records bureau checks, These help to ensure that the people working at the home are suitable to be working with potentially vulnerable people. Files were seen for three people and the files showed this process had been followed for all of them with the exception of one person who was appointed many years ago when only one reference had been obtained by the previous owner. Staff spoken to on the visit said they were proud of the work they did at the home. One person said I cant tell you how much I enjoy working here, and staff who completed questionnaires said that they had good training and support to do their jobs. People living at the home said: I do like living at Burlington House. The staff are nice I am very happy here. Staff are very kind and understanding and I can talk whenever I want to Care Homes for Older People Page 20 of 25 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. The home is being well managed. Evidence: The owner and manager of the home, Amanda Sutherland has owned the home for several years and worked there before she purchased the establishment. She is very well qualified, having an HNC in care management, NVQ level 4 and the Registered Managers Award, which is a specialsit award in managing a care home. She is also an NVQ assessor and has a professional trainers certificate. Since appointing the four team leaders to manage day to day issues at the home she has been able to spend more time looking at extending the training available for staff, service development and managing finances. She still however has considerable contact with people living at the home and staff. There are systems for managing quality issues at the home and for gatherig information about how people experience the service provision. This currently is gathered via a system of regular audits for example an audit of care planning systems Care Homes for Older People Page 21 of 25 Evidence: or the premises. The home owner is considering the use of questionnaires which have been used previously but needed to be improved to make sure the information gathered was useful and reflected peoples experiences. This information needs to be gathered together to form a quality assurance report on the home which is used in cyclical business development planning. The home has recently been re-accredited as an Investor in People. Burlington House employs a health and safety and employment law consultancy to ensure that all areas of health and safety are addressed and monitored. There is a comprehnsive health and safety manual available with policies and procedures to ensure safe working at the home. Some risk assessments needed updating to ensure they were still current. This is to be done by the homes maintenance man who has been on an intermediate health and safety training course. The home has regular tests carried out on their fire prevention and alarm systems and has an Infection control audit which was recently completed. The homes Legionella assessment was last done in 2003 nd the owner is currently exploring ways of ensuring that the water testsing systems used are meaningful. The management of peoples finances was appropriate, with the owner being appointee for many of the people at the home. Each person has their own bank account, but for everyday expenditure some monies are held at the home on a float system. The balances are checked at least daily, and those seen on the inspection were found to balance appropriately. Reciepts are kept for any purchases made on peoples behalf. Some people have appointees or power of attourney/receivership outside of the home to manage their money. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 9 Where staff are giving out medication with a variable prescription ie one or two tablets to be taken, staff should record the number taken. This helps to ensure a proper audit trail can be undertaken of medication held by the home as well as ensure too much medication is not being given to each person. The low bannisters should be risk assessd to make sure that no-one could accidentally fall from them. Some stair carpets need attention. 2 19 3 33 Information gathered through Quality management systems should be used to form an annual development plan for the home. This should include the views of people living at the home about what is working well and what could be improved. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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. Care Homes for Older People Page 25 of 25 - 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. 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