Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 26/09/06 for Burlington Nursing & Retirement Home

Also see our care home review for Burlington Nursing & Retirement Home for more information

This inspection was carried out on 26th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a clean, comfortable and homely environment with a positive atmosphere. Staff were noted to be happy going about their work. They were caring, friendly but respectful to residents. Under Mrs Jellett`s leadership and support the staff provide a good standard of care and staff strive very hard to meet the needs of the residents in a caring, professional and friendly manner. The majority of the staff are provided with the training they need to meet needs of residents and the requirements of the legislation. Residents were complimentary about the staff and the way they care for them. A good choice of home cooked food is provided and available over the 24-hour period.

What has improved since the last inspection?

A number of rooms have been refurbished to a good standard as they have become vacant and some communal areas are being re decorated. Recruitment and training records have been improved. New carpets have been laid as required and a number of new easy chairs purchased.

What the care home could do better:

The medication administration procedures are not robust resulting in residents not receiving their prescribed medication The quality assurance system needs to be updated to ensure the home is meeting its aims and objectives. Fire safety and adult protection training must be provided for all staff and a robust staff appraisal and supervision system must be in operation. Staff should be reminded of the risk to residents and themselves in wedging bedroom doors open, and cleaning staff must be aware of their responsibilities by not leaving cleaning materials where residents may have access to them. Two of the resident`s rooms had an unpleasant odour in them.The kitchen should have adequate equipment in good working order to help the chef to meet the needs of the residents by providing good quality food.

CARE HOMES FOR OLDER PEOPLE Burlington Nursing & Retirement Home 109-111 Victoria Drive Bognor Regis West Sussex P021 2DZ Lead Inspector Mrs A Peace Unannounced Inspection 26th September 2006 09:45 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 Nursing & Retirement Home DS0000024125.V307117.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 Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burlington Nursing & Retirement Home Address 109-111 Victoria Drive Bognor Regis West Sussex P021 2DZ 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) 01243 821446 Burlington Nursing Home Limited Mrs Christine Jellett Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: Burlington Nursing Home is a privately owned company providing personal and nursing care for up to forty-four service users in the category of Older Persons. Burlington Nursing Home is a detached two-storey establishment in a residential area of Bognor, a seaside town in West Sussex. The home is situated approximately a mile from the centre of Bognor and all its amenities. It is about one mile from the sea front. Accommodation is provided in thirtysix single rooms and four double rooms. Twenty of the singles and two of the doubles have en-suite facilities. A lift gives access to most of the rooms. There is a large lounge/dining room and several other small lounges and quiet areas. There is a large well-maintained garden. The responsible person is Mr Mark Holden and the registered manager is Mrs Christine Jellett. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Mrs Ann Peace Regulatory Inspector carried out this unannounced fieldwork inspection on 26th and 29th September 2006. This is the first inspection for the year 2006-2007. It is called a key inspection and will determine the frequency of visits/inspections hereafter. Prior to the inspection, records held on file and information received from the home since the last inspection were reviewed. Mrs Jellett the Registered Manager and the Provider Mr Holden were present for the inspection. During the course of the inspection the Inspector toured the premises and spoke to residents gathered in the communal areas of the home and to some in their rooms. All of the residents said they were happy at the home and were very complimentary about the staff. Some of the comments were: “staff are very kind and look after me well”. “The staff are really friendly and make me feel safe”. “I have been here a long time and the staff look after us well the food is good and we can always have what we want”. “I like it here it is comfortable and Mr Holden is always around to keep an eye on what going on”. Nine members of staff were spoken to they were all positive about their work at the home and said they felt well supported. The home was homely, clean and tidy and the atmosphere friendly. A case tracking exercise from records of admission to care given was carried out for a number of residents. Staff records and relevant records relating to the administration and management of the home were examined. The majority of records seen were in good order. Requirements made at the last inspection were reviewed and the majority met. What the service does well: Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 6 The home provides a clean, comfortable and homely environment with a positive atmosphere. Staff were noted to be happy going about their work. They were caring, friendly but respectful to residents. Under Mrs Jellett’s leadership and support the staff provide a good standard of care and staff strive very hard to meet the needs of the residents in a caring, professional and friendly manner. The majority of the staff are provided with the training they need to meet needs of residents and the requirements of the legislation. Residents were complimentary about the staff and the way they care for them. A good choice of home cooked food is provided and available over the 24-hour period. What has improved since the last inspection? What they could do better: The medication administration procedures are not robust resulting in residents not receiving their prescribed medication The quality assurance system needs to be updated to ensure the home is meeting its aims and objectives. Fire safety and adult protection training must be provided for all staff and a robust staff appraisal and supervision system must be in operation. Staff should be reminded of the risk to residents and themselves in wedging bedroom doors open, and cleaning staff must be aware of their responsibilities by not leaving cleaning materials where residents may have access to them. Two of the resident’s rooms had an unpleasant odour in them. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 7 The kitchen should have adequate equipment in good working order to help the chef to meet the needs of the residents by providing good quality food. 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 Nursing & Retirement Home DS0000024125.V307117.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 Nursing & Retirement Home DS0000024125.V307117.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. The quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. People who use this service have good information about the home in order to make an informed decision about whether the home is right for them. There is a needs assessment which identifies resident’s diverse needs and plans are made to assist staff in meeting those needs. Trial visits are encouraged. EVIDENCE: All bedrooms had a card in big print with useful information for residents and visitors. The statement of purpose in the home was last updated 2005 and does need reviewing it should also make note of the CCTV in the hallways. The last residents survey was 2004 and needs to be reviewed. The complaints procedure in the hall had been updated with the new address of CSCI. All residents have a personalised needs assessment to ensure their needs can be identified and met, and contracts are given. Written documentation was Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 10 adequate and included a copy of the care management assessments where appropriate. Prospective residents and their relatives can visit the home. Intermediate care is not offered at Burlington. Burlington Nursing & Retirement Home DS0000024125.V307117.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have up to date assessments and care plans which instruct staff how to meet their needs. Privacy and dignity are respected in the home. The medication administration procedures in the home are not safe and do not protect residents. EVIDENCE: The majority of staff were spoken with and observed both directly and indirectly, all displayed a caring manner with residents. Residents who were able to offer an opinion were complimentary about the home and the way the staff look after them. Some of the comments were: “Staff are very kind and look after me well”. “The staff are really friendly and make me feel safe”. “I have been here a long time and the staff look after us well the food is good and we can always have what we want”. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 12 “I like it here it is comfortable and Mr Holden is always around to keep an eye on what going on”. Photographs were in the medication administration records so staff can check that medication is being given to the right resident. Residents who were being nursed in bed looked well cared for and comfortable and residents were being nursed on pressure relieving mattresses related to their risk assessment. Other professional’s visits to the home are recorded in the resident’s notes so that staff are aware of any changes. Staff have received training in understanding the care needs of older people this was identified as a need and a requirement was made at the last inspection. The records of a number of residents were tracked from admission records to present records of care given and were in order, Mrs Jellett said residents conditions were discussed during handover to make all staff aware of any changing needs. Residents all had assessments, care plans and relevant risk assessments but the notes were not tidy and it was difficult to track care pathways in some cases. Through looking at care plans and speaking to residents and staff the Inspector concluded that the privacy and dignity standards are met and that residents in the last period of their lives and their relatives would be supported well by the staff in the home. During the tour of the home inspector found tablets in a container in a resident’s room. Mrs Jellett said that staff should have administered these earlier that morning. The MAR charts were checked and the medication had been signed as being given to the resident. The standard for medication administration was not met at the last inspection, and a requirement has now been made that all staff be re assessed to ensure they are capable of administering medication. CSCI is to be informed of the action taken in regards to the medication error. Some of the signatures on the medication administration records were illegible and did not correspond with the list of signatures at the front of the medication record book, so could not identify which member of staff was administering medication at a particular time. Burlington Nursing & Retirement Home DS0000024125.V307117.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities are arranged to suit residents. Residents said that they are happy with their lifestyle at the home, are able to keep in contact with their family and friends and able to have choice and control over their daily tasks. Good home cooked food is provided. EVIDENCE: There were various dates of musical entertainments that were planned for the residents on the notice board in the hallway. There is no other planned formal activity program, however residents spoken with were happy with what was on offer and one lady said she was happy and that she did not want to join in group activities at her age. Many of the residents have nursing care needs and those spoken to said they are content to relax in their rooms. There are well-maintained gardens with lawns, flowerbeds and pot plants to the rear of the home with plenty of seating for residents. The chef was spoken to at length and showed she was knowledgeable about the nutritional needs of the residents in the home. Good home cooked food is Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 14 prepared and the menus are on a four-week cycle. Residents have recently been asked for their input into the menus and because of this the manager and the chef have devised a new menu plan to meet wishes of residents. During the visit the Inspector sampled the lunch of bacon and onion roly-poly served with mashed potatoes, carrots and cauliflower, it was tasty and well presented. Portions were good. Residents who did not want this main course had a choice of smoked haddock or fish cakes. The residents that the Inspector spoke to were complimentary about the food served at the home. Staff were noted to help those residents who needed help in a sensitive manner. Residents are able to have a cold or a hot supper and snacks are available in the evening. The Inspector noted that there was a lack of equipment in the kitchen, the grill had broken down and has not been replaced which did mean that if residents wanted cheese on toast for example they would not be able to have it. The food mixer is a small hand one which is not adequate for a home of this size. A requirement has been made that the kitchen be suitably equipped. Burlington Nursing & Retirement Home DS0000024125.V307117.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and investigated. The majority of staff have received updates in recognising abuse and report according to procedure. EVIDENCE: There have been no formal complaints recorded at the home since the last inspection and CSCI has not received any in relation to the home. The manager said that minor issues are dealt with at the time. Residents told the Inspector that they would know who to complain to and that they were aware that the owner was in the home most of the time. The complaints procedure displayed had been updated to reflect the change of address of the Commission. Mrs Jellett has recently attended the new adult protection training and is cascading it to all staff. All but two of the staff had received training and updates in adult protection. Mr Holden said would be addressed. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 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): 19.20.21.22.23.24.25.26. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Residents live in a comfortable, homely, and clean environment and there are sufficient facilities and equipment to meet their needs. EVIDENCE: The home has a pleasant homely and friendly atmosphere and was clean and tidy. Since the last inspection some new carpets have been laid and some rooms refurbished to a good standard. There is a large lounge/dining room and several other quiet areas and smaller lounges for residents to use. The rear garden is tidy, safe, well maintained and attractive. Maintenance and service records are organised, easy to access and well kept. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 17 The use of CCTV is restricted to entrance areas and the hallways and does not intrude on the daily life of residents. Lighting and furnishings are homely and suitable and the resident’s rooms have been personalised with their possessions. There are adequate toilet, washing and bathing facilities for the residents presently accommodated and aids, hoists and other equipment is provided to meet residents needs. Call bells are available in all areas including one to go into the garden. All resident’s doors are fitted with locks and pipe work and radiators are guarded to protect residents from scalding. Emergency lighting has been checked as required and temperatures of hot water monitored and recorded. As rooms become empty they are being refurbished to a good standard. The policy in bathrooms said staff must test water before bathing a resident but not all bathrooms had a thermometer, Mrs Jellett said this would be addressed. When the inspector returned to the home these thermometers had been provided. Mrs Jellett told the Inspector that thermostatic valves have been fitted to all baths. During a tour of the home the Inspector noted that a number of rooms are wedged open, this is a fire safety hazard. If residents wish to have their doors open they should be provided with automatic closures to protect them in the event of fire. Two doors did not close fully and were also identified as a hazard which need attention. A number of minor issues related to the environment that needed attention were discussed with Mrs Jellett at the conclusion of the inspection; she said they would be attended to. Two rooms had an unpleasant odour due to a continence problem that residents have, Mrs Jellett said she would ask the cleaner to shampoo the carpets. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 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. The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service There are sufficient staff employed to ensure that resident’s needs are met. Staff training is provided and staff are competent to do their jobs, however all staff must have instruction in adult protection procedures and fire safety procedures. EVIDENCE: All residents spoken with very complimentary about staff. Staff were observed going about their work and they seemed happy and were caring and patient towards residents. Those staff spoken to said they enjoyed working at the home. The staff fire training records for all night staff were reviewed and 2 staff were out of date. Mr Holden is required to ensure all staff are up to date with their fire safety training. Two members of staff also need updates in adult protection. There are 27 residents accommodated and there were 2 trained nurses, 4 carers, 3 cleaners a chef and a kitchen assistant on duty on the day of the visit. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 19 The manager said this was adequate to meet needs and residents spoken to were satisfied that there were enough staff on duty to help them, those spoken to said that call bells are answered promptly the majority of time. The staff rota was available for inspection but was not in good order, it was untidy and could not be clearly read which made it difficult for the Inspector to track which staff were on duty and when. The home is required to keep these records in good order. A recommendation has been made to organise and maintain a better system. Staff recruitment records have been updated and there was a discussion about staff having POVA first checks while waiting for CRB checks to come through. The manager told the Inspector that at least 70 of the care staff have achieved NVQ. Staff induction and supervision records need to be reviewed and updated. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 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): 31,32,33,34,35,36,37,38. The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a well-qualified, caring and competent manager and is run in the best interests of residents. Resident’s financial interests are safeguarded and in the majority of cases the health and safety of residents are promoted and protected. The views of residents, their families and friends need to be sought formally so the company can measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home. EVIDENCE: Mrs Christine Jellett is the Registered Manager and has been a manager for almost 4 years at the home. She is a first level nurse and an experienced manager. Mrs Jellett has recently achieved the Registered Manager Award. Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 21 There are clear lines of accountability in the home and residents spoken to knew the management structure at the home, they said Mrs Jellett has a high profile every day and so is available for residents and staff, also Mr Holden the provider is always around the home to speak to. Staff stated they were supervised informally and Mrs Jellett said a system of formal supervision and appraisals have started but these are not complete, she is aware that the standard says supervision must be recorded. Formal staff meetings are not held at present but Mrs Jellett said communication was good throughout the home and that topics were discussed during staff handovers. Staff when spoken to did say that communication was good in the home. The need for formal staff meetings was discussed. The last full residents satisfaction survey was completed in 2004 and a copy is available in the statement of purpose in the home. There is a need to review this. Appropriate policies and procedures are available and Insurance cover is available in the home, the certificate was displayed on the wall in the hall. Service users are encouraged to manage their own affairs with the help of relatives or advocates if necessary but Mr Holden does manage personal allowances of a small number of residents. Two of these accounts were checked against receipts and money and were correct. From reviewing records, speaking to residents and staff the inspector concluded that in the majority of cases service users rights and best interests were safeguarded by the home’s record keeping. Staff training records are available to indicate that staff have received training in the majority of appropriate health and safety procedures. The Provider carries out Regulation 26 visits as required and completes reports on the conduct of the care home, these were available in the home for inspection. A number of health and safety issues were identified during the inspection. A number of doors were wedged open some when the rooms were empty, this had been identified as a concern at the last inspection in case a fire should start and a requirement was made. This requirement has been carried over as the situation has not improved. During a tour of the home a number of cleaning and disinfecting fluids were found around the home and in the bathrooms, although cleaning was in progress, some were still around later on the day. Some of these were Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 22 removed and locked away during the inspection following discussion with Mrs Mayo, a requirement is made that staff are updated in health and safety procedures and safe storage of these substances to protect residents. The fire safety systems had been tested appropriately, however two of the night staff need an update in fire safety training. Burlington Nursing & Retirement Home DS0000024125.V307117.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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 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 2 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 3 3 2 2 2 Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Medicines must be administered according to the prescribers directions. Staff must be re assessed for competence in administering medicines. CSCI to be informed of action taken by Staff to be appropriately supervised and records kept. CSCI to be informed of action taken by. The kitchen should be adequately equipped. CSCI to be informed of action taken by Make arrangements for persons working at the care home to receive suitable training in fire safety prevention and adult protection. CSCI to be informed of action taken by Ensure staff follow safe working practices to eliminate risks to residents by ensuring safe storage of COSHH items. CSCI to be informed of action taken by Make adequate arrangements for DS0000024125.V307117.R01.S.doc Timescale for action 31/10/06 2. OP36 18(2) 31/10/06 3 OP19 23(2)c 31/10/06 4 OP38 23(4)d 31/10/06 5 OP38 13( c) 31/10/06 6 OP38 23(4)c 31/10/06 Page 25 Burlington Nursing & Retirement Home Version 5.2 containing fires by discontinuing the use of wedges. CSCI to be informed of action taken by RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP26 OP33 Good Practice Recommendations All areas of the home to be clear of offensive odours. The views of residents, their families and friends need to be sought formally so the company have yet to measure how successful the home is at meeting its aims and objectives and the statement of purpose of the home. Car records and duty rotas must be maintained in a clear and orderly way. 3. OP37 Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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. Extracts may not be used or reproduced without the express permission of CSCI Burlington Nursing & Retirement Home DS0000024125.V307117.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!