Inspection on 13/11/07 for Burnside Court Care Home

This inspection was carried out on 13th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Burnside Court Care Home 04/11/09

Burnside Court Care Home 06/01/09

Burnside Court Care Home 06/12/06

Burnside Court Care Home 16/03/06

Burnside Court Care Home 04/10/05

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Burnside Court Care Home Burnside Court Care Home 104-106 Torquay Road Paignton Devon TQ3 2AA Lead Inspector Doug Endean Unannounced Inspection 13th November 2007 10:15 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 Burnside Court Care Home DS0000063855.V350754.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. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burnside Court Care Home Address Burnside Court Care Home 104-106 Torquay Road Paignton Devon TQ3 2AA 01803 551342 F/P 01803 551342 burnsidecourt@btconnect.com www.burnsidecourt.co.uk ABC Care Home Ltd 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) Miss Emma Zoe Hume Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (21), Old age, not falling within any other category (21), Physical disability over 65 years of age (21) Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2006 Brief Description of the Service: Burnside Court is a large, three storey, detached property built in 1892, and situated on the level within a quarter of a mile of Paignton town centre, which has been adapted to provide personal care. Local facilities include the library, which is about 100 yards away, the park, and many shops, restaurants and public houses. The main post office is also only a short distance away. The bus service passes the door with a bus stop close by. The home is registered to provide long term care for 21 elderly people who may also have a degree of mental and/or physical infirmity. There are 19 single bedrooms and one double bedroom, all having en-suite facilities. These are spread over three floors that can be reached by stairs or a passenger lift. The home is comfortably furnished and attractively decorated and there are communal spaces on the ground and lower ground floors. The home is entered either at the front off the main Torquay Road or from the rear where there are several parking spaces. At the front of the building there are very pleasant garden with seating for people who live in the home, and their visitors, to use in good weather. The home has won the “Torbay in Bloom” on many occasions for the way it presents the front garden. Fees are displayed in the Statement of Purpose and commence from £350 per week. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection commenced at 10:15 on the 13th November 2007 and lasted a total of four and a half hours. A gentleman who is an “Expert by Experience” accompanied the Regulation Inspector. It was his role to help the Inspector get a picture of what it is like to live in and use the service. During the inspection we looked at the premises including bedrooms, bathrooms and the kitchen. We also were invited to look into people’s own bedrooms and en-suite facilities. Collectively we spoke to 3 people who live in the home and read the records 2 people. We also read the staff files of 2 staff members and both were interviewed. We did not have the opportunity to interview any visiting relatives but did received comments from 2 health care professionals who visit the home using the Commission for Social Care Inspection survey forms. A completed “Annual Quality Assurance Assessment” document was received by the commission that provided additional information about the way the home has performed against the National Minimum Standards from their point of view. What the service does well: What has improved since the last inspection? The home has improved the method by which they verify the work they do actually meets the expectations of others as well as their own aims and Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 6 objectives. They have a professionally prepared quality assurance system, and can show that it has been used, and people have made aware of the outcome. They are also able to show that they have responded to the comments they have received. 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. The summary of this inspection report can be made available in other formats on request. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 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 Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 1 & 3. Standard 6 does not apply. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The information made available to anyone considering moving to the home is comprehensive and of good quality. The pre-admission assessment format is well designed obtaining good levels of information to enable good decisions to be made about a prospective admission. EVIDENCE: The home has a professionally prepared brochure pack introducing Court to prospective clients and their relatives or advocates. It information about the property, staff, menus, a sample contract complaints procedure. It also includes information about the current Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Burnside includes and the fees and Page 9 the contact tells the reader about the items not included in the fees such as chiropody and dentistry. People reading the information will be well informed about the service they can expect to receive should they choose to move into the home. There is also a trial period for every admission and details about this are also covered in the contract. People are invited to visit the home, if this is possible, prior to any decisions being made about an admission. The home also has its own website: burnsidecourt.co.uk and also email address: burnsidecourt@btconnect.com. Before there are any arrangements made to move into the home, all people referred to the home have a pre-admission assessment carried out by the Registered Manager. A copy of the assessment is in the brochure pack. The assessment is completed at the place they reside, which may be at their home or possibly in hospital. Personal details are obtained first and then the Registered Manager will interview the person, or their relative, to find out information about them including the history of the problems they have and the current situation. She will also gain information from the hospital staff and Social Worker if there is one involved. The assessment covers general health needs such as communication skills, sight, mobility and oral care. It also includes a mini mental state assessment as the home does cater primarily for people with dementia. Once the information gathering is complete it is brought together in a dependency profile and scored. This enables the home then to make a decision about their ability to manage the care of an individual and also provides a base for all future assessments to be compared with. We looked at 2 assessments that had been completed, one on a recently admitted person. The information was relevant, clear and easy to read, and did allow the assessor to make an informed decision about the appropriateness of the placement. Addition information was in the files such as discharge summaries and Social Worker referral notes. The Registered Manager said that the decision to admit someone to the home has to include how their admission, and care, will also impact on the care of those people who are already living in the home. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans are well written and provide appropriate guidance for staff to follow in meeting the care needs of the people who live in the home. There are suitable arrangements for people to receive health care from a professional, such as a General Practitioner, when they need it. The staff treat the people who live in the home with dignity and respect. EVIDENCE: We looked at the records of 2 people to see the information that the staff had gathered to enable them to produce care plans. One of the files was about a person who had recently been admitted to the home. We found that the home Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 11 had carried out assessments on issues such as mental health, continence, and tissue viability. They produced care plans in a booklet format that commenced with a contents list and personal facts about the individual that was being written about. There was an assessment for physical well being that looked at what people could do for themselves such as personal care, if they were independently mobile or subject to falls, and how their medication was managed. The plans were well written and the home had obtained the signature of a relative or advocate agreeing to the care plan where the people living in the home were not able to sign themselves. There was also an administrative checklist in the file that quality assured the work making sure that all the correct steps had been followed to complete the care planning process. Finally there was clear evidence that the care plans had been reviewed at least monthly. Where the District Nursing Service was involved with a person living in the home their own records were kept as well as those made by the home. We received 2 completed survey forms from health care professionals and each made very positive comments about the way the home conducts the care that is provided to people who live there. One person did comment that they would like to see better hand washing facilities for themselves when they attend the home. The Commission for Social Care Inspection survey form asked, “What do you feel the care service does well”. The reply from one person was,” Looks at and acts on individual care needs of client. Promote skills and abilities of client.” The home promotes good health through monitoring the people who live in the home and using the services of the General Practitioner, Chiropodist, Dentist and other health care professionals as they are needed. When the people who live in the home have received a visit from one of the health care professionals a record is made in the notes appropriate to that person i.e. the Doctors notes or the Nurses notes. We saw evidence of this in the 2 files that were read. The home has a medication storage room that is in a secure place and kept locked when not in use. They provided good information to show that the monitored does system that is in use is well managed. The supplying Pharmacist inspected the homes medication arrangements one week before this inspection, with a satisfactory result. We also looked at the way medication was received, stored, administered and disposed of and found the arrangements to be good. We also found that only suitably trained staff are involved in the administration of medication to people who live in the home. A major pharmaceutical company has provided medication training to staff that work at the home. The 2 visiting professionals that responded to the Commission for Social Care Inspection survey said that the home always respect individual’s privacy and dignity. We observed that people who needed assistance with their personal needs received this in the privacy of their rooms or an appropriate area such Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 12 as the bathroom. People were called by the name that they appeared to be happy with. The Expert by experience spoke to 3 people during the inspection and made the following comment. “One person said, “the staff work with me” another “they see to my health and look after me”. Those spoken to appeared to have full confidence in the staff. The staff members were seen to be very caring and treated residents with respect.” He also noted, “The cook is also a key worker and takes residents out on her own. On the day of the visit she was later accompanying a gent to a hospital appointment as his relatives live away”. Another observation was that all the people who live in the home were clean and tidily dressed and appeared well cared for. The home has addressed an issue that relates to maintaining the dignity of individual that they care for by offering them information about the staff they are involved with on every occasion. The staff wear uniform that has their name written on it thus providing a visual prompt for the person living in the home as to the name of the person who is assisting them. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The homes approach to the care of the people who live in it, meets the social and therapeutic needs of the individuals, as well as that of the group. The way the nutritional needs of individuals are met is very good. EVIDENCE: The home gathers information about the people who live there, from them, and their friends and relatives. This includes information about past hobbies and interests, work and religious observance’s. The cook also finds out about personal likes and dislikes in what people will eat and how best to present a meal or drink. This information is then used to guide the planning of the persons day from what they will have offered to eat and which activity they might attend, or choose not to attend. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 14 There are regular arrangements for activities that include visits from organisation external to the home who organise activities that have a therapeutic outcome, whilst also being entertaining. During the inspection an activities person was involving several people in a quiz that helped promote memory recall. Also a volunteer from the Alzheimer’s Society comes to the home each week for a variety of activities with individuals and groups of people. Another person attends the home every two weeks and plays music and encourages people to sing along with them. The staff also do a range of activities that involve individuals and groups of people. These include bingo on Saturdays, Karaoke using a music centre that is specially made for this, or going out for a drive in the homes people carrier mainly in the summer. When they go to local places of interest such as the Butterfly Farm the Provider pays for the entry fee and provisions such as ice cream for the people who have attended. Anyone can go to church with two being within easy walking distance from the home. The Expert by Experience reported that Holy Communion is carried out at the home once a month for those of the Anglican and Catholic faith. The Expert by Experience also reported that people enjoyed the activities on offer. He said, “There are events run by outsiders several times a week and the staff also organise bingo, cards and games. It was said by staff that the residents really enjoy music and singing in preference to television. All residents joined in the annual Sunflower growing competition - still in evidence in the front garden”. People were able to also indulge in choice in the way that their bedrooms were decorated using personal items that they had brought from home. The staff and families had used the items both for decoration but also as prompts to aid the persons memories of familiar faces and places in their past. The Expert by Experience also saw that, “One resident has a cat, which gives her much pleasure and sleeps in her room.” We looked at the way the cook runs her kitchen and were impressed with the arrangements. She is a trained cook with City & Guilds qualifications in catering and National Vocational Qualification in Care. She has all the training that the care staff has, as she is also involved in care. There are good arrangements for storage of foodstuffs. Preparation was also well organised as were the records that are kept. The Expert by Experience made the following notes that clearly show what we experienced about this part of the service. “The day’s menu was on a white board outside the dining room and offered a choice of main course, pudding and drinks. The staff said that whilst the residents largely ignored this it was helpful for staff and visitors. The cook demonstrated a good knowledge of people’s likes, dislikes and dietary needs. Meals are cooked from fresh ingredients wherever possible. The day’s main course was sausage casserole with boiled potatoes, sprouts, carrots and peas with onion and tomato gravy, followed by a drink of own choice and apple crumble and custard (the alternative was jacket potato with salad followed by Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 15 fruit). The food was well presented and tasty. Three carers each discretely assisted a diner. Some meals were liquidised. All diners were asked if they were finished before plates were removed.” We only raised one issue that the staff fridge was in the kitchen and staff did use the kitchen when entering and leaving the home. The Registered Manager and cook told us this was an issue that they have responded to in the redevelopment of the lower ground floor that is soon to occur when final planning arrangements are complete. As part of this redevelopment program we saw new dining and lounge furniture delivered to the home, which was used during the main meal in the afternoon. Visiting is encouraged at any reasonable time of the day and visitors can join in any activity that they wish. They are also asked to respond to the homes Quality Assurance questionnaires that ask open questions and have space for people to write comments to describe their experience of the service, from their point if view, and that of their relative or friend who is living in the home. The people who live in the home also have their own questionnaire but the Registered Manager did say that in reality the relatives would help them complete these. They are invited to answer a question, “Does anything need to be changed to make the service better”. A summery of the results of the past surveys were seen and the summery is given to staff and relatives. This formal quality assurance exercise is carried out once a year. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and well advertised. The homes arrangements for safeguarding people from abuse are satisfactory. EVIDENCE: There are good arrangements in place informing people how to make a complaint if they wish. The procedure is displayed on the notice board at the entrance to the home, and is also in the pack of information that is made available as part of the referral/admission procedure. The home has procedures in place for the protection of the people who live in the home from any form of abuse. This begins with training staff in the recognition and reporting of abuse and commences at induction with the use of the “No Secrets” video. Further distance learning training has been carried out involving some members of staff and we saw evidence of this in the training records. There are plans to continue this for all staff in the home. The homes recruitment procedure is good and is commented upon in the section entitled “Staffing” in this report. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 17 Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 19, 20, 21, 24, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well located for all service that are close by and on the level to the home. The home provides good clean and comfortable accommodation for the people who live there. EVIDENCE: Burnside Court is in a good location for many services being a short distance from Paignton town centre. Banks, post office, churches, restaurants, and shops of every kind, Doctors offices, and pharmacies are all on the level to the home. There is the town’s park just 100 yards away with paths leading through Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 19 to Paignton sea front and the multiplex cinema. The bus service passes the front door of the home with a bus stop just 50 yards away. The library is also only about 100 yards from the home. There are several parking spaces at the rear entrance to the property where a second secure entrance to the home can be found. The home is a large detached building that has been adapted to make it suitable to meet the needs of disabled people having a passenger lift to all floors, disabled bathing and toilet facilities including shower and domestic style bath with a floor mounted electric hoist. There are 19 single bedrooms and one double bedroom. These are generally of good size and all have en-suite facilities and are decorated and furnished to the liking of person living in them. Sinks are fitted with thermostatic mixer valves to reduce the risk of scalding and radiators were guarded. During the tour of the home we also saw that the windows had been fitted with devices to prevent them opening beyond the permitted distance. The home was clean, uncluttered, and free from unpleasant odours. It had been decorated nicely and the improvements to the décor are ongoing. We found communal space on the ground floor and the lower ground floor that had a lounge and dining room where most of the people had gathered. The kitchen was of good size and had professional catering equipment. The laundry was also on the lower ground floor and was also used as the staff locker room. It had one washing machine with a sluicing cycle and one washer without a sluicing cycle, and a dryer. Cloths are labelled and baskets that had people’s names on them were available for laundered cloths to be put into and delivered to their rooms. The Expert by Experience viewed the home from the view of someone living there and made the following comments, “Whilst the main entrance is at street level the main lounge and dining room are at the rear garden level (best described as lower ground floor) accessed via a shaft lift or down a well lit but narrow steep staircase. Although this is a little off-putting on first sight once there the rooms are light and spacious. The lounge – a single storey addition to the original building, accessed though the dining room - has windows on three sides and a secure exit to the rear courtyard. There was a television in the corner but it was not in use at the time of the inspection due to activities after which lunch was served. There is a second “quiet” lounge on the ground floor with a music centre (no television). At the time of the visit new dining and lounge furniture was being delivered. All communal areas were seemingly in a good state of repair and redecoration was in progress on the first floor. The lighting was excellent throughout. The secure front garden has a table and seats in a sheltered position and residents are said to take advantage of this in sunny/warm weather. The Home takes great pride in this garden and supports the local “Torbay in Bloom” campaign. All entry and exit doors were secure but had provisions for emergency escape in the event of a fire.” The Annual Quality Assurance Assessment provided information about the maintenance of equipment that was verified by records that we read during the Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 20 inspection. The records included the Registered Manager Health & Safety checks of the environment, fire system maintenance and risk assessment, passenger lift and other hoisting equipment services and the Environmental Health Department report on the catering services. There was also a check regarding “Managing Asbestos” carried out in September 2007. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff recruitment procedure, and training program, is sufficient to prepare them for their duties and reduce the risk of poor practice through ignorance, or abuse, occurring. EVIDENCE: The people who live at the home are informed who are on duty in two ways, there names are on the white notice board on the lower ground floor and staff also wear uniforms that have their own name written on it. We found that the numbers of staff on duty were sufficient to meet the tasks that were to be achieved during a span of duty. Duty rotas confirmed that staffing good levels are planned for, and achieved at all times. The Registered Manager had also made arrangements to have sufficient support staff on duty on the day of this unannounced inspection to manage the delivery of new furniture and disposal of the old outgoing furniture. The Registered Manager and her Deputy Manager led the staff team. The Registered Manager has her National Vocational Qualification level 4 in Care and is studying for the Registered Managers Award. There are 5 staff with National Vocational Qualification at level 3, and 5 with National Vocational Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 22 Qualification at level 2 that is above the 50 stated in the National Minimum Standards. The 2 staff records we sampled, and training records, which showed us that staff complete a comprehensive induction that introduces them to the care they are to provide and the skills they will need use. The induction commences with a “first day” list of things that have to be achieved. This is a comprehensive list of things such as fire instructions, layout of the home, etc, that is signed off by the staff member and the tutor who carries out the introduction. The home then has a structured program of training that includes distance learning and practical in house training by external providers including the local college. We saw that fire training, moving and handling, first aid and Health & Safety had been carried out. Also a major pharmaceutical company had provided training in the management of medication. More focused training on subjects such as dementia has been received from at least 3 sources including the Local Authority and the National Health Service. The staff are given a pack that includes information on the “Mental Capacity Act 2005”, and the homes policies and procedures such as dealing with challenging behaviour, stress, missing persons and the accident procedure. The 2 staff records we read showed that the home does follow its recruitment procedure and does obtain sufficient information about individuals before they commence work at the home. The files included application forms, proof of identification such as copies of passports and birth certificates. There was a photograph of the employee, completed medical questionnaire, contract of employment and Criminal Records Bureau response. We also saw evidence of the individual’s personal training records. Two staff were interviewed. One said that, “Residents come first at the home and we have a responsibility to provide care in a way that does not cause them stress, such as changing routines”. The other felt that the staff are provided with good levels of training to properly prepare themselves for the role they play. The volunteers who attend the home have also had Criminal Records Bureau checks. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): The homes performance was assessed against Standards 31, 33, 35 & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Registered Manager controls the activities of the home so that it achieves its aims and objectives. EVIDENCE: The Expert by Experience made accurate comment when he wrote, “The registered manager appears to be very “hands on”, highly organised and totally familiar with the needs of the residents and the abilities of her staff to meet those needs.” This inspection has gathered enough information to support the observations that were made. The Registered Manager has been registered for 2 years. She has worked in the care home for 8 years coming Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 24 with a Distinction in, “GNVQ in Advanced Health & Social Care”. She has worked in every capacity at the home progressing to her present role that was achieved at interview with the Commission for Social Care Inspection in 2005. She has also achieved the National Vocational Qualification at level 4 in care and has almost completed the Registered Managers Award. Under her control, and supported by the Registered Provider, the home has Investors in People Award and they also have the ISO 9001 2000 which is a quality management audit that is reviewed every six months. In fact the review had begun on the day of this inspection and was reappointed as a result of the key inspection taking place. The manager has also commanded the respect of the people she works with who hold her in high esteem. We saw that the home has a professionally prepared quality assurance system they have purchased as it does meet the needs of this home. We saw how it has been used to include comments from the people who live in the home through their advocate on most occasions. The results of the last audit were seen and they have been widely circulated to staff and advocates. The home does not manage the finances of any person who lives there. They do handle small amounts of pocket money that is given to them by relatives for payments to people such as the hairdresser and Chiropodist. We saw the records of expenditure supported by receipts each being signed by 2 people for greater evidence of good auditing of the account. Any money held is in a locked safe. Throughout the inspection the Registered Manager and her staff were able to provide evidence that the home has strived to meet the standards expected of them and the aims and objectives that they have set for themselves. We saw that the homes record keeping was good. Accidents had been recorded and appropriate action taken. Maintenance had been regular and appropriate to the individual piece of equipment by a competent person. The home was in good order. Staff were correctly recruited and trained and the Registered Manager has made arrangements for proper ongoing supervision and appraisal so that each person’s performance was to a good standard. The staff and the people living in the home presented as happy and comfortable. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 25 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations The staff fridge should be relocated and staff should only enter the kitchen when correctly clothed and on domestic business to reduce the risk of contamination of otherwise well prepared meals. Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Burnside Court Care Home DS0000063855.V350754.R01.S.doc Version 5.2 Page 28 - 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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