Inspection on 06/01/09 for Burwood House

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burwood House 2-8 Todmorden Road Bacup Lancashire OL13 9BA     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: Susan Hargreaves     Date: 0 6 0 1 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. the things that people have said are important to them: They reflect 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 29 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Burwood House 2-8 Todmorden Road Bacup Lancashire OL13 9BA 01706873466 01706873262 burwood.res@virgin.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Deborah Joan Watson Type of registration: Number of places registered: Burwood Residential Home Ltd care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only- Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of people who can be accommodated is: 24 Date of last inspection Brief description of the care home Burwood House is a detached residence in its own grounds. Personal care and accommodation is provided for up to 24 older people. All rooms are single occupancy with one having an ensuite facility. There is a large lounge and dining room on the ground floor and additional seating in the reception area. A passenger lift allows access to all to all floors of the home. The grounds are accessible to people who use the service and a seating area is available at the front of the property. Burwood House is situated close to the centre of Bacup and all local amenities. The current fees fees charged at Burwood House range from £346 to £390 per week. Additional charges are Care Homes for Older People Page 4 of 29 Over 65 24 0 Brief description of the care home payable for hairdressing, private chiropody, newpapers and toiletries. A copy of the statement of purpose and service user guide is available on request. Care Homes for Older People Page 5 of 29 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: A key or main unannounced inspection, which included a visit to the home, was conducted at Burwood House on 6 January 2009. This is the first inspection after the home was registered with Commission for Social Care Inspection as a limited company. The manager completed an annual quality assurance assessment several weeks before the visit to the home. This document is a self-assessment that focuses on how well outcomes are being met for people who use the service. It also gives us some numerical information about the service. Three completed surveys were returned from people who use the service and four from members of staff. Care Homes for Older People Page 6 of 29 At the time of this visit twenty four people were living at the home. A tour of the premises took place and we looked at staff files and care records. We also spoke to members of staff on duty, people who use the service and their visitors. Discussions also took place with the manager regarding issues raised during the inspection. What the care home does well: What has improved since the last inspection? What they could do better: In order to ensure people who use the service receive care in their preferred manner all care plans should include more detailed instructions for staff to follow, the person using the service or their relatives should be involved in planning their care and a written report about the care and condition of each person should be completed during each shift. Action must be taken to improve the management of medication. When medication is omitted the reason for this must be written on the medication administration record. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. To promote the safe handling of medication a system must be put in place to regularly audit all aspects of the management of medication including staff competence. To ensure all members of staff know what to do if allegations of abuse are made the procedure should be amended to include contact details for social services, police and Commission for Social Care Inspection. Paper hand towels should be provided in all communal toilet areas in order to control the spread of infection. Action must be taken to ensure recruitment procedures protect people who use the Care Homes for Older People Page 8 of 29 service from the employment of unsuitable staff. Two written references must be obtained before any new employees start working at the home. References should not be requested from close friends or family. To ensure people who use the service receive the correct treatment in the event of an accident or medical emergency at least one member of staff qualified to administer first aid should be on duty at all times. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 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 10 of 29 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. A thorough admission procedure ensured the needs of people using the service were identified and met. Evidence: A copy of the statement of purpose and service user guide is given to people using the service on admission to the home. They are also available on request to people who are considering using the service and their relatives. The statement of purpose and service user guide provide information about the care and facilities provided at the home. The manager or deputy manager visited people who were considering using the service in hospital or their own home before admission. The purpose of this visit is to assess the persons health and personal care needs to ensure they can be met at the home. Care Homes for Older People Page 11 of 29 Evidence: The care records of a person admitted recently to the home contained a detailed preadmission assessment. The assessment provided important information for the development of the care plan. This person said she was settling in and the home was really nice. People who were considering using the service or their relatives received confirmation in writing that their needs could be met at the home. Care Homes for Older People Page 12 of 29 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. People who use the service were cared for in a manner that promoted their privacy and dignity. Medication was managed safely. Evidence: We looked at the individual care plans of two people who use the service. These plans identified the health and social care needs of each resident and provided some directions for staff to follow to ensure these needs were met. However, some of these care plans would benefit from more detailed instructions about what care workers needed to do to fully meet the needs of people using the service. One care plan directed care workers to promote good hygiene and oral health but did not give detailed information about what this entailed. The care plan about social activities for one person stated they enjoyed talking to other people and helping staff but there were no clear directions about what staff needed to do to encourage these activities. Care plans included information about each persons spiritual needs and clearly stated if they wanted to practice their faith. Details of how each person wanted to practice Care Homes for Older People Page 13 of 29 Evidence: their chosen faith were also included in their individual care plan. Appropriate risk assessments including ones for falls, nutrition and the development of pressure sores were in place. Directions for staff to follow about how to manage identified risks was also included in the care plans. Although a written report about the care given to each person using the service was completed during some shifts these provided only very brief information. It is good practice to complete a written report about the care and condition of individual people using the service during each shift. This report should be in sufficient detail to reflect the health and social care given and provide information for staff about the condition of each person to ensure continuity of care. Care plans and risk assessments were reviewed monthly and updated when the needs of the resident changed. The relative of one person using the service said they were always informed about care issues. However, there was no evidence to suggest that people using the service or their relatives were involved in planning the care given. Although improvements to care records are needed it was clear from discussion with people using the service and their relatives that peoples health and social care needs were being met. One person described the home as brilliant and said that all their needs were being met. There were records of the involvement of GPs and other health care professionals including the chiropodist and district nurses in the care of people who use the service. Medication was stored correctly and administered by members of staff who had been trained in the management of medication. To ensure medication was managed correctly and prevent mishandling appropriate records were in place. These included a record of medication received into the home and a record of medication returned to the pharmacist for disposal. However, there were a number of gaps on the medication administration records of several people using the service suggesting that medication had not been given to that person. The reason why the medication had been omitted was not recorded. There were no written instructions for staff to follow about the administration of medication prescribed when required for individual people using the service. Having written instructions for this ensures people are given their medication when they need it. The manager was advised that regular medication checks, including staff competence, Care Homes for Older People Page 14 of 29 Evidence: would identify problems and ensure that medication was managed correctly. Personal care was given in the privacy of the persons own room or the bathroom. Members of staff were observed attending to people in a friendly and professional manner. One person said, I only have to ask and they see to me. The relative of a person using the service said, The staff are brilliant. Care Homes for Older People Page 15 of 29 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. Peoples choices were respected and they were supported by members of staff to have a fulfilling lifestyle. Meals were wholesome and appetising and people enjoyed them. Evidence: Discussion with people who use the service and members of staff confirmed that a variety of activities were organised at the home. These included bingo, dominoes and aromatherapy. An outside entertainer regularly visited the home. One care worker said she took people using the service to the local market when the weather was nice. One visitor explained that the manager was trying to do new things and they had recently enjoyed a trip to Hollingworth Lake. People who use the service were also encouraged to follow their own interests and hobbies. The manager said a number of people enjoyed reading and were supplied with library books from the mobile library. One person said she liked to spend the afternoon in her room doing puzzles and reading. Local clergy also visited the home and a Church choir came every month to lead hymn singing and prayers for people who who wished to practice their faith in that way. People using the service said their visitors were welcomed into the home at any time. The relative of one person said, were always made welcome. A member of staff Care Homes for Older People Page 16 of 29 Evidence: explained that visitors were always offered refreshments and the relative of one person often came for Sunday lunch. The daily routine was flexible in order to meet the needs and preferences of people using the service. One member of staff said about seven people liked to get up early and were usually up when she came on duty at 7 30am. People using the service said they could choose when to get up and go to bed. The meal served at lunchtime looked wholesome and appetising. Members of staff were observed sitting and chatting with people using the service at lunchtime and assisting them when necessary. Lunch was unhurried allowing people time to socialise and enjoy their meal. All the people asked said the meals were good. Three people told us there were two choices at every meal. Care Homes for Older People Page 17 of 29 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. People who use the service felt able to express any concerns. Members of staff had a good understanding of safeguarding issues. Evidence: A copy of the complaints procedure was displayed in the home and included in the statement of purpose and service user guide. Two people who use the service completed a survey and indicated that they knew how to make a complaint. The manager said no complaints had been made in the last year. No complaints have been made directly to the Commission. One person who used the service explained that they would tell the manager if there were any problems. Another person said she would speak up if she had any complaints. Policies and procedures about the safeguarding of vulnerable adults and whistle blowing were in place and available to all members of staff. Discussion with two members of staff confirmed they had received training in safeguarding vulnerable adults. They both said they would report any concerns to the manager or provider immediately but were unsure what to do if they were not available. To make sure members of staff know which outside agencies must be informed the manager was advised to amend the safeguarding procedure to include contact details for social services, the police and the Commission for Social Care Inspection. Care Homes for Older People Page 18 of 29 Care Homes for Older People Page 19 of 29 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 premises were well maintained and provided a comfortable and homely environment for people who use the service. Evidence: A tour of the premises confirmed that the home was clean, tidy and well maintained. This provided a safe and comfortable place for people using the service to live. The three people who completed surveys indicated the home was always or usually clean. People who use the service were encouraged to bring personal items for their bedrooms to make them more homely. These included ornaments, photographs, pictures for the walls and items of furniture. One person said, Its my own furniture so I feel Im at at home. The grounds and gardens were well kept and accessible to people using the service if they wished to sit outside when the weather permitted. All the laundry was done at the home. A suitably equipped laundry room ensure clothes were washed promptly and returned to people using the service. Members of staff said gloves and plastic aprons were available for them to use in order to protect themselves and people using the service from infection. However, a supply of paper hand towels was not available in communal bathrooms and toilets. Sharing hand towels with other people increases the risk of passing infection from one person to another. Care Homes for Older People Page 20 of 29 Evidence: Care Homes for Older People Page 21 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Members of staff were encouraged to acquire the skills and knowledge necessary in order to meet the individual needs of people using the service. Recruitment procedures did not fully protect people from the employment of unsuitable staff. Evidence: The duty rota provided details about the grades and number of staff on duty for each shift. Four members of staff completed the survey and stated there were always or usually enough staff on duty to meet the individual needs of people using the service. The three people using the service who completed the survey also indicated that there were always or usually staff available when needed. We looked at the files of three members of staff appointed within the last year. Two of these files indicated that all the required information had been obtained before these members of staff had started working at the home. These included two written references and a Criminal Records Bureau check. These checks ensure people who use the service are protected from the employment of unsuitable staff. However, the manager had accepted references from the friends and relatives of applicants. This is not good practice and could put people using the service at risk from the employment of unsuitable staff. It was evident from the other file that this member of staff had started working at the home before the second written reference had been received. Care Homes for Older People Page 22 of 29 Evidence: Discussion with the manager and members of staff confirmed that training was actively encouraged. This included induction training for new employees, health and safety, moving and handling, fire safety and safeguarding vulnerable adults. In addition to this more than half of the care workers had National Vocational Qualifications at level 2 or above in health and social care. Care Homes for Older People Page 23 of 29 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 has a competent manager and the views of people using the service are considered when decisions about the care and facilities provided at the home are made. Evidence: The registered manager has several years experience of management and caring for older people. She kept herself up to date with with current practice by attending relevant training courses, reading care journals and using the internet. She said the provider was supportive and regularly visited the home. Members of staff said the manager was approachable, supportive and willing to listen to new ideas. One care worker said, This is a good home, well managed and a nice working environment. The manager had obtained the views of people who use the service and their relatives by asking them to complete satisfaction questionnaires in September 2008. The manager also held meetings with people using the service to enable them to express and discuss their views on the care and facilities provided at the home. The Annual Care Homes for Older People Page 24 of 29 Evidence: Quality Assurance Assessment stated that as a result of listening to the views of people using the service they had provided more activities and were planning to review the menus. Several people using the service had money kept at the home. To ensure this was managed safely records of all transactions were kept. We checked some of these during the inspection and found them to be up to date and accurate. Policies and procedures for safe working practices were in place. These help to make sure the home is a safe place to for people to live and work. However, only six members of staff had an up to date first aid certificate. To ensure any accidents or medical emergencies are dealt with correctly the manager was advised to ensure where possible that one of these staff was on duty on each shift. The manager agreed to arrange for more of the staff to have training in first aid. She confirmed by telephone after the visit that arrangements for this training were being made. Fire alarms and emergency lighting were tested regularly. An up to date fire risk assessment was in place and fire drills took place every month. Records of the routine servicing of equipment were seen. These included an up to date electrical installation certificate and evidence that the testing of small electrical appliances had been carried out in October 2008. Although the gas safety certificate was out of date the manager has made arrangements for this to be renewed on 14 January 2009. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 9 24 A system must be put in place to regularly audit all aspects of the management of medication including staff competence. To ensure medication is managed correctly 27/02/2009 2 9 13 When medication is omitted the reason for this must be recorded. This will help to prevent error and the mishandling of medication. 30/01/2009 3 29 19 Two written references must 13/02/2009 be obtained before any new employees start working at the home. To ensure recruitment and selection procedures protect people who use the service from the employment of unsuitable staff. Care Homes for Older People Page 27 of 29 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 2 7 7 A report about the care and condition of each person using the service should be completed during each shift. All care plans should include clear directions for staff to follow to ensure the needs of people who use the service are met. People who use the service or their relatives should be involved in planning care to ensure all needs are met in the persons preferred manner. Clear written instructions should be in place for staff to follow to ensure medication prescribed when required is given correctly. To ensure all members of staff know what to do if allegations of abuse are made the procedure to follow should include contact details for social services, the police and the Commission for Social Care Inspection. To control the spread of infection paper hand towels should be provided in all communal toilets. To protect people from the employment of unsuitable staff written references should not be obtained from close friends or relatives. To make sure people who use the service receive the correct treatment in the event of an accident or medical emergency there must be at least one person trained in first aid in the home at all times. 3 7 4 9 5 18 6 7 26 29 8 38 Care Homes for Older People Page 28 of 29 Helpline: 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 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 29 of 29 - 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!