Inspection on 27/12/07 for The Burnham Nursing and Residential Home

This inspection was carried out on 27th December 2007.

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.

Other inspections for this house

The Burnham Nursing and... 25/06/07

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Burnham Nursing and Residential Home 19 Oxford Street Burnham-on-sea Somerset TA8 1LG Lead Inspector Barbara Ludlow Unannounced Inspection 27th December 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Burnham Nursing and Residential Home DS0000069138.V356411.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. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Burnham Nursing and Residential Home Address 19 Oxford Street Burnham-on-sea Somerset TA8 1LG 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) 01278 781757 01278 794861 danielja@bupa.com www.bupa.co.uk BUPA Care Homes (ANS) Ltd Mrs Jacqueline Ann Daniells Care Home 76 Category(ies) of Dementia (11), Old age, not falling within any registration, with number other category (76), Physical disability (5) of places The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) - maximum of 11 Physical disability (Code PD) - maximum of 5 The maximum number of service users who can be accommodated is 76. May accommodate up to 11 persons with dementia on the `Kingfisher` wing only. May accommodate up to 5 persons from the age of 30 years who have nursing needs by way of a physical disability. 25th June 2007 2. 3. 4. Date of last inspection Brief Description of the Service: The Burnham Nursing and Residential Centre is a large established care home that has been registered as BUPA owned since December 2006. The registered nurse manager for the whole service is Mrs Jackie Daniells. The home is located in a converted school and chapel forming a three-storey building. The home is divided into four units, Sandpiper, Nightingale, Kingfisher, which is on two floors, and The Rookery. Two units are for people requiring general nursing care these are Sandpiper and Nightingale. In April 2007 the Kingfisher unit was registered to provide nursing care for 11 people with dementia. A senior nursing sister manages each unit. On the top floor, The Rookery is a residential care unit with a residential unit manager. Each floor has its own dining room and sitting room. All rooms have en-suite facilities of toilets and hand basins. 57 rooms also have a bath or shower. The seafront is within walking distance for more mobile residents. There are two activities co-ordinators who organise a weekly programme of social events. Fees: Social service rate £389 to privately funded personal care at £660 per The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 5 week. Nursing care, social service rate £504 to privately funded care £770 with the Free Nursing Care element refunded. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. At the first key inspection in June 2007 the Annual Quality Assurance Assessment (AQAA) had been completed and returned to CSCI. CSCI comment cards had been distributed and returned. This evidence was used within the report issued after the June 2007 inspection. Further comment cards were sent out after this inspection, CSCI received responses from 20 people living at the home, 18 relatives, 25 staff and 1 visiting professional. Two inspectors for CSCI undertook this second unannounced key inspection on one day over a period of six hours. The outcome findings were much improved and this was a positive inspection visit. A tour of the premises was made and people living and working at the service were spoken with. Daily life was observed and care plans were seen for those individuals whose care was case tracked. Medications management, staff recruitment and maintenance records were all sampled. Feedback was given to Mrs J Daniell’s at the conclusion of the visit and the findings were positive. Comment cards were distributed after the inspection and the inspection was open until 19th February for the return of these forms. The inspector would like to thank all who contributed to the inspection process for their time and valuable feedback. What the service does well: There has been a consistent level of praise from people living at the home and from their relatives about the care given at the Burnham Nursing Home. The company has responded positively to the concerns raised at the inspection in June and to the two successive random inspection visits made to monitor the staffing levels and care at the home. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Burnham Nursing and Residential Home DS0000069138.V356411.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 The Burnham Nursing and Residential Home DS0000069138.V356411.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 is N/A Quality in this outcome area is good. People receive a pre admission assessment to ensure their care needs can be met at the Burnham Nursing and residential care home. People admitted to the Kingfisher Dementia care unit are seen and assessed pre admission by the Registered Mental Health Nurse employed to oversee the care on this unit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last key inspection it was stated that: The home has a Statement of Purpose and Service User guide. There is a welcome pack in each room. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 10 A pre-admission assessment is carried out on potential people for nursing and residential care placements. Those observed in care plans were undertaken thoroughly by appropriately qualified people and included visits to hospital and additional information where needed. People and their relatives can visit the home prior to admission. At this inspection two recent admissions were case tracked. Assessments had been made by staff from the home. Single assessment process forms were on file from the community professionals involved with the assessment of the person prior to their admission to the home. One person said their relative had visited to see the home before they made the decision to come in to the Burnham Nursing Home. One person said they had been apprehensive about moving here from another home but they had found it had gone well. Staff were described as very kind and people said they felt ‘well looked after’. Comment cards indicated that 16 people had received a contract, 3 indicated they were unsure. All 21 respondents said they had received enough information about the home prior to moving in. 18 relatives responded to CSCI, 11 said they received enough information about the care home, 7 said usually. 15 said they feel the care home always meets the needs of their relative, 3 said usually. There were no negative responses. The Burnham Nursing and Residential Home DS0000069138.V356411.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. New care plans have been introduced for all people at the home these are an improvement and are person centred. Health care needs are met. Medications are safely managed. The people living at the home that were spoken with, confirmed they are treated with care and respect. Inspectors overheard friendly conversation and interaction by staff with the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 12 The home has introduced a new care panning system called Quest. The Company had set target dates for the introduction of Quest a person centred methodology and staff have received training to do this in a person centred way. The manager said this is now fully implemented. Care plans were sampled and the evidence was that the system is very detailed and staff have adopted a person centred approach to writing and preparing care plans. There were references to personal preferences and choices. Risk assessments had been completed for nutritional assessment; pressure sore risk and falls risk assessment. One care plan for someone recently admitted to the home was incomplete but appeared to be a work in progress. There was no evidence of the person confirming their agreement to the content of the care plan. People asked spoke positively about the care they receive; one person said that ‘nothing is too much trouble’. One person was pleased to have her hair washed and set nicely by her carer after bathing. Another care plan demonstrated regular reviews, one with a social worker and the updated SAP review. Pain relief had been addressed by the G.P and was recorded. There was a record of leg ulcers that had healed. A map of life had been completed and the care plan showed a very independent lifestyle that was being supported by the care staff. Medications were monitored on one unit (Sandpiper). Medication Administration Records (MAR) were sampled: Photographic identification was seen. Medications that had been hand transcribed onto the medication administration record had two signatures to verify the checking for accuracy of the entry. No gaps were seen in the medication administration signature sections. The drugs room was seen, this was clean and tidy. A drug round was observed in progress and this was satisfactory and in line with the BUPA protocols. Comment cared were returned to CSCI by 21 people living at the home. 20 said they receive the care they need, one said usually. 11 said they always receive the medical support they need, 8 said usually, one said sometimes. 18 relatives responded, 16 said their relatives receive the care and support they expect or agreed, one said usually. 15 said they are kept informed of important issues concerning their relative, 3 said sometimes. Comment included ‘The care is better than we ever expected, we are happy with our choice of home’. ‘the nurse on duty always calls if there are any The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 13 concerns with their relatives health’. And ‘the staff keep me well informed’ ( of important issues affecting their relative). One professional found the care service usually met individual’s health care needs and commented that the service could be variable and the home may need reminding about individual needs. Positive comments were made about staff seeking professional advice from the community health care specialists regarding the residential wing and input from organisation specialists to inform the nurses on the nursing wing. Comment cards indicated that 16 relatives find care staff have the right skills and experience to care for their relative, one person said usually. Comments were made that ‘staff are lovely’, friendly and welcoming’ , ‘trained in dementia care’ and ‘do their job very well’. Staff confirmed that they receive training and have management support with their work. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15 Quality in this outcome area is good. People can spend their time as they choose. Visitors are made welcome. There are dedicated activities staff and there is a range of social activities held at the home. Choices in daily living are supported. Meals are well presented and look appetising. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was made; people were spoken with at this time. People confirmed that they could spend their time as they choose; some people chose to spend time in their rooms with the television, books or the radio for company. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 15 Visitors are made welcome and although none were seen and spoken with at this inspection visitors were seen to be welcomed into the home. There is a range of social activities held at the home this includes crafts and trips out. There are opportunities for religious worship, this is supported and there is a small chapel at the home. Independent lifestyle is supported and care plans demonstrated attention to support people’s choices and preferences in daily living. There were no structured activities on the day of this inspection. People said that the Christmas festivities had been enjoyable. The inspectors heard that one person had family in for Christmas lunch. Also that the homes Deputy Manager had visited the home on Christmas Day and the Homes Manager Mrs Daniells on Boxing Day. Daily life in the dementia care wing was observed. People were seen in their rooms sleeping in bed or watching television from their chair. Three people were seen together in the lounge watching television and chatting together. Three people asked commented that they were happy and well cared for. People seen before and after lunch commented that they had enjoyed the food. Notice boards display the day, the date, the staff on duty and these were up to date. The menu is displayed at the home but is not on the tables, this may help to remind people what they have ordered. Lunch was seen served in the dining room to 11 people from the ground floor. Staff were seen helping people on a 1:1 basis they were seated and help was given discreetly. The chef was seen and spoken with; he had a good knowledge of people likes and dislikes and of their special dietary requirements. A friendly rapport between staff and the people having lunch was heard. The menu is written up and is displayed. Menus on the dining tables should be considered. This may be helpful as a reminder to people of what they have ordered and alert them to the alternative choice. People said they enjoyed the food. One person commented that they had enjoyed a lovely Christmas meal at the home with their family. A concern about the crockery used to serve lunch prepared as soft diet was discussed. It was agreed that large soup style plates or higher sided plates would be preferable for those people requiring specialist aids to remain independent with eating. This was later discussed with the manager, Mrs Daniells. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 16 Kitchen records were seen and these were well maintained. The chef confirmed that the health and safety inspection had been satisfactory. A new dishwasher had been requested. Comment cards were received from 21 people living at the home, all responded ‘always’ when asked if staff listen and act on what they say ‘. 11 people said they always have activities they can join in with, 8 said usually, One person said never but confirmed that this was their choice and they were content with their own company. 13 people said they always enjoy the meals and 9 said usually one said sometimes. One visiting professional commented that it would be more dignified for some people to have the choice of a cup or mug and to have the help they may need to drink safely in preference to them being given a feeding beaker for safety from accidental spillage. Positive comment was made about the care staff responding to different needs of individuals by helping them in their own rooms to tune into age appropriate music. Visitors said they are made welcome. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 17 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): 16,18 Quality in this outcome area is adequate. The company has a complaints policy and procedure to follow, this is available to people at the home and their relatives. Complaints from individuals are not always fully recorded. It was not clear that all complaints raised were fully investigated. Staff recruitment now meet with Care Homes Regulations and National Minmum Standards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The company has addressed the policy that had allowed staff to live on site at Burnham Nursing Home. There is a company complaints policy and procedure that is available to people living at the home and their relatives. The monthly visit by the company to conduct a care home regulation 26 visit includes checks on the incidence and nature of any complaints received that month. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 18 There were no new complaints or concerns recorded at the home. Concerns had been raised with the Commission for Social Care Inspection with regard to the dementia care unit and staffing. Random inspections and the cooperation of the manager and the BUPA area manager had resolved these issues at this inspection. Social services have reported some concerns to the commission for social care inspection. The concerns had been raised with the manager of the home and more recently serious concern was raised regarding some missing records. People reported that they did not feel they were listened to and they felt the manager was defensive in her approach when any concerns are raised. The events above were not brought to the attention of the inspectors at the inspection visit. Since the visit the matter concerning the records has been fully investigated and steps have been taken to ensure that the risk of a similar event occurring is reduced. At the last key inspection it was noted that there was evidence of compliments received from relatives pleased with care their families had received. Comment cards received at this inspection indicated that 18 people always know who to talk to if unhappy and two said sometimes and all said they know how to make a complaint. All 23 staff responding said they would know what to do if someone raised concerns about the home. 15 relatives responded saying they knew how to make a complaint, 2 said they couldn’t remember, one person said they would speak to the management. Asked about concerns four said they had ‘never had any’, another said any concerns they had raised had been ‘dealt with in a very professional manner’. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 19 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): 19,26 Quality in this outcome area is adequate. The environment is safely maintained but in parts the home is in poor decorative order. Some of the corridor carpets are discoloured and worn and need to be replaced. Infection control is generally well managed. The waste bins in the grounds opposite the kitchen were overfilled and bin bags piled next to them pose an infection control hazard. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 20 The home has been suitably adapted as a nursing home with assisted bathing and toilet facilities. There is equipment for patient handling and nursing care provision. There is a nurse call system through out the building. The home has fire alarm and fire safety equipment all of which are regularly maintained. BUPA has invested in extra equipment to improve evacuation procedures in the event of a fire. At the last inspection it was noted that: the home is large and there is a 5 year rolling programme of planned works. Substantial maintenance work has been undertaken on the roof and windows. Communal areas are decorated in a homely manner. Bedrooms have en-suite facilities and bathrooms were clean and well equipped. The kingfisher dementia care unit is well decorated and is comfortable, clean and fresh. At this inspection the home appeared quite drab in other places. One bedroom was seen that required redecoration as the walls were scuffed and damaged. Some carpeting in corridors was discoloured and worn along the main tread route. One person who had visited the home remarked to the inspector that carpets were in a poor state. The view from most windows onto the exterior of the home and grounds other than from the newly landscaped dementia care garden is poor. Flagged areas were moss covered, uneven and had considerable amounts of weeds growing. Most of the garden beds looked unkempt. The area used for the waste bins was unsightly with waste bags piled next to the full containers. This poses an infection control hazard from vermin and seagulls. The dementia garden for which the home achieved grant funding towards its development last year, has been landscaped. A low impact surface has been installed around the seating area and the edges have been levelled to prevent trip hazards. The large tree at the centre of the garden has been pruned back to make its branches safe. Infection control is generally well managed. There are staff hand washing facilities around the home and staff have access to personal protective clothing such as gloves and disposable aprons. Comment cards indicated that the home is always clean but people did comment on the poor state of some carpets and decoration of some parts of the home. The Burnham Nursing and Residential Home DS0000069138.V356411.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): 27,28,29,30 Quality in this outcome area is adequate. There are policies and procedures in place for recruitment practice that will protect service users from the risk of harm, recruitment practice was confirmed as safe and is much improved Training is taking place and this has included dementia care training and person centred care planning to improve the quality of care practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a sufficient number of staff on duty at the time of this inspection. The skill mix of the team is also good and there is a registered mental health nurse (RMN) working on the dementia care unit, full time each week. The RMN is supported by a team of regular care staff that have received dementia care training. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 22 The inspector has heard from people who live at the home and from staff that the number of staff on duty in the evening is low on the first floor nursing unit at the time of medications rounds or when the nurse otherwise engaged. The inspector heard that this situation has arisen as a result of the dementia care unit requiring dedicated staffing when there has not been an increase in staffing to this floor in the evening. The staffing number has been increased during the daytime, which is very good. However without the evening shift being covered which was the case at the random evening inspection visit; care can be compromised for the 20 nursing people reliant upon one carer when the registered nurse rostered to work with her is busy. This was not discussed in detail at the inspection in part as concerns reached the inspector after the site visit. A response is required with the inspection report and subject to the feedback; further discussion with CSCI and monitoring will be required. The dementia unit staffing is by one carer on the unit overnight with assistance from the trained nurse on the Sandpiper unit. Staff files were examined and staff were seen and spoken with during the inspection visit. Staff were heard to be pleasant and helpful in their interactions with people who live at the home. Praise was heard for their kindness and for the care they give to people living here. Staff recruitment demonstrated safe practice with references and criminal record bureau checks being on file for all staff. Registered nurses personal identification numbers (PIN) had been checked with the nursing and midwifery council (NMC). Not all interview records demonstrated good interviewing techniques and recording. This was discussed with the manager who agreed that the senior staff would be supported and given practical help. Specific interview skills training is recommended. Staff files demonstrated that mandatory training had been given and specific skills training for nurses had been undertaken. This training included, insulin administration and updating, tissue viability, management, dementia training and medications training. Meetings are held regularly for all staff. Trained staff meet on a monthly basis, as do heads of departments. Meeting minutes were sampled at the inspection. Staff supervision was recorded and it was found that staff had set objectives for their personal development under the company ‘Personal Best’ programme. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 23 At the last inspection it was noted that 43 of permanent and bank care staff have NVQ 2 or above. This is below the National Minimum Standard recommendation of 50 . Staff received praise from people in residence and their families. Staff were described as kind, professional, caring, helpful. Concerns were raised at this inspection about the number of staff available, people said that more staff would ‘help throughout the house’. 18 said staff were always available and 2 said usually. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 24 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): 31,32,33,35,38 Quality in this outcome area is good. The manager is qualified and experienced. The home has a system of planned maintenance and health and safety monitoring. The premises were in need of attention. The manager and the company have addressed all action points for improvement since the last key inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 25 The manager is Mrs Jackie Daniels who has been at the home for over twelve years and holds the Registered Managers Award. There is an improvement plan in place for this home following the poor first key inspection with BUPA as the owners, in June 2007. Since this time there have been two CSCI random inspection visits made to the home. CSCI have met with the company representative and improvements have been made to staff recruitment practice, staff training and the management of the dementia care unit. At the last inspection it was reported that: There are several ways in which the home seeks the views of the residents. Quarterly meetings are held where people can express their views and recorded minutes can be acted on. The manager has informal review meetings with families. Notes of meetings are kept and signed by all parties. There is an annual quality assurance questionnaire. There is planned servicing and health and safety management by designated staff members. Records of peoples’ finances are recorded and kept safely. Records are kept safely by administration staff. There have been no changes to the above so these areas were not reinspected at this second key inspection visit. One concern has been raised regarding the security of an assessment record. Somerset Social Services brought this to the attention of the Commission for Social Care Inspection and this has now been investigated and steps have been taken to reduce the risk of a similar event occurring. The waste bins opposite the kitchen were seen at this visit to be overfilled and bin bags were piled next to the waste containers. This was post Christmas but the situation had arisen between bank holiday periods and had not been catered for and was potentially to become more problematic. There was a risk of rodent and seagull damage to the exposed waste bags posing potentially a health and safety hazard. This situation should be reviewed and extra containers should be brought in as necessary to contain the waste in a safe manner in the grounds of the care home. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 3 1 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 X 3 X 1 2 The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 27 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 OP27 Regulation 18(1)(a) Requirement Staffing levels must be sufficient to meet the needs and safety of the people in residence. Staffing levels must take into account the layout of the building and the staff to people in residence ratio in the Sandpiper unit. This is in part restated following feedback from this inspection visit. The premises must be maintained in a good state of repair both internally and externally The registered manager must ensure that all concerns and complaints are documented and fully investigated following the homes policies and procedures. Timescale for action 20/03/08 2. OP19 23(2)(b) 20/04/08 3. OP16 22(3) 20/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 28 No. 1 2 3 Refer to Standard OP26 OP29 OP16 Good Practice Recommendations Extra bins should be considered to protect the bin bags from the risk of damage by rodents and seagulls and to maintain a high standard of health and safety. Staff who undertake new staff recruitment interviews should be offered specific interview skills training to develop and strengthen their technique. Service users and their relatives should feel confident that any concerns raised are listened too, taken seriously and acted upon. Recording concerns and outcomes found is seen as good practice. The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 The Burnham Nursing and Residential Home DS0000069138.V356411.R01.S.doc Version 5.2 Page 30 - 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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