Care Home: Burger Court

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What the care home does well What has improved since the last inspection? The home has dealt with 2 of the 3 requirements from the last inspection. The outstanding work relates to improving access for people with disabilities and the home is currently looking at how to address this. The home has worked hard to improve the standard of record keeping and is continuing to work on involving people and their representatives in care planning. This will help to make sure they continue to provide care in a way that takes account of people`s preferences. Since we last visited work has continued to improve the environment. This has included work recommended by the fire officer to make the home safer. The home has put picture signs on doors, for example on the lounge, to make it easier for people with dementia to find their way around. The home has achieved the Investors in People award. This is an external quality award given to organisations that are able to show a commitment to improving the quality of the services they provide through staff training and development. What the care home could do better: Improvements are needed to the outside areas to give better access for people with disabilities and to provide a safe outside area for people to use. The home does not have much office space and care should be taken to protect confidential information about people`s needs. Particular attention should be given to where care records are kept. CARE HOMES FOR OLDER PEOPLE Burger Court 131 Barkerend Road Bradford BD3 9AU Lead Inspector Mary Bentley Key Unannounced Inspection 19th August 2008 09:30 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 Burger Court DS0000029144.V370369.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. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burger Court Address 131 Barkerend Road Bradford BD3 9AU 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) 01274 726826 01274 726292 burgercourt@eldercare.org.uk Mr B W Vincent Mrs H M Vincent Mrs Ann Van Lelyveld Care Home 24 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (24), of places Physical disability (4), Physical disability over 65 years of age (4), Terminally ill (4) Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of four places in total to be occupied by PD and PD (E) service users 21st August 2007 Date of last inspection Brief Description of the Service: Burger Court is registered to provide personal and nursing care for up to 24 people. It is a converted property close to Bradford city centre and is easily accessible by public transport. The home has 18 single and 3 double rooms, privacy screening is provided in the shared rooms. One of the bedrooms has en-suite facilities. There are bedrooms on three floors; a passenger lift and stair lift provide access to all floors. The home has three communal bathrooms, one on each floor. There are two lounges, one on the ground floor and one on the first floor; there is also a dining room, which is on the ground floor. There is a small garden at the front of the home but is not suitable for everyone because it is not secure and the home is on a busy road. The home is within easy reach of a number of local amenities including shops and a public house. A small number of car parking places are available at the front of the building. The weekly fees in August 2008 ranged from £377.00 to £595.00. Hairdressing and private chiropody are provided at an additional charge. People are also asked to contribute to the cost of some organised outings for example visits to the theatre. Copies of previous inspection reports are available in the home. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The inspection process included looking at the information we have received about the home since the last key inspection in August 2007. This unannounced inspection was done by one inspector between the hours of 9:30 and 4:45pm. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including care records and looked at parts of the building. Before the visit we sent surveys to the home to be given to people living in the home, staff and health care professionals. During the visit we gave surveys to some relatives. In total 2 were returned. Before the visit we sent a self-assessment form to the home, this was returned and gave us the information we had asked for. What the service does well: We asked people what the home does well and these are some of the comments we received from relatives: • • • • “I’m very satisfied with the care my sister is getting” “All the staff are helpful and kind to residents” “Show a great deal of care and love to ------ and sympathy towards me when we have a crisis” “They have a lovely lady to do activities, play games and outings etc” People said they enjoy the food and they are offered a choice. The home has a 4 star rating (the best is 5) from environmental health for its food safety standards. People are encouraged to visit the home before making a decision about moving in and are given enough information to help them make an informed decision. The home works with other health care professionals to make sure that people’s health care needs are met and that people have access to the full Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 6 range of NHS services. The home has good recruitment procedures, new staff are fully checked before they start work and this helps to protect people. The home has an open door policy and encourages people to tell them what they think about the service. There are regular meetings for people living in the home, and questionnaires are sent out approximately once a year. 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. Burger Court DS0000029144.V370369.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 Burger Court DS0000029144.V370369.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): 3 & 5. Standard 6 does not apply. People who use the 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 are given information about the range of services offered, they are encouraged to visit and their needs are assessed before they move in. EVIDENCE: One person told us they had chosen the home because it was recommended by a friend, they said it has lived up to their expectations. People are encouraged to visit the home before making a decision about moving in. When people are not able to do this themselves their relatives or friends are encouraged to visit on their behalf. The records showed that whenever possible the home carries out detailed pre admission assessments. They visit people and get information from relatives and other professionals to help them decide if they will be able to meet people’s needs. The records showed that when people come in because of an Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 9 emergency the home does a full assessment of their needs within the first few days. Burger Court DS0000029144.V370369.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): 7, 8, 9 & 10 People who use the 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’s personal and health care needs are met in a way that respects their privacy and dignity. EVIDENCE: We looked at the records of four people living in the home. The care plans are based on a detailed assessment of needs. The care plans set out how people’s personal and health care needs will be addressed. They include information about people’s preferences. For example in one persons plan we saw that they do not like wearing make up and in another we saw that the person likes to have the bedside light on at night. Risk assessments are done in relation to falls, pressure sores, nutrition, moving and handling and the use of bed rails. Where necessary plans are in place to show how these risks will be managed. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 11 The home has been working to improve the way it involves people or those close to them in planning care and we saw evidence of this in some of the plans we looked at. Relatives told us they are happy with the care provided and said they are kept informed by the home. People’s weights are recorded at least every month and more often if there are concerns about their weight. When there are concerns about people’s weight food charts are used to keep a record of what they are eating and drinking. The charts we looked at showed that people are getting drinks and snacks throughout the day and night and while in the home we saw people being offered drinks and snacks throughout the day. The records showed that people have access to a range of NHS services such as tissue viability nurses, dieticians, and GPs. There are suitable systems in place to make sure that medicines are managed safely and people get their prescribed medicines. At the present time no one in the home is able to manage his or her own medicines. Staff were seen to be kind and respectful in the way they spoke to people and helped them with their care needs. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 12 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 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers people the opportunity to take part in a variety of social activities and is continuing to look at ways of improving this aspect of the service. EVIDENCE: Information about people’s past lives, interests, and preferences is recorded and this has been used to draw up social care plans for most people. The home told us they are continuing to look at ways to improve the way they address people’s social care needs. Daily routines are reasonably flexible and take account of people’s preferences. Some people in the home are able to express their wishes about their daily routines, others are not. In these circumstances we saw that the home tries to get this this information from other sources. For example the care plan for one person with dementia showed their preferred times for going to bed and getting up. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 13 Some visitors told us they are pleased that there relative is encouraged to get up and dressed every day and spend time in the lounge with other people. Information about planned activities is displayed in the home and there are photographs of events that people have taken part in. The activities organiser works approximately 18 hours a week. She organises games, videos, quizzes, sing-a-longs, entertainers, and outings. People’s birthdays are celebrated. She also spends time with people on an individual basis. One person likes to go out to the theatre and others go shopping. Other people go to a lunch club once or twice a month. A number of homes in the area recently organised an event called the “Care Homes Olympics”. Some of the people living in the home had taken part and really enjoyed it. One person had appeared on a regional news television programme and was clearly enjoying his celebrity status. The home has visitors from the local Anglican and Roman Catholic churches. Visitors told us they are always made welcome and offered refreshments. The home has a four weekly menu. We observed the service of lunch in the first floor dining room. The meal service was well organised and the meal looked appetising. People said they enjoyed it. The home has provided a hot trolley in the first floor lounge/dining room so that meals can be kept warm until people are ready to eat. Staff were available and helped people discreetly where necessary. Aids such as plate guards were provided to make it possible for people to eat without needing help from staff. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 14 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from abuse. EVIDENCE: The home told us they have not had any complaints since the last inspection and none have been referred to us. The home told us they encourage people to tell them if they have any concerns. Relatives said they know how to make a complaint but have not had any cause for concern. One relative told us the manager is always helpful. The majority of staff have attended training on the protection of vulnerable adults and this is now included in induction training for all new staff. The manager is aware of the local Adult Protection procedures and has used them appropriately when necessary. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 15 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, 20, 21, 24 & 26 People who use the 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 provides a comfortable, safe, and clean place for people to live. EVIDENCE: The home was clean when we visited and people said the home is always clean. One relative said, “When I visit and pop up to her bedroom it is always clean and tidy, no smells anywhere”. The carpets in some of the communal areas and corridors are showing signs of wear and tear. The home told us they are thoroughly cleaned on a regular basis. Some of the lighting in the same areas is dull and this combined with the condition of the carpets can give the impression that the home is not clean. This was discussed with management. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 16 In many of the bedrooms we saw that people are able to bring some of their personal belongings, such as photographs and ornaments, with them when they move in. There is an ongoing programme of refurbishment and some bedrooms have been redecorated since our last visit. Since our last visit the ground floor bathroom has been upgraded and new assisted bath has been installed. This has improved the bathing facilities for people living in the home. In addition to this bathroom there are shower/wet rooms on each of the other two floors that are also easy for people to use. The path leading to the back door, which is the door that provides wheelchair access, is very uneven, this makes it difficult to manoeuvre wheelchairs and creates a potential hazard. This was discussed at the previous inspections and not been dealt with. The home told us there are plans to deal with this and make other improvements to the outside of the building, such as creating a secure garden area, but were unable to give a definite timescale for the work. Before we visited we received some concerns about control of infection systems in the home. We found the home has suitable systems for reducing the risk of cross infection. Most of the staff have just completed training on infection control. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff available to make sure people’s needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. People are protected because all the required checks are completed before new staff start work. EVIDENCE: There were 22 people living in the home when we visited. There is a nurse on duty at all times. Throughout the day there are between 5 and 3 care assistants on duty. Since our last visit the home has changed some of the hours of work so that there are 5 care staff over lunchtime to help people with their meals. We saw that this has made an improvement. The lunchtime meal service was much more relaxed making it a more enjoyable experience for people. Overnight there is one nurse and a care assistant on duty. People said the staff are kind and friendly, one person said, “they are wonderful, and can’t do enough for you”. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 18 One person was concerned that staff didn’t have enough time to spend with people in the lounge on the first floor. This was discussed with the manager. Information provided by the home showed that 58 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. There is an ongoing programme of NVQ training. Training is provided on safe working practices such as moving & handling and fire safety as well as on more specialist subjects such as dementia care and palliative care. We looked at the files of 3 new staff and they showed that all the required checks are completed before new staff start work in the home. The records showed that new staff are given training when they start work to make sure they have the right skills and knowledge to care for people properly. Staff have appraisals once a year and receive support through regular supervision. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 19 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, 33, 35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements in place to make sure that the home is managed properly. The home provides a safe place for people to live and work. EVIDENCE: The home manager is a nurse with several years experience in the care of older people and she has successfully completed management training. The regional manager visits the home at least once a month to audit various aspects of the service; we receive copies of the reports from these visits. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 20 There are meetings for people living in the home and their relatives every 3 months. A list of meeting dates is displayed in the home. This gives people the opportunity to share their views of the service and make suggestions for improvements. Staff meetings are held every month. The company sends questionnaires to people involved with the service every year, this includes health care professionals. The results go to the company’s head office where they are analysed. Areas for improvement are identified and any individual issues are dealt with. The results of the most recent surveys are displayed in the home. The home collects pensions on behalf of two people, this is a long standing arrangement and the home no longer gets involved in managing people’s personal finances. The home deals with small amounts of spending money for some people. Records are kept of all transactions and invoices are issued for additional services provided to people such as chiropody. There are systems in place to make sure that people can have access to their money when they want it. The self-assessment form completed by the home indicated that all the required maintenance and servicing of equipment is up to date, the records we looked at confirmed this. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 21 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 3 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 X X 3 X 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 3 X 3 X 3 X X 3 Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP19 Good Practice Recommendations Safe and adequate access should be provided for people with disabilities and the home should provide the Commission with information on how and when this will be addressed. Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Burger Court DS0000029144.V370369.R01.S.doc Version 5.2 Page 24 - 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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