Care Home: Burking Banks

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What the care home does well The overall feedback from all interested parties was that the care delivered by staff at Burking Banks was good. People`s comments included "It`s A1 here" "The care is good and the staff are excellent". Relative`s comments included "Mum has thrived since she came to live at Burking Banks" "Staff are so thoughtful and kind." Health professionals` comments included "Staff communicate really well with us" "We have every confidence in this service". Overall we were very impressed with the professional yet friendly way in which staff assisted people in the home. A friendly, lively and welcoming feel was evident in Burking Banks. People said that the home was "a friendly place" this was evident on the day of our visit. All comments about the food were positive. People said the quality and choice of food served was very good. People and relatives said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. People said that the home was always kept "spotlessly" clean. People spoke highly of the staff team and said staff always listened and acted on what they said. People and relatives said that staff were always available when needed. What has improved since the last inspection? There had been positive action on the requirements listed within the last inspection report. All requirements had been acted upon and resolved. People and relatives said they thought the amount and type of activities available for people had improved over the last year. Refurbishment of the home has continued to take place over the past year. A large pleasant conservatory has been built and the gardens of Burking Banks have beenlandscaped to a good standard. New floor coverings have also been fitted around the home. Staff said that training opportunities had improved. What the care home could do better: Staff should ensure that they record the time when they make any written entries in peoples care plans. The written entries staff make also need to relate more specifically to the persons plan. Some medication practices and storage procedures need to improve so that people`s health and welfare are protected. To maintain people`s safety the hot water temperatures in bathrooms should be monitored more frequently. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burking Banks 69-73 Moorlands Road Dewsbury West Yorkshire WF13 2LF     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: Mike ONeil     Date: 2 3 0 6 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. that people have said are important to them: They reflect the things 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 25 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Burking Banks 69-73 Moorlands Road Dewsbury West Yorkshire WF13 2LF 01924456653 01924457285 enquiries@burkingbanks.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Kevin Martin care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Burking Banks is a care home registered to provide personal care for up to 35 older people. It is situated in a residential area of Dewsbury, a short journey from the town centre. The home is easily accessible by public transport and is within easy reach of the local hospital. The home is made up of two houses linked by a first floor corridor. Both parts of the home have their own dining rooms, lounges and kitchen areas. The main meals are cooked in a central kitchen. The home has an extension to one of its lounges, which makes the outdoor patio area accessible for service users. A conservatory has been recently added onto the other lounge and a ramp from the conservatory provides access to a pleasant garden area. The gardens to the home are well maintained. Parking is available at the rear of the home. The home is furnished in a homely style, with six smaller communal rooms rather than one large one. Care Homes for Older People Page 4 of 25 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: Information about the home kept by the Care Quality Commission. Information returned to us by 6 people who live at Burking Banks, 3 relatives, 6 staff and 1 health professional who regularly visits the home. Prior to the visit the service had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the service was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. The AQAA also included data as to when utilities and equipment at the home was serviced. Information from the AQAA is included in the main body of the report. Care Homes for Older People Page 5 of 25 An unannounced visit to the home. This was carried out by Michael ONeil, regulation inspector on 23rd June 2009 and included talking to 6 staff and Ann Fisher, registered home manager about their work and the training they have completed. And checking some of the records, policies and procedures the home has to keep. Some time was spent observing staff supporting people and talking with 6 people, 3 visiting health/social care professionals and 4 visiting relatives. We wish to thank the people living in the home, their relatives and the staff for their time, friendliness and co-operation throughout the inspection process. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? There had been positive action on the requirements listed within the last inspection report. All requirements had been acted upon and resolved. People and relatives said they thought the amount and type of activities available for people had improved over the last year. Refurbishment of the home has continued to take place over the past year. A large pleasant conservatory has been built and the gardens of Burking Banks have been Care Homes for Older People Page 7 of 25 landscaped to a good standard. New floor coverings have also been fitted around the home. Staff said that training opportunities had improved. What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. Peoples needs are assessed prior to their admission into the care home. Evidence: Three care plans checked showed that people within the service had been assessed before moving into the home. Risk assessments and a plan of care reflected any specialist interventions. The assessment forms checked were detailed and fully completed. The manager and staff liaised with professionals, the person and their families to find out about peoples needs. This assessment will help to ensure that people have the information needed to make choices about where they live. Care Homes for Older People Page 10 of 25 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. Peoples health is monitored and arrangements for dealing with health issues were met with support from health professionals. People were treated with respect and said they were very happy with the care they received. Some medication practices and storage procedures provided some risk to peoples health and welfare. Evidence: Three peoples care plans were checked. The care plans contained good detail about the persons biography, personality and their preferences and choices. Overall we felt the standard of the plans were good and they did focus on the individual person. Detailed risk assessments were included within the documentation and included moving and handling, skin integrity, and other risk factors. The care plans identified that a range of health professionals visited the home to assist in maintaining peoples health care needs. People said they had regular contact with their GP and other health professionals such as district nurses. Care Homes for Older People Page 11 of 25 Evidence: There were three issues within the care plan documentation that did require staff attention. Relatives and people said they were aware of care plans and that they were involved in discussions about their care. However there was no evidence recorded to show that people and/or their relatives were involved in drawing up and reviewing the care plans. Staff were failing to record times they made entries in the plans. Staff must be reminded that peoples care plans are a legal document and must always be signed, dated and timed. Staff, when writing peoples daily notes, were not being reflective of the information actually recorded in the persons care plan. Therefore, there were no records to evidence that staff had met certain care needs of people over several days. Documenting, for example settled today, pleasant mood is not sufficient or specific enough information when recorded, in isolation, in a persons daily record. People looked clean, well dressed and had received a good level of personal care. The overall feedback from all interested parties was that the care delivered by staff at Burking Banks was good. Peoples comments included Its A1 here The care is good and the staff are excellent. Relatives comments included Mum has thrived since she came to live at Burking Banks Staff are so thoughtful and kind. Health professionals comments included Staff communicate really well with us We have every confidence in this service. Care Homes for Older People Page 12 of 25 Evidence: People were treated with respect and dignity and addressed by their preferred name. Staff were observed interacting in a friendly and pleasant way. Staff took time to explain what task or support they were about to offer people. Overall we were very impressed with the professional yet friendly way in which staff assisted people in the home. Medication records were up to date with no gaps. All except refrigerated medication was securely stored in the home. Staff said they had received medication training and records were seen of this training having taken place. However peoples health and safety was not fully maintained because not all Medicine Administration Records (MAR) and other medication procedures were adequate. Some medicines, eye drops, were not being stored appropriately. Several bottles of eye drops were being stored in unlocked domestic fridges which were accessible to people and their relatives. Drops in one fridge were stored in a metal box, however this was unlocked. Other bottles of drops were just being stored in the fridge with other food items. We spoke with the manager about this requirement and she gave assurances that she would address this shortfall in storage without delay. Some handwritten MAR sheets checked did not contain General Practitioners or two members of staffs signatures alongside any directions regarding the dosage of the medication or the time the medication was to be given. We would also recommend that consideration be given to providing a larger secure area where a fridge and other pharmacy/ treatment items such as dressings may be stored. Despite the inadequacy found in the medication storage overall evidence shows that the home has a good record of compliance with the receipt, administration, safekeeping, and disposal of medicines and that people at Burking Banks experience good outcomes relating to health and personal care. This judgement is based on the evidence that the service has far more strengths than areas for improvement. The manager has also given assurances that the areas in need of improvement will be addressed and managed promptly. Care Homes for Older People Page 13 of 25 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. People had a choice of lifestyle within the home and were able to maintain contact with family and friends ensuring that they continued to be involved in community life. People were able to make choices about daily living and be involved in some social activities. Meals served at the home were of a good quality and offered choice to ensure people receive a balanced diet. Evidence: People said they were able to get up and go to bed when they chose and generally how they spent their day and evenings. They said they often went out with their families. Relatives said they were able to visit at any time and were made to feel very welcome. A friendly, lively and welcoming feel was evident in Burking Banks. People said that the home was a friendly place this was evident on the day of our visit. Care Homes for Older People Page 14 of 25 Evidence: Some people said they enjoyed the activities available at the home, whilst other people said that they chose not to join in with the activities arranged. Activities were advertised around the home. People and relatives said they thought the amount and type of activities available for people had improved over the last year. We saw that some people welcomed the opportunity to undertake simple activities and talk to staff or other people in the home. We spoke with the activities coordinator employed at Burking Banks. The coordinator showed great enthusiasm about her role and was keen to include as many people as possible in different types of activities. All comments about the food were positive. People said the quality and choice of food served was very good. The mealtime experience for people in the home was very positive. The tables were set nicely with table cloths, condiments and matching crockery. The meals were served in a relaxed unhurried manner by staff and the cook himself. People said they were always offered a choice and asked what they wanted for their breakfast, lunch and teatime meals. People said they were offered drinks on a regular basis throughout the day. Care Homes for Older People Page 15 of 25 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. Complaints procedures were in place and people and their relatives felt confident that any concerns they voiced would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure that people were protected from abuse. Evidence: People had been provided with a copy of the homes complaints procedure, which was also on display in the entrance hall of the home. This contained details of who to speak to at the home and who to contact outside of the home to make a complaint should they wish to do so. People and relatives said that they felt very comfortable in going to the manager knowing that any concerns they may have would be addressed without delay. Adult safeguarding policies and procedures were available to the staff. Staff said they had undertaken Safeguarding Adults training, and the manager was able to evidence this by producing the training records. Care Homes for Older People Page 16 of 25 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 environment within the home was well maintained and clean providing a comfortable, safe environment for people. Evidence: Burking Banks was clean and tidy and no unpleasant odours were noticeable. Lounge and dining areas were domestically furnished to a good standard. Refurbishment of the home has continued to take place over the past year. A large pleasant conservatory has been built and the gardens of Burking Banks have been landscaped to a good standard. New floor coverings have also been fitted around the home. People said that the home was always kept spotlessly clean. Bedrooms checked were comfortable and homely. People said their beds were comfortable and bed linen checked was clean and in a good condition. The lounges for people to use were homely. They were small enough to give an intimate feel and allow conversations to take place across the rooms, between people. People liked this. Care Homes for Older People Page 17 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were employed in sufficient numbers and recruitment procedures promoted the protection of people. People receive care from a well-trained staff team. Evidence: People spoke highly of the staff team and said staff always listened and acted on what they said. People and relatives said that staff were always available when needed. Staff and the manager confirmed that staffing levels were adequate. Three staff files were checked at this visit. The files contained a range of information including two references and a declaration of health and identification. The staff had undertaken a criminal record bureau check (CRB), at the enhanced level. This confirmed thorough recruitment practices were in place, which was sufficient to safeguard people. Staff said that they really enjoyed working at the home and got a lot of job satisfaction. We found that the staff were very enthusiastic and keen to improve the service further. Care Homes for Older People Page 18 of 25 Evidence: The staff training records and the AQAA provided the evidence that the staff have all of the training needed to make sure that they can care for people. This included all of the mandatory health and safety training specific to the needs of people at Burking Banks. Staff were able to talk about the various training courses that they had attended. Staff said training opportunities were excellent. Staff said they had thoroughly enjoyed recent training they had undertaken in relation to person centred care. They said they had learnt a lot and knew that by implementing what they had learnt it would further benefit the quality of care people received at the home. A sample of development and training records were checked. These records showed when staff had completed mandatory training and refresher training. Care Homes for Older People Page 19 of 25 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 procedures and ethos of the home ensure that the home is run in the best interests of people who use the service. The homes procedures promote the health, safety and welfare of people who use the service and the staff. Evidence: Ann Fisher has many years experience within the nursing and caring profession. She has been manager at Burking Banks for some years and has previously completed a certificate in management in Health and Social Care at Leeds University. Staff, people, relatives and health professionals spoke very highly of the manager and said she was always available and very approachable. The manager and providers had ways in which to check out the quality of the service that they were providing. The service has sent out food satisfaction surveys to people Care Homes for Older People Page 20 of 25 Evidence: and their families. Staff meetings were arranged. The responsible individual visited the home on a regular basis, a report was written following the visits and any identified actions taken. There was evidence of internal auditing of the homes environment, services and records. Overall the quality assurance systems currently in place at Burking Banks will help to ensure that the service is operating in the best interest of the people who live there. A sample of monies that was looked after on behalf of people living at the home was checked. Records were kept and money tallied with the records. The temperature of the hot water in one bathroom was felt to be excessively high; no thermometer was available to measure the actual temperature. The temperature felt hot enough to pose a risk of scalding some people. The manager called for the homes maintenance person to visit the home and check the temperature. The temperature measured 48 degrees centigrade which is excessively high. The thermostat was adjusted to bring the temperature within safe limits before the end of our visit to the home. Records showed that maintenance staff had been monitoring hot water temperature in the bathrooms. The temperature had been previously recorded as being within safe limits. However we would strongly recommend that thermometers are provided in all bathrooms so that staff can monitor temperatures on a more regular basis i.e. before assisting people to bathe. The AQAA provided information of the dates that equipment and systems within the home had been serviced and maintained. A fire risk assessment was in place at the home. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. At the time of the visit fire exits were clear and hazardous products were safely stored in the home. This will promote the safety and welfare of people. Care Homes for Older People Page 21 of 25 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 22 of 25 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 13 Medication must be securely stored.(Fridge items) To keep people safe. 01/09/2009 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 7 Documentation should show that people and/or their relatives have been involved in drawing up and reviewing the care plans. The persons daily notes should reflect the information actually recorded in the persons care plan. Staff should ensure that all written entries they make in peoples care plans are dated, timed and signed. Consideration should be given to provide a larger secure area where a fridge and other pharmacy /treatment items could be stored. The Medication Administration Records (MAR) should contain General Practitioners or two members of staffs signatures alongside any directions regarding the dosage of the medication or the time the medication is to be dispensed. To maintain peoples safety the hot water temperatures in 2 3 4 7 7 9 5 9 6 38 Care Homes for Older People Page 23 of 25 bathrooms should be monitored more frequently. Thermometers should be provided for staff to check temperatures. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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