Care Home: Burley House Nursing Home

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What the care home does well Information about services provided by the home is good, it is available to those people who wish to use the service and provides enough information for them to be able to decide if the home will be suitable for them. People and their families are encouraged to visit the home prior to admission. They are encouraged to stay for the day before making a choice. People are happy living at the home and were very positive about the care on offer. Comments included, "I`m very happy here, the staff are good, I get involved in things if I want", "go to bed when I want and get up when I want", "I have some good friends here". Staff have attended training which has provided them with information about how to make sure people are protected. Staff interact well and communicate well with people who use the service. They show warmth and a positive approach. Staff are good at encouraging people who use the service to be more independent. One staff member said, "Being independent makes people feel good". What has improved since the last inspection? The home now has a walk in shower on the first floor. They have also installed a new bath and a men`s urinal. New flooring has been laid in the dining room, hallway and kitchen. Home baking has been introduced to enhance the choice of snacks available. New menus has been introduced with the assistance of people living there, incorporating their food choices. The home star rating for food hygiene has been raised from 3 stars to 4 stars. Regulation 26 visits are now done every month by the acting operations manager for the company. Adult protection is included in the common induction standards training. Recruitment and selection procedures have been further improved and people who use the service have been encouraged to take part in the interview process. What the care home could do better: Some care plans need more explanation and more detailed and specific information for staff to make sure that important care needs are not missed. A good support plan should give clear and detailed information on how and when care is given, taking particular notice of the people`s preferences and choices. The complaint procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. The water stains/leak in bedrooms ceiling, Corridor and stairways need to be redecorated and decoration in the bathroom should be completed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Burley House Nursing Home 258 Burley Road Leeds Yorkshire LS4 2LA     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: Frederick Rawlins     Date: 1 5 0 4 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 28 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Burley House Nursing Home 258 Burley Road Leeds Yorkshire LS4 2LA 01132305485 01132249197 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: European Care Lifestyles (B) Ltd care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Burley House is registered to provide nursing care for 22 people who have enduring mental health problems. It is situated in the Burley area of Leeds. Buses into Leeds City Centre, and surrounding areas are within easy access. Local shops and amenities are only a short distance from the home, and a large leisure complex is within ten minutes walking distance. Accommodation is on three levels in the home, this consists of eighteen single bedrooms and two double bedrooms. Communal space includes a dining room, a large lounge and a small quiet lounge. Due to the layout of the home, parts of the home are not accessible to people who Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 22 Brief description of the care home have mobility problems. Care Homes for Adults (18-65 years) Page 5 of 28 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star (2*). This means that people that use the service experience good quality outcomes. A visit was made on 15th April 2009 from 09:00 to 17:00. The home did not know that this was going to happen. The inspection was conducted in the company of the deputy manager. Feedback was given to her at the end of the visit. The purpose of the visit was to assess what progress the home had made and the impact of any changes in the quality of life experienced by people living at the home. Before visiting the home we asked for information from the manager (the Annual Quality Assurance Assessment - AQAA) which asks about what policies and procedures are in place and when they were last reviewed, when maintenance and safety checks Care Homes for Adults (18-65 years) Page 6 of 28 were carried out and by who, menus used, staff details and training provided. The methods used during the inspection included talking to people who live in the home, staff, manager and relatives visiting at the time. Care records were looked at and a tour of the home was carried out. At the time of writing this report, the fees charged for care provided ranged from 498 pounds to 508 pounds per week. 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? What they could do better: Some care plans need more explanation and more detailed and specific information for staff to make sure that important care needs are not missed. A good support plan should give clear and detailed information on how and when care is given, taking particular notice of the peoples preferences and choices. The complaint procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. The water stains/leak in bedrooms ceiling, Corridor and stairways need to be redecorated and decoration in the bathroom should be completed. Care Homes for Adults (18-65 years) Page 8 of 28 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 Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. People who use the service can be sure the home will meet their needs following assessment. There are written and verbal information which provides enough information for them to decide whether the home will meet their needs. Evidence: The statement of purpose provides information about the service and facilities. The home also provides prospective people using the service with a range of information regarding the home including the service users guide. People using the service said they were very happy with the home. One said I like it here another said Its nice here, I help to say who comes here. The needs of people who use the service have been assessed before they moved in to the home. The assessment used covers all aspects of daily living. Care plans are then drawn up from any needs that are identified. People who use the service had also had a re-assessment carried out, if their needs had changed. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: All the people spoken with said they had received a contract and they all confirmed that they had enough information about the home before they moved in. One person said he was invited to visit the home and stay for a while before making any decision about moving in. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 are, in the main, aware of the individual needs of people who use the service. However the home needs to continue to develop care plans and risk assessments. Evidence: Some people who use the service have support plans that have been developed from the assessment of their needs. The plans tend to focus on peoples needs and do not highlight peoples individual strengths or aspirations. Some of the plans gave reasonably clear, detailed instruction on how needs are met. However, some plans need more explanation and more detailed and specific information for staff to make sure that important care needs are not missed. For example, a plan encouraging continence said, toilet regularly. A good support plan should give clear and detailed information on how and when care is given, taking particular notice of the peoples preferences and choices. Care plans looked at showed they had been reviewed at regular intervals. However one of the care plan looked at was just dated as reviewed. It is not clear who has Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: carried out the review and what has been considered during the review. This did not show if people using the service are developing skills or working toward meeting their aspirations. Risks to people who use the service have been identified and assessed. From talking to staff it was clear they have good knowledge on some of the care and support needs of the people using the service. Most were able to accurately describe the care they give and talk about the detail of how people like to be supported in their daily routines. Some of the people using the service have been involved in the drawing up of care plans. One person said that staff had talked to them about their care plan. This person had also signed the care plan. People using the service were offered choices throughout the day, around what to do or what to eat. Staff interactions with people were very good. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers opportunities to people who use the service for personal development in addition to a range of leisure activities. People using the service are able to make choices about their lifestyle. They also benefit from a good, healthy and varied diet. Evidence: Staff said that people who use the service have a variety of activities that they are involved in within their local community. This includes day centres, shopping, meals out, going out to the pub and going on holidays. Staff said they felt there were enough staff to make sure people who use the service get a good level of activity. They are encouraged to take part in activities they were engaged in prior to entering the home. People who use the service said they are supported to keep in touch with their family Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: and friends. Some people who use the service have regular visitors to the home. Others are supported to keep in touch by making phone calls or sending cards. One person said, in answer to does the home help your relatives to keep in touch with you, Burley House is a good home I have regular contacts with my family and go and visits. People are involved in deciding on and planning individual or group outings. Minutes of meetings with people and staff meetings are kept of discussions taking place. People have an individual care plan regarding social activities. Menus are developed based on the likes and dislikes of people who use the service. The have introduced new menus with the assistance of people living in the home, incorporating their food choices. In the Annual Quality Assurance Assessment the manager said the home star rating for food hygiene has been raised from 3 stars to 4 stars. Home baking has also been introduced to enhance the choice of snacks available. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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, personal and social care needs are set out in care plans. But the gaps in care planning documentation, means that there could be a risk of peoples healthcare needs not been identified or met. Evidence: Care plans have details of the personal and health care needs of the people who use the service. As already mentioned in the Individual Needs and Choices section of this report, the level of detail in some support plans on how personal care and health related task are to be carried out is not always detailed enough and could lead to important needs being overlooked. People using the service who are nutritionally at risk had charts in place for monthly weight records. From looking at the records this appear to be done at hock, there were no regular patten as to when the weighing of people would be done. Not all support plans had details of health professionals that people who use the service see. Some files looked at did not have records of the General Practitioner (GP) dentist or optician. To enable peoples health care needs are met, good records should Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: be kept of any health appointments and their outcome. Despite the gaps in care planning documentation, staff have a good awareness of the personal care, and likes and dislikes of the people who use the service. They were able to talk about the way in which people liked to be supported. Staff were seen to offer support to people with their personal care needs in private and with dignity. One person said I like it here staff always help me when I need it. Medication records sheets were looked at. There were no errors in the recording of medicines that had been administered.l Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 who use the service and their relatives have their views listened to taken seriously and acted upon. Evidence: The home has a complaints procedure, which is displayed in the entrance. However the complaint procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. People using the service, said they would tell staff if they were unhappy. The last recorded complaint in the home complaint book was dated 03/11/08. There was clear evidence showing how this was handled. Most staff have received training in the protection of vulnerable adult. Staff spoken with were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe some of the different types of abuse. Care Homes for Adults (18-65 years) Page 19 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is homely, clean, safe and hygienic. However some areas of the home are in need of re-decorating and work that has started should be completed. Evidence: It was not possible to look at all the rooms available during the site visit, as some bedrooms were locked and people were out. Most of the bedrooms seen were decorated and furnished to a good standard. Those showing signs of wear and tear the staff said the manager is aware of this and has informed the organisation. For example: water stains/leak in bedrooms ceiling, Corridor and stairways need to be redecorated and decoration in the bathroom should be completed. Speaking to the domestic staff it was evident they maintain a high standard of cleanliness within the home. People are encouraged to respect the environment and buy items of their choice for their own bedrooms. People living in the home said that they were pleased with their rooms and were glad to have many of their own personal belongings with them. They also said some areas of the home is looking grubby. Staff said they would like to see improvement in the environment by re-decoration. They also said they would like a suitable designated smoking area other than the main lounge for people living in the home. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The kitchen was clean and tidy throughout and the cook said all equipment was in working order. A professional visitor was spoken with during the visit and asked about the home, response were I had some miss-givens at first but find the place suite the people here. It looks a bit run down, deco is poor and it could do with a place where people could see visitors beside their bedroom. Care Homes for Adults (18-65 years) Page 21 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. There are sufficient staff employed to make sure peoples needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. Evidence: The majority of staff have been employed in the home for several years so are familiar with the needs of the people using the service. In returned surveys, people spoke highly of the staff. Comments included, staff listen and act on what I say. Recruitment is properly managed; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. When staff start work at the home they are provided with the company handbook which provides detailed information of what is expected of them. The staff rota showed that sufficient staff are employed on day and night duty to meet peoples needs and the home has a stable staff team, which helps to make sure people receive continuity of care. The manager confirmed that all new staff receive induction training in line with their role. Comments from staff regarding their training Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: was positive. Staff felt they had received enough training to carry out their role. In the AQAA (Annual Quality Assurance Assessment) the manager said the plan is to to continue to encourage new staff to apply for NVQ (National Vocational Qualification) in care at level 2 or above and ensure that 50 of the care staff obtain an NVQ level 2 in care. Staff said they felt they had a good team and the manager is very supportive and they are encouraged to take up training opportunities. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 management structure in place makes sure that the home is well managed and run in the best interest of the people living there. Evidence: The manager is registered with the Care Quality Commission (CQC). She has been in post since 1997 and is a registered mental health and general nurse. People said the manager is approachable and helpful. Regular meetings are held with people living in the home and records kept. To make sure that there are clear lines of communication within the home regular staff meetings are held and the manager operates an open door policy so that people are able to approach her at any time if they have a problem or concerns. Formal oneto-one staff supervision also takes place, which gives staff the opportunity to discuss their training and personal development needs. The home holds money in safekeeping for a number of people. Only senior staff deal Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: with peoples personal finances and receipts are obtained for any items purchased on their behalf. We checked a number of transaction sheets and no concerns were raised. This means that people can be confident that the system is safe and well managed. Policies and procedures are in place to ensure the health and safety of people living at the home, visitors and staff, which are audited on a regular basis to make sure that they comply with changes in legislation good practice guideline. Information provided in the self assessment form show that all equipment in use at the home are serviced in line with the manufactures guidelines, which means that people can be sure they are in good working order. Care Homes for Adults (18-65 years) Page 25 of 28 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 Adults (18-65 years) Page 26 of 28 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 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 6 Some care plans need more explanation and more detailed and specific information for staff to make sure that important care needs are not missed. A good support plan should give clear and detailed information on how and when care is given, taking particular notice of the peoples preferences and choices. To be sure that peoples health care needs are fully met. Staff must review peoples health care needs to make sure they are receiving the support and health care they need. The complaint procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. The water stains/leak in bedrooms ceiling, Corridor and stairways need to be re-decorated and decoration in the bathroom should be completed. 2 18 3 22 4 24 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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. 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