Care Home: Burlington Nursing & Retirement Home

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What the care home does well The home has a comprehensive activities programme in place, the daily routines within the home promote independence, individual choice and freedom of movement. Care plans, procedures and practices were in place to ensure the service users health care needs are met. Comments from the people who use the service included `very impressed with the staff`. What has improved since the last inspection? An infection control audit was conducted by the Primary Care Trust in April 2009, the Responsible Individual stated that the home was fully compliant. Some areas of the home have been redecorated, including the lounge and some of the bedrooms. The communal areas have been re carpeted. What the care home could do better: The homes medication storage facilities were seen and it was noted that the home had not disposed of medication that was no longer required. Following the inspection, the Commission has now received written confirmation from the manager that this shortfall has now been rectified. The majority of the home was clean and fresh smelling; however, an offensive odour was present in one area of the home. Key inspection report Care homes for older people Name: Address: Burlington Nursing & Retirement Home 109-111 Victoria Drive Bognor Regis West Sussex PO21 2DZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah MacLennan     Date: 2 3 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Burlington Nursing & Retirement Home 109-111 Victoria Drive Bognor Regis West Sussex PO21 2DZ 01243821446 01243830960 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Burlington Nursing Home Limited Name of registered manager (if applicable) Mrs Christine Jellett Type of registration: Number of places registered: care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The total number of service users to be accommodated at any one time must not exceed 44. Date of last inspection Brief description of the care home Burlington Nursing Home is a privately owned company providing personal and nursing care for up to forty-four service users in the category of Older Persons. Burlington Nursing Home is a detached two-storey establishment in a residential area of Bognor, a seaside town in West Sussex. The home is situated approximately a mile from the centre of Bognor and all its amenities. It is about one mile from the sea front. Accommodation is provided in thirty-six single rooms and four double rooms. Twenty Care Homes for Older People Page 4 of 23 Over 65 0 44 44 0 Brief description of the care home of the singles and two of the doubles have en-suite facilities. A lift gives access to most of the rooms. There is a large lounge/dining room and several other small lounges and quiet areas. There is a large well-maintained garden. The responsible person is Mrs C Jamieson. The manager of the service is not currently registered with the commission. Care Homes for Older People Page 5 of 23 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: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out on 23rd February 2010. The manager and the Responsible Individual were present as representatives for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and Responsible Individual and any information that CQC / CSCI has received about the service since the last key inspection. On the day of this visit we met with some of the people who use the service, information was gained from surveys completed by some of the people who use the service prior to the visit and from staff on duty. Some of the comments made to us are quoted in this report. The home sent us their annual quality assurance assessment (AQAA). The AQAA is a Care Homes for Older People Page 6 of 23 self assessment that focuses on how well outcomes are being met for residents living at the home. It also gives us some numerical information about the service. The AQAA was clear and gave us the information we asked for. Service user care plans, staff recruitment and training records, menus, health and safety check lists, activity records, quality assurance monitoring audits, medication records and storage were all seen and assessed on the day of this visit. We looked at how well the service was meeting the standards set by the government and have in this report made judgments about the standard of the service. We would like to thank the people who use the service and the staff for their time, assistance and hospitality during this visit. Care Homes for Older People Page 7 of 23 What the care home does well: What has improved since the last inspection? 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 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 23 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 23 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. Service users were assessment prior to admission to the home to ensure that the home can meet the identified needs of the people who use the service. Evidence: We were advised that the deputy manager carries out a pre-admission assessment on all prospective service users. Trial visits can be arranged for prospective service users who wish to visit the home prior to admission. The care plans of three service users were seen and contained pre-admission assessments. The pre-admission assessment form was a tick-box form which provided adequate information in relation to the service users needs. Care Homes for Older People Page 10 of 23 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. Care plans, procedures and practices were in place to ensure the service users health care needs are met. Care was seen to be provided in a respectful and sensitive manner. Evidence: The care plans and files of the people who use the service were randomly sampled; three service user care plans, risk assessments and daily statements were looked at in detail. The care plans were person centered and covered a range of needs; including various aspects of personal care, memory loss and mental function, individuality, activities and lifestyle. Individual risk assessments had been completed and were reviewed. The service users daily statements evidenced that the care plans were followed and provided details of the service users 24 hour day. The people who use the service stated that they were happy with the care and support they received; additional specialist support including GP, chiropodist, optician and Care Homes for Older People Page 11 of 23 Evidence: dentist were also available. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that We have established an extremely good relationship with our GP practices and other health care professionals. All residents are registered with local GPs who are happy to come out to visit them. Where they wish and are able residents can be supported to attend the GP practice. The homes medication storage facilities and administration records were seen. Creams were prescribed as directed and there were no written guidelines in place regarding the administration of as required medication. The home had a suitable policy for the administration of medication. The controlled drug storage was seen, it was noted that the home had not disposed of medication that was no longer required. Following the inspection, the Commission has know received written confirmation from the manager that this shortfall has now been rectified. Care Homes for Older People Page 12 of 23 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. The daily routines within the home promote independence, individual choice and freedom of movement. Evidence: The home employs two activities assistants on a job share basis. This enables activities to be provided between 9am and 5pm seven days a week. The homes activites programme was displayed on the notice board in the hallway. Activities within the home included music for health, games, quizes, poetry, music, coffee mornings, and making cakes. The activities assistants ensure that activities are provided for service users who wish to stay in their rooms, these include; 1:1 reading, sit and chat, manicures and hand massage. The home also arranges for people to visit the home, including; church services and communion by the local baptist church, a local primary school visits at christmas, and people from Chichester theatre and Bognor museum. The people who use the service are also able to visit the local community, including walks to the seafront, cream teas and visiting the local shops. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that We feel that residents are as independent as they can be, lead their Care Homes for Older People Page 13 of 23 Evidence: chosen lifestyle and have the opportunity to make the most of their abilities. We try to involve residents as much as possible to influence the running of the home. All of the people who use the service who returned surveys or who were spoken to said that they were happy with the provision of food within the home. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that All meals are home cooked., Residents decide the menus and although there is one choice at lunch, residents can have an alternative if they wish. For breakfast and supper residents have a free choice. and Drinks, fresh fruit and snacks are available at any time, on request. Care Homes for Older People Page 14 of 23 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. The home had a simple and accessible complaints procedure; service users stated that they felt safe at the home. Evidence: The home had a simple and accessible complaints procedure. A copy is given to all the people who use the service as part of the service users guide. Service users who returned surveys and were spoken to during the visit were aware of who to speak to should they have any complaints and felt confident they would be listened to. Additional comments included I have no complaints and I am very satisfied with the home. Safeguarding adults and whistle blowing policies and procedures were in place and readily available to staff. Staff had received training in the protection of vulnerable adults and had read the homes policies. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that We have our own safeguarding policy and staff have attended training. We also have and follow Sussexs safeguarding procedures, with the latest addition being readily available to all staff. At the time of this visit there was an on-going safeguarding investigation, which was being investigated by the local authority. Care Homes for Older People Page 15 of 23 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 home was found to be clean, tidy and suitable in layout for its purpose. An offensive odour was present in one area of the home. Evidence: We toured areas of the home. The people who use the service are able to access all areas of the home and grounds. The decor was domestic in nature and the majority of the home was free from offensive odour. An offensive odour was present in one area of the home; it is required that all areas are free from odour. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that We encourage our residents to arrange their room so that it feels like their own, it is comfortable and they feel safe when they use it. We encourage them to bring in their personal possessions and furniture, involve them in choosing the decoration for their room and ensure that there is appropriate light and heat. Care Homes for Older People Page 16 of 23 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. The staffing arrangements in place on the day of the visit were sufficient to meet the needs of the service users. Evidence: Discussion with the manager, staff and people who use the service demonstrated that the staffing numbers and skill mix were appropriate to meet the assessed needs of the people living at the home. The home curently has 26 service users. The duty rota demonstrated that a trained nurse is on duty at all times and the home maintains care staff numbers of four in the morning, three in the afternoon and two at night. Four staff files were seen during the visit and found to contain the required information and documents specified in paragraphs 1 - 9 of schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). The staff training records were sampled. They evidenced that staff had received training appropriate to their work. This included fire safety, moving and handling theory and practice, food hygiene, safeguarding vulnerable adults and the safe administration of medication. Comments from the people who use the service included very impressed with the Care Homes for Older People Page 17 of 23 Evidence: staff. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that Our service is provided by our manager and newly appointed deputy, with the support of a team of permanent full time members of staff many of whom has been with us for years. We have established an excellent working relationship and staff provide cover for each other if one of them is off sick. We avoid the need for agency staff as much as possible. We believe this is one or our strengths as this means we offer a well trained, supervised and consistent support committed to and understanding the needs of our residents. Care Homes for Older People Page 18 of 23 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 service users benefit from the management approach at the home, which provided an open, positive and inclusive atmosphere. Evidence: The manager has been in post for 2 years and is not yet registered with the Commisssion. All staff and people who use the service appeared happy, content and relaxed with the inspection process. The atmosphere within the home was lively and cheerful. The manager stated that various quality audit systems were in place to ensure the staff and service users had a forum for airing their views. These included service user and relatives meetings, service user surveys and reports in line with Regulation 26 of the Care Home Regulations. The minutes of these meetings were randomly sampled. The people who use the service who returned surveys or were spoken to during the visit felt that their views were usually listened to and taken serviously. Care Homes for Older People Page 19 of 23 Evidence: The manager was aware of the need to maintain a safe environment for service users and staff. Required policies, procedures and safety checks were in place. In the AQAA, to demonstrate what the home does well, the Responsible Individual stated that We are totally committed to providing the best possible care for our residents and Our philosophy is that people come first. We try to be friendly and open and do not just accept things but deal with them in an open minded and objective manner. Care Homes for Older People Page 20 of 23 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 21 of 23 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 1 26 23 The registered person must 23/03/2010 ensure that all areas of the home are free from offensive odours. To ensure that the people who use the service are provided with a clean and pleasant environment. 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 Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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