Care Home: Burnham

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What the care home does well The service users have complex support needs including significant physical and communication difficulties. The home understands and supports the needs very well. In particular they communicate well with the service users and support them to maximise their independence. Service users have choices in repect of their daily life at the home. Staff are good observers and listeners and make sure that any thing they note or is raised in conversation is acted upon. Service users go out into the community a lot and pursue their own chosen leisure activities, some they do independently and others in small groups. They can go out to lots of different places of interest that they have chosen for themselves. Staff make sure that residents receive good healthcare. The home is well managed with residents best interests at the heart of whatever they do. What has improved since the last inspection? The Aqaa informed us of improvements made to the service since the last Key inspection. These include an amended and improved Statement of Purpose and training for staff in areas specific to the needs of the service users they support. Particularly in communication and sensory impairment. What the care home could do better: The home continues to identify and plan for improvement through their quality assurance process. It was agreed that this may benefit from the inclusion of staff and care professionals in the satisfaction surveys. Key inspection report Care homes for adults (18-65 years) Name: Address: Burnham 19 Julian Road Folkestone Kent CT19 5HW     The quality rating for this care home is:   three star excellent 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: Geoffrey Senior     Date: 0 3 1 2 2 0 0 9 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 Adults (18-65 years) Page 2 of 27 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 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 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 27 Information about the care home Name of care home: Address: Burnham 19 Julian Road Folkestone Kent CT19 5HW 01303221335 P/F01303221335 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: MNP Complete Care Group care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Physical disability (PD). Date of last inspection Brief description of the care home Burnham is a home providing care and support for up to five adults with complex disabilities. It is a large detached Victorian-style house, situated in a pleasant residential area of Folkestone. The home is near to a public park, a leisure centre, the town, shops and the sea. The MNP Complete Care Group, the registered providers, are experienced providers of care services for older people and people with physical and learning disabilities. They have other care homes in the area. The homes in the group work closely together. Accommodation at Burnham is provided on two floors. There are five single bedrooms, Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 5 Brief description of the care home all with en-suite toilet and shower or bathing facilities. One of the bedrooms has its own front and rear access to the building. All rooms are fitted with call bells. Access to the first floor is via a passenger lift. There is a good-sized lounge/diner with a conservatory that overlooks the rear garden. The garden is large, flat and wheelchair accessible. There is a summerhouse in the garden. There is parking for up to four cars to the front of the house and on street parking in the vicinity. The fees for this home range from £750 to £1,600 and are based on the individually assessed needs of the residents. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent 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: This report takes into account information gathered since the last key inspection on 28.10.2006 and includes a visit to the home. The visit to the service was an unannounced Key Inspection which took place over one day. We arrived at 13.30 pm on 3.12.2009 and stayed for about three hours. The homes Registered Manager, members of staff on duty and the service users were involved in the inspection. We received the homes annual quality assurance assessment, known as an AQAA for short on the day of the visit. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the previous year, what they aim to do and lets us know when they have completed important environmental safety checks. At the time of the visit there were 5 service users living at the home. We observed how Care Homes for Adults (18-65 years) Page 6 of 27 staff interacted with service users during the day when offering care support and had discussions with the manager and the staff on duty. We found out about the way the service users individual support plans and risk assessments are agreed and recorded. We also looked at and discussed the training records and quality assurance arrangements. Care Homes for Adults (18-65 years) Page 7 of 27 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 Adults (18-65 years) Page 8 of 27 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 9 of 27 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 can be sure that a thorough assessment of their needs will be carried out with them. There is good information about the home to help people decide about moving in. Evidence: We talked to the manager about what happens when she is contacted by, or on behalf of people who are interested in living at the home. She told us that although they have not had any new placements in recent years there is a clear admissions procedure that is followed. Upon receipt of an enquiry the prospective service users and their current carers are provided with the homes statement of purpose, a brochure and the service users guide. People may visit the home before moving in, to meet the service users who already live there and the staff. They may also have a look around the house and find out about the lifestyle and routines they can expect to experience at the home. We saw that care managers are asked to provide profiles and assessments of the service user which, together with the homes own assessments, help to form the Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: homes plan of care and support. The care plan is written and agreed with the service user where possible, their family and representatives. This makes sure that their individual needs and wishes are known and it shows the support they need to help them with the things they want to achieve. Changes are made to the care plans as new things come to light. People we spoke with said they were happy to be living at Burnham and had either had a chance to visit before they moved in or members of their family had done so on their behalf. Care Homes for Adults (18-65 years) Page 11 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their own plan of care that shows their assessed needs and wishes. Staff and service users work together to make sure these are met. Service users are encouraged and supported to make their own choices and decisions. They are supported to take reasonable risks and develop their life experiences. Evidence: The Manager told us that effective communication plays a vital role in the home. She feels that staff have got to know each person well and have found out and recorded what support they need and how they like it to be offered. Some routines have been established and guidelines have been written in the support plans so that every one is doing the same thing. We found that the service user files were person centred. They reflected, as far as possible, the service users involvement and covered areas that are important to the individual. Things are noted, such as daily routines, things they need reminding about, where they need encouragement and where support is needed. Religious and cultural needs are recorded to make sure any related things are known, and plans are put in place to make sure the persons wishes are respected. One Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: service user told us how he is supported to attend a nearby church and a church related social group. We saw from the records and were told by staff, that the support plans are regularly up dated as people develop and their needs change. Keyworkers write a monthly report on their key client and share the information with other staff. The parents of three of the service users told us how the home keeps them informed of progress and will always consult them before making any major changes to the way they provide care and support. They are asked for their thoughts and opinions and are invited to attend care reviews. The support plans contain thorough risk assessments. These are seen by the home as ways of supporting people to do things safely rather than as a reason to stop something. We were give examples of action taken by the home to promote increased mobility and independence for one of the service users. Equally we were also told about actions taken to increase the care and comfort of a more dependent service user in his own room. Care Homes for Adults (18-65 years) Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being supported to live fulfilling lifestyles within the home and the wider community. They are helped to take part in activities that enrich their lives and widen their experience. Service users are helped to stay in touch with their family and friends. A good variety of balanced meals are available to the service users. Evidence: Communication between the staff and service users was easy going and informal. Several of the service users have severe communication difficulties but staff were observed using differing forms of communication to establish their wishes and ensure that everyone was included in the interactions. Staff told us that people were active in the home and, with recently improved transport facilities, were often out and about doing things that interest them. There are various activities scheduled for inside and outside the house. A planner is used so that people know who is doing what and the levels of support that are needed. One service user told us about his individual activity Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: plans that he organizes together with the staff. There is a mixture of college related activity and leisure pursuits. He spoke enthusiastically about the things he does in the community and of the friends he has made. The manager told us of efforts made to uphold service users civil rights and how they were supported to register their vote in local elections. People are helped to keep in touch with members of their family. Family and friends are welcome to call and service users may ring home when they wish. We were told that staff also contact service users family and tell them how things are going. The home also asks them for their comments and opinions whenever a review is due or when there are any changes in circumstances. The service users have all lived at the home for some time and the staff have got to know their food preferences and dislikes. One service user confirmed that the food is good and they always have plenty to eat. There is a weekly menu plan but this can be changed if people want something different. Care Homes for Adults (18-65 years) Page 15 of 27 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 excellent 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 home have their health and personal care support needs thoroughly assessed. Staff support is based on knowledge of the individuals and their condition. Systems are in place for the safe storage and administration of medications. Evidence: The home has conducted personal and health care assessments and have clear support plans based on the identified needs. The staff have clear guidelines on the maintenance of privacy and dignity when offering support. Specialist support is sought and used when necessary and recommendation from these sources is followed. Service users have been supported to attend Well Man clinics and have chosen whether or not to have influenza inoculations. The relative of one service user praised the home on the level of care and attention and their efforts to improve his comfort and mobility. The management systems monitor individuals well being and update how health care needs are being met. They are discussed at handovers and meetings to inform staff of any necessary changes. We looked at the storage arrangements and records for medication. These were Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: satisfactory and up to date. Staff who are involved with medication receive training and have their competency assessed by the provider. We were told that risk assessments indicate that none of the current service users group can manage their own medication. Care Homes for Adults (18-65 years) Page 17 of 27 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. Residents are supported and enabled to make complaints. The management and staff make sure that complaints are listened to and sorted out. Residents can be confident that staff work in a way that makes sure they are protected from harm. Evidence: The home has a written complaints procedure that is available to service users, staff, family and visitors. We were told that service users are observed for any indication that they are unhappy, worried or have any concerns. We saw instances where staff stopped what they were doing to listen to what the service user wanted to say and always responded. Staff have attended courses to widen their awareness of issues such as protecting vulnerable people. The homes recruitment procedure includes obtaining references and Criminal Record Bureau checks to make sure people are suitable to work with vulnerable people. Relatives we spoke with commented that although they are aware of the procedure they have never had cause for concern or complaint and they felt that the staff were very sensitive to the service users needs. Care Homes for Adults (18-65 years) Page 18 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home which is well maintained, clean and comfortably furnished. The home is arranged in a way that suits their individual and collective needs. Evidence: Service users each have their own large single bedroom with ensuite facilities. They have all the basic furniture items provided and can choose to bring in their own furniture if they wish. Each room has a lock and residents may keep their own keys. We were able to see that the rooms have been personalized and made to look very homely, reflecting the occupants individual interests and lifestyles. One service user said that he was very pleased with his room, staff respect his privacy and he is free to come and go as he pleases. There is plenty of communal space that is comfortably furnished so that residents can socialise and dine together as they wish. The kitchen and laundry facilities are domestic in scale but, we were informed, are adequate for the needs of the home. All areas of the home were seen to be clean, tidy and free from undue odours. The garden at the rear of the home is wheelchair accessible, level and well maintained. There is a barbeque area and a summerhouse. The manager told us that maintenance and gardening teams are employed by the organisation and are available at short notice for repairs as well as for planned routine Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: maintenance and safety checks. Care Homes for Adults (18-65 years) Page 20 of 27 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. Residents can be confident that that there will be enough staff on duty at all times to support them and that the staff are competent and properly trained. They can be assured that the homes recruitment practices will protect them. Evidence: We talked to the manager about staffing in the home and looked at the staff duty rotas. There are usually two support workers on duty, plus the manager on weekdays. There are also staff on the premises overnight. Staff are good at listening and responding to residents and are well motivated. There is a commitment to staff training and all staff are supported to achieve their national vocational qualification, NVQ, in care to at least level 2. All new staff have to complete initial training to acquaint them with the home, residents and things to ensure safety. This is followed by a further period of induction where staff from Burnham join with staff from other homes within the group to complete a rolling induction programme to give them the skills and confidence to do their job properly. There are a number of training courses that staff must attend following their introductory training, these are called mandatory courses and include things like, food, first aid, safe moving and handling, fire safety, health and safety and infection control. Once these are completed they have lots of opportunities to attend other courses that Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: are specific to caring for people at Burnham. The organisation has robust recruitment procedures in place to protect residents. We saw that a number of security checks that are completed before new staff start working at the home. Written references are sought and a criminal records check is undertaken to make sure that they are trustworthy and safe to be around the service users. Service users are involved in the recruitment process and are asked for their opinions before staff are employed. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well managed home where their best interests are safeguarded and their health, safety and welfare are promoted and protected. Residents can be confident that their views are listened to and affect any changes introduced in the home for their benefit. Evidence: The manager has been in post at the home since March 2006 and is registered with us. This means that we think she has the right qualifications, experience and necessary skills to run the home. The manager and her staff were described by a service user family member as being wonderful and rock solid. We saw that there is open and approachable management in the home that makes sure there is good communication between the staff and between residents and staff. This means that residents are consulted and involved in the daily running of the home and in planning their individual lifestyles. There are regular staff meetings for exchange of information and ideas. Service users have regular contact with their keyworker and staff have regular supervision meetings with the manager. A representative of the organisation makes monthly visits as part of the ongoing quality Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: monitoring process. The AQAA indicates that they utilise review meetings, family visits and residents feedback on the home to assess how well they are doing and identify areas for future development. They encourage people to respond to the relatives satisfaction questionnaire and to make written suggestions for change and improvement. Those we spoke with confirmed that they are regularly contacted and consulted on all aspects of their relatives care and support. We received comments such as, Burnham in its current state is first class, I am totally relaxed about my relative being there, and 5 stars for the home and all its people. They also said that the Manager is always open to ideas and ways to improve the service, keeps them informed and up to date with developments. It was agreed that the QA system may benefit by being expanded to include staff and care professionals in the satisfaction surveys. The AQAA indicates that safety checks are up to date. The manager said that regular health and safety audits are carried out so that anything identified can be quickly remedied by the maintenance team. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 Care Homes for Adults (18-65 years) Page 26 of 27 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). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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