Care Home: Burrows Lea

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What the care home does well Training opportunities and development of staff skills continue to be excellent, so that people have the confidence and competencies to provide the care and support people who live at the home need. Some members of staff have exceeded the required qualifications to work in a care home. One member of staff is qualified to provide training on the premises which helps staff develop. One staff member wrote in a survey, "Training availability is excellent". A staff member spoken to about training and access to courses said, "Its the best place I have worked in for training". A person who lives at the home commented, " They certainly know how to care for us". Information in the AQAA tells us of the emphasis and commitment to training staff to ensure they are competent to provide the care residents need. There is little change in the people who work at Burrows Lea, which helps build up relationships with people who live at the home. One resident spoken to said, "Its nice being a small home and the same people to look after you". One resident wrote, "The staff are good and seem to stay". Surveys returned from staff and residents were positive in there comments on how the home is run and they included, "Its a relaxed place to be", Also, "We work hard to run the home well". Routines in the home appeared relaxed with people allowed unrestricted access to communal areas and outside gardens. One resident spoken to said, "Its nice and peaceful". Another said, "I please myself what to do, I have my meals in my room its my choice and not a problem". What has improved since the last inspection? Walking around the building we found improvements made to the decorations and furnishings of the home, so that people can live and work in pleasant surroundings. One staff member said, " The new kitchen area is good". The owner confirmed the improvements in the AQAA by telling us of the new kitchen and some new furnishings and decoration in bedrooms. The outside back garden area has been tidied up and made more accessible for residents to sit out in, One said, "I enjoy to sit out in the garden now". Some new systems of recording the care of residents have been introduced so that they are easier to follow and the health and welfare of people who live at the home can be monitored. One staff member said, "We are always looking at ways to improve things". What the care home could do better: We felt from watching routines during the day,talking to people who live and work at the home, that a small increase of staff should be on duty at certain times of the day. This should ensure people who live at the home are receiving the support and care to meet their needs. comments about more staffing included, "We need a little more help". Also one resident said, "They are very busy in the mornings".At the time of the inspection we could not look at staff selection and recruitment files as the owner was away for the day and they were locked away. Records should be made available any time for inspection purposes. However from discussion it was evident staff had been through a robust recruitment procedure to ensure they were suitable. One staff member said, "I couldn`t start work until everything was cleared. The owner tells us in the AQAA the process of selecting staff and how the correct checks have to be in place before people start to work at Burrows Lea. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burrows Lea 502 Lytham Road South Shore Blackpool Lancashire FY4 1HJ     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: Kevan Royston     Date: 1 6 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Burrows Lea 502 Lytham Road South Shore Blackpool Lancashire FY4 1HJ 01253341294 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Robert James Shirt care home 8 Number of places (if applicable): Under 65 Over 65 8 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 8 Date of last inspection Brief description of the care home Burrows Lea is registered for eight older people. The home is a large detached residence situated in the south of Blackpool close to Highfield Road shopping centre and local bus routes. All the bedrooms are single rooms with an en-suite and aids and adaptations have been fitted where required. The home is on two floors and there is a stair lift to access the first floor. There is a large through lounge with a conservatory attached and a dining room. The outside provides seating at the front and rear of the property with a ramp fitted for wheel chair access. The range of fees at the home is from £303.52 to £364.70 per week. There are Care Homes for Older People Page 4 of 26 Brief description of the care home additional charges made for hairdressing and chiropody. Care Homes for Older People Page 5 of 26 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: This unannounced visit was part of the key inspection process and took place on the 16/07/09. We spoke to people who live at the home, staff, the person in charge on the day and a group of residents in the lounge. Care, maintenance, previous inspection reports and other records were looked at, as well as a walk around the building. As part of the inspection process we talked to people using the service and asked staff about those people needs. We also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who live at the home were invited to pass their opinions to us if they wish. We received responses from surveys/ questionnaires sent to people who live at Care Homes for Older People Page 6 of 26 Burrows Lea and staff for their views on how the home is run. Comments we did receive were positive and some are included in this report. Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. What the care home does well: What has improved since the last inspection? What they could do better: We felt from watching routines during the day,talking to people who live and work at the home, that a small increase of staff should be on duty at certain times of the day. This should ensure people who live at the home are receiving the support and care to meet their needs. comments about more staffing included, We need a little more help. Also one resident said, They are very busy in the mornings. Care Homes for Older People Page 8 of 26 At the time of the inspection we could not look at staff selection and recruitment files as the owner was away for the day and they were locked away. Records should be made available any time for inspection purposes. However from discussion it was evident staff had been through a robust recruitment procedure to ensure they were suitable. One staff member said, I couldnt start work until everything was cleared. The owner tells us in the AQAA the process of selecting staff and how the correct checks have to be in place before people start to work at Burrows Lea. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 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 10 of 26 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. The admission and assessment procedures were clear and precise, to ensure care needs of residents are met and people can make an informed choice before moving into the home. Evidence: We looked at assessment information for two people at the homewhich showed that, comprehensive information was obtained by the manager and from social services. We spoke to a person who lives at the home about the time he moved in and he said, I moved from home and liked the way they introduced me to Burrows Lea. A care plan had been developed from the information to ensure health, social and welfare needs are identified and the care and support needed can be met. There was evidence of family involvement to gather information so that all needs of people who come to live at the home are looked at. One member of staff wrote in a survey, From Care Homes for Older People Page 11 of 26 Evidence: the start we look after people and make them feel comfortable. The owner of the home informs us in the AQAA how the process for assessing people is undertaken prior to them moving in and a plan of care developed within 24 hours of the person joining them at Burrows Lea. This ensures they can provide the care and support for the resident. We confirmed there is a brochure available to potential residents setting out what the home provides, the terms and conditions and the aims and objectives, ensuring people have enough information to make an informed choice before moving in. Standard 6 was not assessed as the home does not provide intermediate care. Care Homes for Older People Page 12 of 26 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. People who live at the home have their health and personal care needs met by staff who respected their privacy and dignity. Evidence: Care records looked at for people living in the home were comprehensive and set out a plan of care monitoring all health,welfare and social needs. Relatives and people who live at the home have a say in care plans and in the way they are supported. This was evidenced by signitures of care records by residents and relatives. Staff spoken to confirmed they had an awareness of peoples needs who live at the home when asked about individuals care, one said, The keyworker system works well. One staff survey returned said, I feel the care given to the residents is of a good standard. Each person has a risk assessment in place to ensure their safety, we confirmed these are updated when necessary to reflect any changes that may have occurred in the building or individually ensuring people are protected and safe. Records of people we case tracked had recently had risk assessments updated to confirm what the manager said. The care for people who live at the home is reviewed on a monthly basis, to ensure the Care Homes for Older People Page 13 of 26 Evidence: right care is given and any health needs are updated so staff are aware of what each resident requires. Records looked at confirmed this and one staff member spoken to said, Everbody has their care looked at monthly. Comments from people who live at the home about the care provided included, They are very good, And, They are all nice. We went through the medication procedures with the person in charge at the time of the visit, medication of people we case tracked had safe practices in place to ensure people receive the right medicine at the right time and they are protected by the procedures in place. One member of staff spoken to said, Only those of us who are trained do the medication. The manager explained to us they have good a good relationship with the pharmacist,one staff member said, The chemist is good with any information we need. We looked at records and confirmed nutritional screening of people who live at the home is monitored so that any health issues are noticed and acted upon. This was confirmed by the owner in information provided to us in the AQAA. Notes of people who live at Burrows Lea show they have access to health professionals and where possible a doctor (GP) of their choice. During our time at Burrows Lea we talked to people who live here in the lounge and watched staff caring for people and helping them in a sensitive, dignified way. One person who lives at the home said to us, Kind and considerate, respect there elders. The owner tells us in the (AQAA) how it is important for staff to care for residents with respect, dignity and equality.They are given instruction so they are aware of how to treat people to ensure respect is shown at all times. Care Homes for Older People Page 14 of 26 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. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. Evidence: Routines watched during the day looked relaxed, some people were sat in the lounge area, staff were carrying on with their daily routines, we noticed staff chatting to residents and generally supporting people sensitively. We spoke to people who live and work at the home about activities and social events, comments included, We play games and whatever interests the residents have we try and accommodate, Also, I enjoy getting out in the garden. One member of staff wrote, I like sitting and talking to residents. We looked at records of people we case tracked and found hobbies and interests of people who live at the home recorded, to help staff provide stimulation and allow residents to follow there interests. We had a look around the kitchen area and spoke to a staff member preparing food, she said when asked about training, Any member of staff preparing food has completed the Food and Hygiene certificate. One staff member spoken to said about the meals, Today its lamb casserole with fresh vegetables. We looked around and Care Homes for Older People Page 15 of 26 Evidence: found evidence of fresh fruit and vegetables stored in the kitchen and plenty of stocks in the fridge and cupboards, to ensure people who live here receive a healthy diet with plenty of choice. A person who lives at the home spoken to about meals and set times said, I have mine in my room its not a problem. One member of staff said, Most of the cooking is home made. A member of staff spoken to confirmed they provide food for diabetics and are able to provide meals if required from any religious cultures. Records looked at show staff monitor the intake of food and liquid of people living at the home to ensure any concerns are identified and appropriate action taken. We spoke to people who live at the home about visiting times and if any restrictions had been placed upon people calling to see them. All residents spoken to confirmed friends and relatives are welcome any time, one resident spoken to said, Anytime is ok. there is a visitors policy explaining people are welcome to see friends and relatives any time at the home. People we spoke to who live here confirmed they were able to bring some personal items into the home which was agreed during the admission. Rooms we were invited into had personal possessions around so that residents felt it was home. One resident said,I brought my own stuff to furnish my room it wasnt a problem. Care Homes for Older People Page 16 of 26 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. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The owner tells us in the AQAA how every resident who comes to live and work at Burrows Lea are provided with a copy of the complaints procedure to ensure they are aware of the way to complain. Also there is a policy available in the home for visitors to see. One resident spoken to said, I know how to complain its only a small home I would talk to B...(the owner). A staff member spoken to said, We are made aware of the complaints when doing our induction. There has been no complaints since the last inspection. All staff are trained annually by attending safeguarding adults courses so that any issues are picked up, identified and acted upon to protect residents. This was confirmed by information provided in the AQAA and talking to staff. One member of staff spoken to said, I have attended safeguarding adults training. Care Homes for Older People Page 17 of 26 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 premises is safe and clean maintained to a good standard providing comfortable surroundings for people who live at the home. Evidence: We had a walk around the building and outside areas, we found it clean, tidy and maintained to a good standard ensuring people live in comfortable surroundings. The owner takes care of any minor repairs and they are recorded by staff. One staff member spoken to said, Small repairs are done by B..... We spoke to staff and people who live at the home about the appearance and maintenance of Burrows Lea comments included, They do well to keep it clean and tidy. And, Its homely. The owner tells us in the AQAA of how they have improved the environment by adding a new kitchen, redecoration of parts of the home including bedrooms and new furnishings in rooms to ensure the home is a pleasant place to live and work in. One resident spoken to said, The garden area is lovely now. There are policies in place for laundry processes and for the control of infection ensuring the home is kept clean and hygienic. Information in the AQAA informs us of how staff are trained in infection control, this was confirmed through talking to staff. Care Homes for Older People Page 18 of 26 Care Homes for Older People Page 19 of 26 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. Access to training and staff development is excellent, this helps to develop their skills and competencies. Recruitment records are in place however were not available to look at to ensure all checks had been carried out on staff members, Evidence: We were unable to look at staff recruitment records as the owner/manager was away on the day of the visit and access to records were locked away. Recruitment records should be available for inspection to ensure the proper checks have been completed and all are in place before people start to work at the home. However we spoke to staff about the process for recruitment and comments included, I was not allowed to start work until everything had been checked. Also, All the paperwork was done before I started. Previous inspections have confirmed no concerns in the recruitment of staff and records checked. Access to and training of staff is excellent which ensures people are cared for by competent skilled staff. We looked at training records, received positive comments from surveys and spoke to staff about training. One staff member said, The induction training was very good. Another staff member wrote in a survey, Training is excellent. The owner tells us in the AQAA the relief manager provides training in house. She is qualified and has completed the necessary qualifications needed to run a Care Homes for Older People Page 20 of 26 Evidence: care home. her qualifications include, National Vocational Qualification to level 4 (NVQ) and a recognised management award as well as qualified to provide training for others. Records show and staff confirmed over 50 of care staff have a recognised qualification in care which helps develop skills when supporting and caring for the residents Some staff are being supported to achieve a higher level of qualification in care to enable them to develop there skills and competencies. Staffing levels were sufficient in numbers to care for the people who live at the home. However from speaking to staff and residents, watching routines during the day and comments made in staff surveys it was clear a small increase of staff in the mornings should be beneficial for the residents to ensure there needs are being met and enough time is spent caring for them. One resident spoken to said, They seem a bit pushed at times. Other comments included, The mornings are sometimes very busy. One staff member wrote, I would like to spend more time with the residents. It was clear from watching staff with people during the day and speaking to staff they are clear about their role and work well as a team to ensure the individual and collective needs of people who live at the home are being met . One person who lives at the home said, Its nice being a small home we get to know the staff better. Care Homes for Older People Page 21 of 26 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 home is run well and has policies and procedures in place to ensure the health and safety of staff and people living at Burrows Lea are promoted and protected. Evidence: Although this is a small home we looked at records and they show systems are in place to get residents, families and staff views on how the home is run and suggestions are made and implemented to improve the home for the people who live here. Staff meetings are held and records are available to show what was discussed. Informal systems are in place to ensure that opinions of people who live at Burrows Lea are suoght. One member of staff said, It works well. One resident spoken to said, We talk around the dining table and I give my views. The owner who manages the home is highly qualified and as a wealth of experience in running care homes. He tells us in the AQAA he has been running Burrows Lea and has completed all the necessary qualification required. Comments about the running of the Care Homes for Older People Page 22 of 26 Evidence: home included, I enjoy working here. Also, He is good to talk to. One person who lives at the home spoken to about the way then home is run said, He is good to talk to. We checked records of health and safety and confirm regular tests are carried out to emergency lighting, fire procedures, gas appliances and electrical equipment, ensuring the safety of people living at the home is maintained. One staff member said, B.. (The Owner)is a stickler for health and safety. We looked at financial records and found good systems in place for people to control their own money where possible and ensure safeguards are in place for their protection. Records of finances for people who live at the home were accurate and up to date. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Older People Page 25 of 26 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. 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