Archived: Burwood House

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

During this inspection we spoke with eight people using the service and with two visitors. We spoke with two care staff, the cook and the registered manager. We viewed records which included, two care plans and daily care records, staffing rotas, menus and records of meals served, maintenance records and quality assurance information. We also spoke with the local authority.

We considered the evidence we had gathered under the outcomes. This is a summary of what we found:

Is the service safe?

People were happy with the staff team and said there were always enough staff. Comments included, "The staff are lovely; they are very nice", "I need a lot of attention during the night but I press my buzzer when I need help and they always come" and, "The girls are very kind; they deserve a good report". During our visit we observed staff were attentive to people's needs. We found the home had sufficient experienced care and ancillary staff to meet people's current needs.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We were told no applications had needed to be submitted. Training around the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) had been provided for staff.

We found all areas of the home, that we looked at, to be safe and comfortable but there were some areas in need of attention. The manager agreed to improve the systems used to ensure any shortfalls were recognised and acted on.

Is the service effective?

Regular reviews were carried out to respond to any changes in people's needs and to ensure the level of care was appropriate. However, updated information was not always recorded clearly in the care plan. This meant staff may not be clear about people's changing needs.

We found the service had good links with health care professionals to make sure people received prompt, co-ordinated and effective care.

There were varied comments about the food. Comments included, "The food is very nice", "If the meals aren't up to scratch, we tell them and they sort it out" and "The food is very good; very tasty". Records showed there was a choice of food and drinks available. People's views about the meals were regularly sought and any concerns had been acted upon. The cooks, and a number of other staff, had received 'Food Hygiene' training and formal nutritional training. This should help staff ensure people's nutritional needs were met.

Is the service caring?

People told us they were happy with the care and support they received. Comments included, "It's a nice place; staff know what I like", "I can choose what I want to do", "I am happy with the care I get" and "Staff are very good to me; they let me go at my own pace. I do the things I can for myself and staff help me if needed'.

We observed staff interacting with people in a pleasant and friendly manner and being respectful of people's choices and opinions.

Is the service responsive?

The care plans contained information about people's preferred routines, likes and dislikes which would help staff to look after them properly and help ensure people received the care and support they needed and wanted.

People's health and well-being was considered and appropriate advice and support had been sought in response to changes in their condition. However, action to be taken by staff to reduce risks were not always clearly recorded. This meant the risks to people's health may not be recognised in a timely way.

There were opportunities for involvement in different activities and people were involved in discussions and decisions about the activities they would prefer.

People told us they had no complaints about the service but were confident they could raise their concerns with the staff or managers. Comments included, 'I know they would sort things out if I told them anything' and, 'They ask us if there is anything we are unhappy with and they listen to us'. There had been no complaints made about this service since our last visit. However, we found clearer records needed to be maintained of people's concerns to ensure they were followed up. We saw messages of appreciation for the care and support that people had received.

Is the service well-led?

A manager was responsible for the day to day management of the service. The manager was registered with the Care Quality Commission (CQC) and was supported by the owner of the organisation.

There were systems in place to regularly assess and monitor how the home was managed and to monitor the quality of the service. People indicated they were satisfied with the care and services they experienced at the home and were encouraged to express their views and opinions of the service. People told us they were kept up to date and involved with any decisions about how the service was run.

Staff were aware of the procedures for reporting any concerns about poor practice. There was evidence the service had used previous information of concern to improve the service.

We saw that the home was properly maintained and a programme for further redecoration and refurbishment was available.

We noted that arrangements were in place to ensure that all members of staff received the training they needed in order to provide safe and effective care for people using the service.

We saw that systems were in place to monitor the quality of the service provided. There was evidence to demonstrate that people were regularly consulted about the care and facilities provided at the home.

We found that suitable arrangements were in place for the safe keeping and handling of medicines.

We saw that in all the bedrooms the skirting boards and window sills were dusty and dirty. Several bedrooms were in need of redecoration and the carpets in some areas were badly worn. Access to the ground floor fire exit was blocked with a variety of items preventing people from using this escape route in the event of a fire.

We noted that management support for members of staff had improved and annual appraisals had taken place. However, members of staff were not up to date with all the required training including fire prevention.

Although we found that some improvements had been made to the system for monitoring the quality of the service provided this did not include the standard of cleanliness and the safety of the premises.

We saw that care planning had improved and care plans identified and addressed the care needs of each person using the service.

We found some unsafe practices in the management of medication which could put people using the service at risk.

Members of staff were not being adequately supported by management through an organised system of appraisal and supervision.

An effective system for assessing and monitoring the quality of the service provided at the home had not been developed in order to ensure that people received safe and appropriate care.

We saw that people's care records did not accurately identify and address their individual care needs.