Archived: James Burns House - Care Home Physical Disabilities

James Burns House is a residential care home that was providing personal care to 19 adults with physical disabilities at the time of our inspection.

People’s experience of using this service:

People told us they felt safe and there were enough staff to meet their needs. Staff understood their role in recognising and reporting any safeguarding concerns or poor practice. People were involved in how their risks were managed. Actions taken to minimise avoidable harm were the least restrictive respecting people’s freedoms and choices.

People had their medicines administered by trained staff who understood the actions needed should an error occur. Infection control processes were in place which protected people from avoidable infections. People had access to healthcare both for planned and emergency events.

Staff had received an induction and had on-going support and training that enabled them to carry out their roles effectively. Care plans were person centred, clear to follow, reviewed regularly and reflected people’s needs and diversity. People had communication plans that were effective in enabling them to be involved in choices and decisions about their care. People’s eating and drinking needs were understood and met. Meals were well balanced and provided people with hot and cold options at each mealtime.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People described the staff as caring. Relationships between people and the staff team were friendly, kind and caring. People described how staff had been emotionally supportive and helped them overcome anxiety and regain confidence.

Staff spoke positively about their roles in supporting people, teamwork and communication. People, families and the staff team had opportunities to share views and feedback through meetings and quality assurance processes. A complaints process was in place that people felt able to use and records showed us concerns were investigated in line with the complaints policy. The leadership promoted an open culture and when things went wrong they were honest and transparent.

Rating at the last inspection:

At our last inspection we rated the home Good (published 10/11/2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported by staff that had completed training and understood what types of abuse people could be at risk from, what signs to look for and the actions they needed to take if they suspected abuse. Relevant checks had been carried out on staff to check they were suitable to work with vulnerable people. There was enough staff with the appropriate training and skills to effectively meet the needs of people living at James Burn House. Staff were supported with regular supervision and an annual appraisal which provided opportunities to discuss their professional development.

People were involved in decisions about how risks they lived with were managed. Risk assessments were regularly reviewed.Actions taken to minimise risk were put in place whilst supporting people to remain independent and have their freedoms and choices respected. Accidents and incidents were investigated and where appropriate led to referrals to other professionals and changes to people’s care and support plans. Personal evacuation plans were in place that provided an overview of people should they need to leave the building in an emergency.

People had their medicine stored and administered safely by staff that had received training and had their medicine administration competencies checked annually. When people administered their own medicines a risk assessment had been completed and was regularly reviewed. People had access to healthcare in a timely way and when they needed supported with appointments.

We found the service was working within the principles of the Mental Capacity Act. People were supported by staff to make choices about their day to day care. Deprivation of liberty safeguards had been applied for when people had been assessed as not having the mental capacity to consent to their care. When decisions had been made in peoples best interests they had included staff, families and other professionals and any decisions had been the least restrictive to the person.

People were supported by staff who understood their eating and drinking requirements. Menus provided choices and alternatives were available at any time.

Staff interacted with people in a relaxed and friendly way and knew how to communicate with people in ways that were individual to them. People were involved in decisions about their care and had their views listened too. Advocacy information was available and staff encouraged people to access it when appropriate. People had their privacy, dignity, independence and individuality respected by staff. A complaints procedure was in place that people felt able to use and that they would be listened to and any necessary actions would be taken.

People had care and support plans that provided clear information about how people wanted to be supported and were reviewed with people at least six monthly. Reviews included setting goals with people of things they would like to achieve. People were able to get involved in a range of activities linked to their interests both in the home and the community.

Staff were positive about the service and felt it was well led, communication was effective and they felt empowered to share ideas and views. Systems were in place to monitor service quality which included audits and an annual quality assurance survey. We saw that when improvements had been identified appropriate actions had been taken. .

We found that people's needs were assessed and a plan of care drawn up to meet these needs. Plans contained sufficient information to ensure people were supported in accordance with their personal preferences. When people were at risk of harm, measures had been taken to minimise this risk.

People were able to choose how they spent their time and could participate in a range of activities. We saw that the home had volunteers who helped to coordinate these activities.

People were support to eat and drink sufficient amounts to meet their needs and had a choice of what to eat and drink and where to take their meals.

Appropriate infection control procedures were in place. These included training on hand hygiene, checks on practice and routine monitoring of the cleanliness of the home.

People were supported by staff that been recruited in a safe manner and when possible involved in this process.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

The purpose of this inspection was to check whether action had been taken about the unpleasant odours in the home. We also checked whether there were PRN (as needed) medication plans in place for people.

We completed a tour of the home and talked with people during the inspection visit. However, we did not specifically speak to people about living at James Burns House.

We spoke with the deputy manager and three staff, reviewed medication plans and management systems. We checked communal areas, toilets, bathrooms and bedrooms for cleanliness.

We found the home was free from unpleasant odours and there was a regular schedule of carpet cleaning.

PRN (as needed) medication plans were in place and regular medication audits were taking place.