Burlington Hall Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment, and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question good. At this inspection, the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The registered manager and management team fully understood the importance of discussing people’s needs with them when they started using the service. Assessments focused primarily on people’s preferences and specific ways in which they wanted to be supported. People and their loved ones were put at the centre of the assessment process and encouraged to share their preferred ways of being supported in all aspects of their care. This also included discussions about their cultural and individual needs related to the way they chose to live their life. As a result of the incredibly thorough and detailed assessment process, people had the best possible start, when moving into the service. They experienced a smooth transition to the service and received care that reflected their individual needs and preferences from day one.

Many people and relatives told us they felt nervous when they or their family member were looking for a service. However, the assessment process at Burlington Hall immediately put them at ease. One person said, ‘‘When I first moved in, I was really worried as I like to do things my own way. I had loads of meetings with [registered manager] and we discussed in detail how staff were to help me with my support. It was important to me that staff knew who I was and still am now I live here. I was so happy when staff started supporting me and already knew [facts about me].’’ A relative told us, ‘‘[Family member] suddenly became unwell and needed care quickly. We were so scared about finding the right place for them. [Registered manager] visited us multiple times and was so supportive and positive about how they would meet [family member’s] needs. We discussed every detail and the staff literally know them as well as we do thanks to the information we discussed. I feel so good about them living here. The assessment process was so reassuring.’’

Staff knew people very well as individuals and knew how they presented when they felt well. This enabled them to pick up on any signs that a person’s needs may need reassessing. Staff gave us detailed explanations and examples about what may indicate people’s support needed to be reassessed or changed. They immediately alerted the management team to any changing needs and support for people to keep them safe. We saw evidence how one person’s changing needs had been acted on immediately by the staff team. This enabled the person to maintain their independence as equipment was sourced to support them to do this. We observed how happy the person was to be able to maintain their independence and regain their skills as a result. One family member said, ‘‘From the moment [family member] arrived, the staff worked diligently to build trust, facilitating a seamless transition into a more robust care framework. The daily care team are outstanding; they knew their personal preferences perfectly such as precisely timed morning cooked breakfast and greeted them by name with genuine warmth. It was beautiful to witness the distinct bonds they formed, sharing quiet, comforting moments with some carers and mischievous laughter with others.’’ A professional told us, ‘‘I visit the service often to discuss positive ways we can support people and work together when their needs change. The staff team keep me very busy, and it is a joy to see how quickly changes are noticed meaning we can help people as soon as possible.’’

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The management team stayed up to date with best practice in relation to supporting people. For example, they organised training for staff specifically based around supporting people living with dementia or health related conditions. They updated people’s care plans where necessary and took feedback from visiting professionals seriously to promote best practice. Staff were knowledgeable about people’s individual needs as best practice was discussed with them regularly in 1 to 1 discussions and meetings. One relative told us, ‘‘The staff and management team are exceptional and know everything there is to know about looking after [family member].’’

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Staff were very knowledgeable about what signs may indicate people needed support from another service. People saw professionals in a timely manner, as soon as the need for support was identified. This enabled them to maintain their independence as be supported in their preferred ways with extra help from professionals where needed. As a result, people had access to support such as equipment or medicines to keep them in good health almost immediately. This supported them to maintain and continue to be supported in their preferred ways. For example, staff notices one person had not been sleeping well since the start of being supported with a new medicine. They immediately contacted the relevant health professional to start addressing this. The person was supported to try another medicine and this dramatically improved their sleep and their wellbeing.

Without exception, professionals we spoke with told us they had an excellent working relationship with the management and staff team. They told us information was shared with them about how best to enable people to discuss the support they needed. They told us staff advocated for people when needed and were extremely knowledgeable of their individual needs. This enabled effective partnership working, ensuring people were supported well. One professional said, ‘‘I find the service to be extremelywell run with good organisation and a committed and hardworking team lead by an excellent registered manager.They respond to people’s needs well and communicate with our clinical team in a timely manner and carry out the treatment plans asinstructed. We know people are getting the best care they can have.’’ Another professional told us, ‘‘The staff that support me when I phone or visit the service are professional and caring. They are very much the advocates for people and family members. They are conscientious and when I ask for information they provide it. They like for me to confirm any changes to medication, for example, by email. They are good at noting when reviews of people’s needs are needed.They are very caring in their approach to people and family. I feel they go the extra mile for people.’’

The staff team gave consistently positive feedback about working together as a team. They told us they had complete trust in one another and could rely on each other for support to help make sure people had the best experiences they could. We observed staff speaking with one another and it was clear they had taken the time to share information about how best to support people. This resulted in extremely consistent care for people. Staff also told us they had great working relationships with the registered manager and management team. They told us they could ask for any support they needed, and as the management team knew people exceptionally well, they understood the reasons for these requests.

People and their relatives told us the huge positive impact these working relationships had for them. One person said, ‘‘Every staff member here know me like the back of their hand. I don’t have to worry about anything at all.’’ Another person told us, ‘‘The staff team are like one big family with us. They get us help when we need it and we can talk to them at any time. It’s so nice that we can all laugh together.’’ A relative told us, ‘‘Staff gave us updates which were communicated with absolute clarity. Whether managing [multiple health conditions] the transition between the home and external medical professionals was seamless for [family member].’’

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Supporting people to live healthy lives and maintain good health was a key value and aim for the management and staff team. They fully understood good health was fundamental to enabling people to live their lives to the fullest and have good outcomes from their support. Changes to people’s health no matter how small were taken extremely seriously and monitored very closely. For example, if people were prescribed a short-term course of medicines, specific plans were put in place for staff to monitor this and make sure they had the desired result for people. This meant immediate support could be sought if the medicines were not having the desired effect. One family member said, ‘‘[Family member] used to get unwell all the time. They weren’t eating and drinking enough. Now, they are in the best health they have been in for years. The staff make sure they stay healthy and as a result they are so much healthier and it has made us so happy and assured.’’

Staff were acutely aware of what support people needed to stay healthy. They were able to clearly explain to us what support people needed in areas such as eating and drinking or having regular exercise. Whilst people were supported with this it was done in a non-intrusive way fully enabling the person to be as independent as possible and make choices. For example, staff would encourage people to drink and eat at their own pace or would encourage exercise in ways that they knew the person enjoyed. One person chose to complete exercises in a certain way, and this was understood by the staff team. We observed how happy the person was to be supported with this. Staff supported people to always have their choice of food and drink with them at all times of the day. They subtly and conscientiously reminded people to eat and drink regularly whilst respecting their choices to do so. One person said, ‘‘I like to drink myself, but the staff remind me all the time especially if the weather is hot or if I forget. I don’t mind- I know how important it is.’’ A relative explained, ‘‘[Family member] does struggle with drinking or walking regularly. The staff have been amazing. They worked with [family member] and us to identify times when it was easier to help them drink or move around. Now they are so much healthier and happier.’’

The cook and catering team at the service understood the importance of offering food that looked appealing to people as this encouraged them to eat and drink enough to stay healthy. They also regularly discussed the food they cooked with people to ensure it met their likes and preferences. One person said, ‘‘The food is top quality here and we have an amazing amount of choice.’’ A relative told us, ‘‘The food is consistently outstanding—and hospitality was always extended to me during my visits. The roundtable dining format beautifully accommodated varying levels of need while fostering natural, everyday social interactions.’’

Crucially as a result of the excellent support people had to stay healthy and improve their health they had been supported to have brilliant outcomes in relation to their health. We discuss this in detail in the ‘monitoring and improving outcomes’ quality statement of this report.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Without exception, people had been supported to have amazing outcomes thanks to the support of the management and staff team. People who had struggled to eat and drink enough to stay healthy, had gained weight since living at the service. They had not needed to visit other services in relation to not drinking enough. One relative told us, ‘‘[Family member] was not eating where they were before. Now they eat more than they have done in ages. They have gained weight and look so happy and healthy as a result. They are themselves again!’’ A professional said, ‘‘It is a pleasure to come to [service] and monitor how people are getting on. We get referrals from the staff team, give them advice and before we know it people are healthy again. It is great to see and a credit to the management and staff team.’’

People had also been supported to improve their health in areas such as pressure area care. Not one person had developed any pressure related injury at the service. If people started using the service with concerns related to pressure area care, these had improved since being supported by the staff team. This meant people were having extremely positive outcomes in relation to this area of their support. One person said, ‘‘I had a hospital visit and couldn’t walk like I used to anymore. But I am back to where I used to be with it now. The staff have helped me.’’ A relative explained, ‘‘We thought [family member] would stay in bed when they started using the service and they had [pressure related concerns]. They are completely mobile again now and I am sure this was hard work for the staff team. We are incredibly grateful.’’

As well as health related outcomes people had also had hugely positive outcomes in relation to their mental health and wellbeing. One relative explained, ‘‘At previous placements [family member] was unhappy and showed this by damaging the environment. Staff just did not know how to help them. But here it is a completely different story. The staff have worked to help [family member] feel completely in control of how they spend their time and where they go. They trust the staff implicitly and are so much happier now.’’ Another relative told us, ‘‘[Family member] was very low before they lived at the service. They are a completely different person now and it is incredible what the staff team have supported them to achieve. They are happy, content and smiling all the time.’’

The registered manager took time to share multiple pieces of evidence with us during the inspection of the difference staff members care and support had made to people. The outcomes people had as a result were fantastic. For example, people had been supported to improve their health, access community events that interested them or develop friendships. We discuss this further in the ‘equity in experiences and outcomes’ quality statement of this report.

The provider told people about their rights around consent and respected these when delivering support. People were supported in line with the MCA. Where people did not have capacity to consent to their support, assessments were completed and decisions were made in their best interest, with involvement from those who knew them well. Staff understood the principles of the MCA and knew the importance of asking people for consent. A relative told us, ‘‘[Staff] are extremely respectful and know [family member] has their own mind. They make choices based on what [family member] would like.’’