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Burlingham House Requires improvement

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Inspection report

Date of Inspection: 12 August 2014
Date of Publication: 11 September 2014
Inspection Report published 11 September 2014 PDF | 90.37 KB


Inspection carried out on 12 August 2014

During an inspection in response to concerns

Prior to our inspection the Care Quality Commission (CQC) had received concerns about the care provided at Burlingham House. In particular there were concerns about how the home managed people who suffer falls. There were also concerns raised about how the home manages it cleanliness and protects its residents from infections such as diarrhoea and vomiting.

The person named in the report as registered manager is no longer correct. The provider is in the process of formalising the acting manager's position as registered manager.

The purpose of this inspection was to check that people who used the service were provided with safe and effective care that met their needs. We spoke with the manager and staff members who told us about recent improvements made in the service to meet people’s needs and expectations.

We conducted this inspection to establish the following about Burlingham House:

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive and

• Is the service well-led?

An adult social care inspector carried out this this inspection on 12 August 2014.

As part of this inspection we spoke with four people living at the home, two friends of people living in the home, the manager, three members of care staff, laundry staff and cleaning staff. We reviewed records relating to the management of the home which included four care plans. We also looked at staff training files.

This is a summary of our findings. If you would like to see the evidence supporting this summary please read the full report.

Is the service safe?

People were able to indicate to us that they felt safe living at Burlingham House. We saw that the provider had satisfactory recruitment procedures in place. This ensured that only suitable people were employed to work with vulnerable adults.

The manager was able to tell us how they protected vulnerable adults. They told us how they responded to and reported safeguarding incidents to the relevant authorities. Staff we spoke with demonstrated knowledge of safeguarding adults and how to respond to and report safeguarding issues. We saw how staff kept people free from harm whilst observing them using hoists and wheelchairs. We saw how staff re-assured the person at all times.

There was a system of assessing risks designed to keep people living in the home, and staff, safe from harm. Risk assessments were appropriate to people’s current and changing needs.

There were recently implemented systems in place to reduce the risk and spread of infection. An audit to check cleanliness was being prepared at the time of the inspection to meet the Department of Health's code of practice on the prevention and control of infections.

The provider had an effective system of recording person centred information. This meant that staff relayed important information to other staff relevant to the person's care. People were provided with their medication when they needed it.

Staff were supported with training which enabled them to do their job effectively and safely.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to people living in care services. At the time of the inspection fourteen people required these safeguards. Applications had been made to the appropriate authorities however the provider had been told of a long delay in processing the submissions. Proper policies and procedures were in place so that people who could not make decisions for themselves were protected. Relevant staff had been trained to understand when DoLS should be implemented.

Staff understood their roles and responsibilities in making sure people were protected from the risk of abuse. The provider ensured that all staff were kept up to date with safeguarding training and accompanying reporting procedures. The premises were well maintained and met the needs of people living in the home.

We noted that the provider had emergency and contingency plans in place to secure and maintain the safety of people using the services and staff.

Is the service caring?

We observed that people received helpful, consistent and respectful support from care staff. One person told us, “It’s okay here, but I hope to be going home soon.” Care and support plans were up to date and reflected the support needs of people living at the home. People we spoke with understood their care plan and met regularly with their key worker to discuss daily living events and any concerns they may have. Visitors told us how impressed they were with the welcome they received each time they visited.

Is the service responsive?

People's care and social needs were assessed and reviewed on a monthly basis or as and when needed. Where changes to people's needs occurred, the service referred to other health and social care professionals for advice and guidance if required. All such changes were documented and recorded. We noted however that there were some lengthy delays in getting requested services through from the local GP practice. These delays were outside the control of the provider.

An activities programme was in place to ensure daily activities were made available for those wishing to take part. For example reminiscence, quizzes and bingo took place. At the time of the inspection chair exercises were taking place in one lounge and dominoes in another. No one was pressured to take part in activities if they did not want to. There were quiet lounges available for people who did not wish to take part in activities. There was also a large conservatory available to people living in the home.

Is the service effective?

People using the service that we spoke with said, or indicated to us, that the care and support provided was satisfactory. The majority of people we spoke with did accept that the care provided was in their best interests. From our observations we saw that care and support was effective and consistent. People were supported to be as independent as possible.

We saw that people’s care needs were assessed by staff prior to and on their admission to the home. We saw people's care needs were monitored through a review system. A recent review of care records had resulted in changes relating to how reviews were recorded. This helped the home to meet people's expectations and needs.

One person living in the home told us that the food was, ‘…much of a much-ness…’ Another said, “I eat everything I can.” When asked if they got enough to eat they replied, “Oh yes, always enough and if I ask for more I always get it or something else I might take a fancy to.”

Is the service well led?

The views of people using the service and, where possible, their families were sought. Staff told us that they felt supported and had received sufficient training to carry out their role effectively. Staff training records reflected this. Staff added that if they felt they needed further or additional training or support that they were confident this would be arranged by the provider. This told us that the provider took reasonable steps to keep the staff updated and trained to a high professional standard.

Quality monitoring systems were in place and a programme of audits was scheduled to ensure that people received a good service.

People’s personal care records, and other records kept in the home, were kept safe and filed appropriately and securely.

Staff were clear about their roles and responsibilities. They spoke of how they worked as a team with the needs of the person central to the work they did.