Archived: Burton Cottages

This service was previously inspected on 24 September 2014 where we found it to be compliant with all areas inspected.

The service had a registered manager in post. 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.

Staff had good knowledge of safeguarding adults and knew what actions to take if they suspected abuse was taking place. The provider had ensured that appropriate employment checks had taken place to ensure that staff were safe to work with people at the home. There were sufficient numbers of staff to keep people safe. The provider gave staff appropriate training to meet the needs of people. Staff received supervisions and appraisals from the registered manager.

Medicines were stored securely and safely administered by staff who had received appropriate training to do so. Stock counts of medicine that was to be taken as needed did not match what had been recorded. However, people’s medicine records did reflect when these medicines were taken. We have made a recommendation about this in our report.

The principles of the Mental Capacity Act 2005 (MCA) were applied. People were being assessed

appropriately and best interests meetings took place to identify least restrictive methods. Staff had received training on MCA and had good knowledge. The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005.

People's needs had been assessed and detailed care plans developed. Care plans contained risk

assessments for daily living needs that were personalised for the people staff supported. People were given options on what they would like to eat and those that required support to eat were supported.

People were being referred to health professionals when needed. People’s records showed that appropriate referrals were being made to GP’s, speech and language therapists, dentists and chiropodists.

Relatives spoke positively about staff. Staff communicated with people in ways that were understood when providing support. People’s private information was stored securely and discussions about people’s personal needs took place in a private area where it could not be overheard. People were free to choose how they lived their lives. People could choose what activities they took part in and would decorate their bedrooms according to their own tastes.

The provider had ensured that there were effective processes in place to fully investigate any complaints. Records showed that outcomes of the investigations were communicated to relevant people. People and their relatives were encouraged to give feedback through resident meetings and yearly surveys. The provider had ensured that there were quality-monitoring systems in place to identify shortfalls and the registered manager acted on these appropriately.

Relatives and staff spoke positively about the registered manager. The registered manager had an open door policy that was used by staff. The registered manager was approachable and supportive and took an active role in the day-to-day running of the service. Staff were able to discuss concerns with the registered manager at any time and had confidence appropriate action would be taken. The registered manager was open, transparent and responded positively to any concerns or suggestions made about the service. The registered manager was informing the CQC of all notifiable events detailed in the regulations.

Our inspection team was made up of two inspectors. We answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People lived in an environment that was well maintained and free from hazards. There were systems in place in the event of a fire which were checked regularly. There were up to date risk assessments in place for each person that lived there which meant that staff were aware of risks and how to minimise them. We found that staffing levels were sufficient to keep people safe and provide them with the support they needed.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Proper policies and procedures were in place at the service and relevant staff understood when an application should be made, and how to submit one. We spoke with the operations manager about one person who used the service where guidance had not been sought from the DoLS team. We were told that this would happen and it was due to be discussed at the person's review. The provider has since confirmed that this person has been appropriately referred to the DoLS team.

Is the service effective?

It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. Staff had received training to meet the needs of the people receiving care. Staff told us that they felt well supported and liked working at Burton Cottages .

Is the service caring?

People were supported by committed and caring staff. We observed that people appeared comfortable in the home and familiar with the staff that worked there. We saw that staff members spoke directly with people and supported them at an appropriate pace.

Is the service responsive?

People's needs were continually assessed. Records confirmed people's preferences, interests, goals and diverse needs had been recorded and support had been provided in accordance with people's identified needs. People's needs were regularly reviewed by keyworkers to make sure that changes in needs were identified and action taken. Senior staff told us that they had the flexibility to increase staffing levels if people required additional support. This meant that staff ratios were responsive to people's individual needs.

Is the service well-led?

Staff had a good understanding of their roles in the service and said that they were supported by management. There were quality assurance processes in place to maintain standards in the service. We saw that staff and people who used the service, or their representatives were given opportunities to express their views.

We examined three care plans and observed care during our inspection. Care plans were comprehensive, person-centred and up to date and care we observed was respectful, enabling and supportive.

The provider responded appropriately to any allegation of abuse and all staff had received training in safeguarding vulnerable people.

We examined the home's policy, practice and records in relation to medication. We found that staff were appropriately trained, medication was stored appropriately and administered correctly. We saw that record keeping in relation to medication was accurate and up to date.

We spoke with staff and examined staff files. We found that people were cared for staff who were supported by the home to provide safe care and given opportunities to improve their professional standing through relevant training.

The home had quality assurance systems to assess their performance and ensure improving standards. This included analysis of incidents, reviewing risk assessment and canvassing the views of relatives and visiting professionals.

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service. This was confirmed by our observations and the record keeping.

Care records showed that people had been supported and involved to make decisions about their lives, including their care and support. When people's needs changed, we found that records had been updated to reflect this. We found that care records showed that staff worked individually and collectively with people to ensure that they had opportunities to activities and facilities locally.

Staff spoken with demonstrated good understanding of how to safeguard people from harm. Training records showed that staff received regular training to update their knowledge on a wide range of subjects including safeguarding, autism and first aid.

Records showed the provider regularly assessed and monitored the quality of the service.