Burnham

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

People were involved in their assessments and care planning processes. Before people moved into the service their needs were assessed. Care plans were in place which detailed people’s care and support needs but these required reviewing and updating to include people’s changing needs. The provider had systems and processes in place to meet people’s nutrition and hydration needs. The service worked with GP’s and health professionals to meet people’s health needs. The provider had a clear process in place to escalate health concerns. Staff had a good understanding of meeting people’s changing needs.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were involved with their assessments and setting goals. A person told us they were saving money to go on a holiday in 2025. A relative told us, “We always got contacted by [previous registered manager] when she was updating the care plan and we discussed changes.”

People had face to face assessments once they had been referred to the service. No one new had moved into the service for many years. Care plans were created, using the information gained at the assessment together with referral documents from the hospital or local authority. Care plans were further developed once the person moved into the service. Staff told us they had access to the assessments and care plans on their hand-held devices and could read these at any time. Changes to people’s care needs were passed on at handover meetings and documented in handover notes. A staff member said, “We have handovers between shifts.”

Some people had risks and needs that had not been fully assessed as detailed in the safe key question. However, most people’s basic needs were assessed and documented, such as their personal care, continence, eating and drinking and communication. The provider used recognised tools for assessing some risks, such as nutrition and skin integrity. A person with a percutaneous endoscopic gastrostomy (PEG), which is a surgically fitted feeding tube, had their medicines and food through their tube following specific guidance provided by a specialist team. There was clear guidance and instructions for staff. The processes in place for updating care plans and risk assessments was not robust and people’s care plans and risk assessments had not always been reviewed and amended when their needs changed. The management team knew about this and were arranging for these to be reviewed.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

People were supported with their healthcare. We observed staff making contact with the GP practice in relation to a person's health during the assessment.

Staff had a good understanding of meeting people’s changing needs. Staff members told us, “A chiropodist/podiatrist comes” and “If there was an issue with the catheter such as not draining, firstly I would reposition the bag and check the pipe was not kinked and if did not work I would call the district nurses. I would call the referral line and they would triage and call back.”

People living at the service had access to health care professionals, for example, the GP, community mental health team, home enteral feeding team, chiropody, physiotherapist, dietician, dentists and SALT (Speech and language therapists). People had received vaccines. Visiting was encouraged and people were supported to attend medical appointments.

People received support from staff when health clinicians assessed their health needs. A healthcare professional said that staff supported people during assessments. They said, “Staff member always present when pt (patient) being reviewed” and “Service follow instructions well and will ask and follow up if haven't heard from surgery.”

Some staff told us they had not had all the training and support to meet people’s health needs. Those not trained did not undertake tasks relating to the health need; for example, supporting a person with their PEG and supporting a person with emergency epilepsy medicine. The management team told us they planned for staff to have this training to ensure all staff could meet people’s needs effectively.

There were assessments in place to detail how to support people within their home and their community to achieve their goals and aspirations. These assessments included details of how to communicate effectively. However, some had not been reviewed as people’s needs had changed. The management team were aware of this and were in the process of updating these. There was no evidence of any harm to people as staff knew people well and new staff and agency spent time shadowing experienced staff.

People's choice and consent was valued, and the staff continually consulted people about their wellbeing and wishes. A person said, “I make choices every day. I get my clothes out ready for the next day.” We observed people making choices about their day, those that were unable to communicate verbally were given time to communicate in their own way and staff respected their decisions.

Staff were aware of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). All people living at the service had capacity to make their own choices and decisions. A staff member said, “[Person] has the right to make decisions including unwise ones, she is head strong and very spirited, which I love about her.” The management team told us 2 people had DoLS authorisations in place.

We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty. The service worked within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. When people were assessed as lacking capacity to make decisions appropriate procedures were followed to ensure principles within the MCA were followed. DoLS applications and authorisations were in place for people around any restrictions within their lives that they did not have capacity to consent to. Systems to review these were also in place. People's ability to consent to care and support had been assessed.