Background to this inspection
Updated
19 June 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 17 March 2015 and was unannounced. It was carried out by two adult social care inspectors.
The provider had not completed a provider information return as we had not requested one. This document enables the provider to give key information about the service, what the service does well and improvements they plan to make. We spoke with the registered manager about the improvements they had made since the last inspection. We looked at information held about the service before the inspection date. At our last inspection of the service in March 2014 we did not identify any concerns with the care provided to people. However we received concerns regarding staff shortages before the latest inspection took place.
At the time of the inspection there were 33 people living in the home. We spoke with eight people, three visitors, seven members of staff and two visiting health care professionals.
We also looked at records which related to people’s individual care and the running of the home. Records included six care and support plans, four staff recruitment files, quality assurance records and medication records.
Updated
19 June 2015
This inspection was unannounced and took place on 17 March 2015.
The Burnham Nursing and Residential Centre is registered to provide personal and nursing care for up to 54 people. The home specialises in the care of older people.
There is 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.
Throughout the inspection there was a relaxed and cheerful atmosphere; staff and people living in the home were happy and at ease when they spoke with us. We observed friendly but professional banter with staff discussing the St Patrick’s day celebrations and topics of interest with people. One person said, “It’s always a happy place, I like all the green hats, we are going to see some Irish dancing later.” We were told one of the care workers had entertained people with Irish dancing. One person said, “Gone are the days I could have got up and danced. It was good to watch though.”
Prior to this inspection we received concerns that care was not being carried out properly due to a shortage of staff. The registered manager confirmed they had been short of staff but a recruitment program had solved the problem and they had a full team who worked well together. One staff member confirmed that the home had been short of staff but that staff morale had improved and they had enough staff to meet people’s needs. One visitor said, “There has been a vast improvement, plenty of staff and they are willing to chat and take time with you.”
Records showed there were adequate staffing levels on each shift. The manager confirmed staffing levels could be flexible to meet the care needs of people and to support other staff with activities such as parties and trips out. We observed staff took the time to chat and socialise with people and call bells were answered promptly.
The manager’s vision for the home was to ensure people received person centred care, and were at the centre of everything. Staff demonstrated their awareness of the manager’s vision and could tell us how they helped people to maintain choice and provide support in a dignified and respectful manner. One staff, member said, “It’s good that the manager wants to help people make their own decisions. Nobody likes to lose control.”
Staff had received training in identifying and reporting abuse. Staff were able to explain to us the signs of abuse and how they would report any concerns they had. They stated they were confident any concerns brought to the manager would be dealt with appropriately. There was a robust recruitment procedure in place which minimised the risks of abuse to people. People told us they felt safe in the home and they all knew who to talk to if they wanted to raise a concern or complaint.
People’s health care needs were fully assessed and care and support was provided on an individual basis. One staff member told us, “Communication is good and the records give us very clear guidance on people’s likes and dislikes.” This meant people’s individual changing needs were considered and catered for in consultation with them or a family member if necessary. Care plans and care practices were monitored to ensure people’s preferences were being followed and improvements were made when needed.
People saw healthcare professionals such as the GP, district nurse, chiropodist and dentist. Staff supported people to attend appointments with specialist healthcare professionals in hospitals and clinics. Staff made sure when there were changes to people’s physical well- being, such as changes in weight or mobility, effective measures were put in place to address any issues. One visiting healthcare professional said the registered nurses were very good at recognising the specific needs people had and referring them to specialist teams.
Everybody spoken with told us they enjoyed the food, they all said the food was good. People were offered choices and the food was nutritious and well presented. People who needed assistance with eating were supported in a dignified and unhurried manner. Some people chose to eat in their room.
There were systems in place to monitor the care provided and people’s experiences. An external audit was carried out by the manager of another home in the organisation as well as the regular audits carried out by the registered manager. Action plans were then put in place to address any issues found. A regular survey was carried out asking people and their relatives about the service provided by the home. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.